# 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.

## Key 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.