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To study the epidemiology of occupational hand injuries and associated social and industrial factors. DESIGN. For this retrospective case series of patients with occupational hand injuries, case records were retrieved to gather data. In addition, all the subjects were interviewed by a single interviewer using a predesigned questionnaire.Division of Hand Surgery, Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong.A total of 250 patients with occupational hand injuries were treated during the period from 1999 to 2001. This period was chosen to obtain 10 years of follow-up data to assess return to work and any secondary injuries.Personal particulars (gender, age, marital status, education level, length of stay in Hong Kong, type of employment, wage system, personal habits, family size, number of breadwinners, income), type of industry and mode of injury, causes of injury according to the worker, work conditions, type of injury, and treatment given.Two groups of workers in our study had more occupational hand injuries, namely those with less than 1 year of experience on a new job and immigrants from China. Factors associated with a large proportion of occupational hand injuries were male gender with personal risk factors (smoking and regular consumption of alcohol, long working hours), and in the case of machine operators, inadequate training and use of safety devices.Occupational hand injuries lead to loss of working hours and compensation. For prevention, the workplace should be made into a safer and work-friendly environment. Workers should also have sufficient training.

To review currently available evidence on the epidemiology and methods of management for necrotising fasciitis, with particular reference to Hong Kong.Medline, PubMed, and Cochrane Library searches of local and internationally published English language journals, from 1990 to July 2008 using the terms 'necrotising fasciitis', 'Hong Kong', 'diagnosis', 'epidemiology', 'vibrio', 'streptococci', 'clostridia', and 'management'.All articles involving necrotising fasciitis in Hong Kong were included in the review.The incidence of necrotising fasciitis in Hong Kong and around the world has been increasing. This rapidly progressive infection is a major cause of concern, due to its high morbidity and mortality. Up to 93% of affected patients at our hospital were admitted to the Intensive Care Unit and many still died from septic complications, such as pneumonia and multi-organ failure. Radical debridements in the form of amputations and disarticulations were considered vital in 46% of the patients. Early recognition and treatment remain the most important factors influencing survival. Yet, early diagnosis of the condition is difficult due to its similarities with many other soft tissue disorders such as cellulitis. Repeated surgical debridement or incisional drainage continues to be essential for the survival of sufferers from necrotising fasciitis. Many authorities have reported that carrying out the first fasciotomy and radical debridement within 24 hours of symptom onset was associated with significantly improved survival, which also emphasises the importance of early diagnosis.Clinicians must adopt a high index of suspicion for necrotising fasciitis. Empirical antibiotics must be started early and repeated physical examinations should be performed, while maintaining a low threshold for tissue biopsy and surgery. The timing of the first fasciotomy and radical debridement within a window of 24 hours from symptom onset is associated with significantly improved survival.

To review currently available evidence on the epidemiology and management of occupational repetitive strain injuries with particular reference to Hong Kong.Medline, PubMed and Cochrane Library searches of local and internationally published English journals from 1990 to 2007 regarding repetitive strain injuries.All articles involving occupational repetitive strain injuries in Hong Kong were included in this review.There were 16 articles contributing data on the impact of repetitive strain injuries both in Hong Kong and around the world. There were seven articles dealing with the problem of computer station set-ups and methods for improving the workstation environments.Currently there were significant data on the impact of repetitive strain injuries in Hong Kong. The data took the form of compensation claims, days away from work, and cost of medical consultations. Other articles described proper workplace adjustments to help prevent repetitive strain injuries. However, there were no figures in the current literature showing the impact of these adjustments in reducing the incidence of repetitive strain injuries. More research could help to delineate the relationship between different types of interventions and occupational repetitive strain injuries.