From those I spoke to diving on other reefs the Caribbean is in the worst state, although apparently the Great Barrier Reef is increasingly suffering because of the large numbers of people who go there and are careless about it. Its quite sad.
Though I did hear one story from a friend about a person who got their comeuppance. Apparently this person had had these like...Titanium reinforced gloves and consequently used to poke at EVERYTHING. Sticking their hands in holes and all that to harass the wildlife. Eventually, however, they messed up and stuck their hand in a hole which was the home of a Moray Eel. Didn't lose their finger purely because of the gloves but ended up with like half the bones in their hand broken from the bite.
In general people are just really bad at looking after the environment. I mean its hard to have NO impact but some people are rather ignorant about minimising it. First rule of actually working out there was unless you were taking a sample...you touch absolutely nothing. In fairness in a lot of cases that's because tons of things are lethally toxic.