How to Investigate a Hand Injury

Katie Wohlust


Cause Mapping

Have you ever injured your hand? Have you ever had a paper cut, accidentally closed a finger in the car door or grabbed something that was hot? I have. I have done all three. We use our hands to perform most of the tasks we do in our lives. When a hand injury occurs, it can have a huge effect on our day-to-day lives.

In 2014, according to the U.S. Bureau of Labor Statistics, hand injuries accounted for 137,440 non-fatal occupational injuries involving days away from work. Those hand injuries resulted in employees missing an average of five days of work.

If we can better understand why hand injuries occur, then we can better identify ways to reduce the risk of hand injuries. After conducting many root cause analysis investigations for hand injuries, we started to see a pattern with the cause-and-effect relationships. We have developed a consistent method to using the Cause Mapping® method of RCA for hand injuries.

Types of Hand Injuries

In 2004, EHS Today reported on a study co-sponsored by the National Institute for Occupational Safety and Health. The study summarized the most common occupational acute hand injuries (see graph below). The study also found common causes that increased the risk for hand injuries. These causes included: working with equipment or tools that did not perform as expected, using a different work process to do a task, performing an unusual or unique task, and being rushed or distracted.


How Does a Hand Injury Occur?

Let’s break down a hand injury incident using generic language. There are four basic parts of a hand injury:

  1. The hand
  2. The hazard 
  3. Contact between the hand and the hazard
  4. Severity of the contact

The injury may be small in severity, such as a scratch that only required a Band-Aid or the injury can be very severe, such as broken bones or lacerated tendons.

A Cause Map™ provides a visual explanation of why an incident occurred. It connects individual cause-and-effect relationships to reveal the system of causes within an issue. It can be basic, or it can be extremely detailed depending on the issue. A Cause Map™ is built by starting at one of the impacted goals and asking “why” questions. Although there can be more than one organizational goal impacted by a hand injury, we are going to keep it simple and focus on the safety goal.

We start with the question, “Why was our safety goal impacted?” Because someone injured their hand. This simple 1-Why Cause Map™ is a great place to start the root cause analysis investigation.



Why did someone injure their hand? The injury occurred because a hazard contacted the unprotected hand. With that question, the Cause Map™ expanded into the following 2-Why:




For a hand injury to occur, an unprotected hand AND a hazard must contact each other, meaning they must be in the same location at the same time.

Recognizing that the hand can be unprotected even if an employee is wearing gloves is an important concept. Gloves come in many different styles and materials to protect employees from many different hazards. For example, employees in the food service industry typically wear nitrile, latex or vinyl disposable gloves. Those types of gloves protect them and us from infections, but it does not protect the employee from sharp objects such as a knife.

Every hand injury begins with the same fundamental cause-and-effect relationship, and from here, we can continue to ask Why questions based on the specific hand injury. This fundamental relationship gets the incident investigation started.

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