Occupational Upper-Limb Injuries: A Retrospective Review of Outcomes at a Private Hospital in Gqeberha (Formerly Port Elizabeth), South Africa

TL;DR

This study examines upper-limb injuries among workers in South Africa, finding that young males in manufacturing and service sectors are most affected, with fractures and tendon injuries being common.

Contribution

The study provides new insights into occupational upper-limb injury patterns and outcomes in a low- to middle-income South African context.

Findings

Young male workers in manufacturing and service sectors were most affected by upper-limb injuries.

Fractures were the most common injury type, followed by tendon injuries and amputations.

Return-to-work rates were high, but job loss occurred in 9% of cases, emphasizing the need for workplace safety improvements.

Abstract

Background

Occupational upper-limb injuries represent a significant burden on healthcare systems and workforce productivity globally. While developed nations have implemented comprehensive workplace safety measures, data from low- and middle-income countries, particularly South Africa, remain limited. This study addresses this knowledge gap by examining injury patterns and outcomes in a major industrial region.

Objective

To describe the epidemiology, injury mechanisms, and return-to-work outcomes of occupational upper-limb injuries managed at a private hospital in Gqeberha (formerly Port Elizabeth) in the Eastern Cape province, South Africa, between April 1, 2013, and December 31, 2020.

Methods

A retrospective review was conducted of 334 consenting patients aged ≥18 years with occupational upper-limb injuries treated by the principal author. Data collection included demographics, industry sector, injury mechanism and type, and return-to-work outcomes. Statistical analysis employed descriptive statistics and Fisher’s exact test for categorical associations, with significance set at p < 0.05.

Results

The cohort was predominantly male (267 patients, 79.9%) and right-hand dominant (320 patients, 95.8%), with 266 patients (79.6%) under 50 years of age. Manufacturing (117 patients, 35%) and service-sector workers (107 patients, 32%) were most affected. Fractures were the most common injuries (144 patients, 43.1%), followed by tendon injuries (45 patients, 13.5%) and amputations (36 patients, 10.8%). Falls (115 patients, 34.4%) and crush injuries (114 patients, 34.1%) were the predominant mechanisms. Younger workers (18-30 years) had a significantly higher amputation rate, while workers over 50 years showed increased rates of rotator cuff tears and dislocations (p = 0.0025). Return-to-work outcomes were favorable, with 267 patients (80%) resuming original roles; however, 30 patients (9%) experienced job loss. Rotator cuff tears required the longest recovery period (mean 59.3 ± 28.7 days).

Conclusions

Occupational upper-limb injuries predominantly affected young male workers in manufacturing and service industries. The study identifies specific age-related injury patterns and temporal risk factors that can inform targeted prevention strategies. While return-to-work rates were encouraging, the socioeconomic impact of job loss emphasizes the need for comprehensive workplace safety interventions and injury-specific rehabilitation protocols.

Figures