Occupational upper limb injuries and their outcomes in a Port Elizabeth private hospital:Retrospective study

Abstract

Background: Occupational injuries are a common occurrence both in developed and developing countries. Developed countries have managed to reduce these injuries due to improvements in their structure and the implementation of prevention strategies. There are no studies done on the outcomes for the occupational injuries of the upper limb as a whole. A review of the literature shows only the outcomes of occupational injuries of the hand. Aim: The aim of the study was to determine the epidemiology of occupational injuries of the upper limb and their outcome in a private hospital in Port Elizabeth for the period of 01 April 2013 to 31 December 2020. Methods: A retrospective study was conducted at a private hospital in Port Elizabeth, South Africa, for a period of seven and a half years starting from 01 April 2013 to 31 December 2020. A total of 334 patients over the age of 18 years were included after their consent was obtained. The data relevant to this study were collected from their files. Results: The age distribution of participants in this study was 18 ‒ 30 years old (28%), 31 ‒ 40 years old (25%), 41 ‒ 50 years old (27%), and older than 50 years old (20%). Eighty percent were males versus twenty percent females. Right-hand dominants were 95.8%, left-hand dominants were 3.6%, and ambidextrous were only 0.6%. The majority of injuries occurred to manual labour workers; however, all groups were involved in these occupational injuries. About 35% of injured workers came from the manufacturing industry and 32% from the service-oriented sector. The workers had presented with different types of injuries including fractures (43.1%), tendon injuries (13.5%), amputations (10.8%), dislocations and rotator cuff tears less than 10 % and other miscellaneous injuries were (18.3%), respectively. These injuries occurred due to fall (34.4%) and crush (34.1%). Crush-type injuries were seen more in male workers from the manufacturing industry and falls were the most common cause for these injuries in females from the service-oriented sector. About 80% of workers continued viii with the same job under the same employer, 9% of workers lost their jobs, and 8% of workers continued under the same employer after they were accommodated with an alternative job. Surprisingly, fractures were common findings in 41 – 50-year old workers while amputations mostly occurred in 18 – 30-year old workers. Rotator cuff tears were more prevalent in workers above 50 years of age. Overall, these injuries were common during the weekdays and occurred less frequently over the weekend. The longest average return to work time was required for rotator cuff tears. With regard to the time of day for injury occurrence, two peaks were noted in this study. The first peak was observed around 3 PM and the second peak was noticed in the morning at 10 AM. Conclusion: Most of the workers were younger than 50 years old and predominantly right hand dominant. Just over 50% of workers belonged to skilled trade occupations and process, plant and machine operators. More than-two thirds of injuries took place in the manufacturing and service-oriented industries. The workers sustained different types of injuries, with fractures being the most common finding while the rotator cuff injuries were the least common with two peaks for these injuries at 10:00 and 15:00 hours. Falls and crushes were the two most common causes of injuries. Almost 90% of workers went back to the same company they were with when they sustained the injury, 80% of whom resumed pre-injury jobs and 8% were given accommodated jobs. A multidisciplinary team approach is required to treat these injuries for better outcomes. A larger multi-centre prospective study is recommended for more accurate outcomes. Occupational health and safety measures must be implemented in the workplace to limit these injuries.