Poor design and excessive use of hand tools are associated with increased incidence of acute trauma and subacute/chronic disorders of the hand, wrist, and forearm. Acute trauma includes burns, cuts, lacerations, abrasions, fractures, sprains, strains, and dislocations and amputations caused by hands or fingers being caught, cut, or burnt by a tool. Short-term fatigue and discomfort have been considered as the risk factors for musculoskeletal syndromes and therefore, have been used as criteria in ergonomic guidelines and standards. The exposure factors associated with subacute/chronic trauma include high forces extreme postures of fingers, wrist, and shoulders; repetitive movements; high localized pressure; and segmental vibration. For all subacute/chronic trauma exposure factors, the duration of exposure is of crucial importance. Several other factors must also be considered during hand tool and task design. These factors include design of grip, tool weight, trigger design, tool vibration characteristics, and duration and frequency of tool use. Worker characteristics, such as left/right handedness, gender and age, strength, technique, body size, and posture, also profoundly influence both risk of injury and productivity in work with hand tools.