A case-control study of occupational hand injury was conducted in an effort to identify risk factors for disabling injury. Case employees in this study were municipal employees who had sustained restricted activity or lost work time as a result of hand injuries while at work. Each case employee was individually matched to a control employee of the same sex who held the same job and was at work on the same date and shift that the case employee's injury occurred. A conditional logistic regression model was used to adjust for confounding variables. Performing a task that was not a usual job requirement, using defective materials, presence of cardiovascular disease, sleeping nine or more hours per night, and being less than 25 years of age were identified to be risk factors after adjustment.