Nail Gun Injuries Surge

ByDAN CHILDS <br>ABC News Medical Unit

April 13, 2007 &#151; -- For die-hard do-it-yourselfers, the nail gun aisle at any major hardware store is almost impossible to ignore.

Dozens of these plastic and metal contraptions, holstered in rows and arranged according to size and power, evoke the feel of an armory or a toy store. Or perhaps something in between.

For most amateur carpenters, the temptation to pick up and cradle these tools is all but irresistible.

However, a new Duke University study in the current issue of Morbidity and Mortality Weekly suggests that inexperienced users may want to take pause before adding a nail gun to their home tool kit, as using these high-powered nail guns may be risky business for amateur carpenters.

Researchers looked at hospital reports and government statistics and found that the number of weekend warriors treated for nail gun injuries in American emergency rooms has more than tripled over the past 16 years -- a rise mirrored in the increasing availability of nail guns to the average consumer.

In total, doctors went from treating about 4,200 home users for nail-gun related injuries in 1991 to about 14,800 in 2005. Moreover, the study shows that 40 percent of all nail gun injuries were sustained by those not professionally involved in construction or carpentry.

"It was actually a surprise to me that consumers made up 40 percent of the emergency room visits for these injuries," says lead study author Hester Lipscomb, associate professor of occupational and environmental medicine at Duke University Medical Center. "What has been historically an occupational hazard is now a hazard to consumers as well."

Dr. Corey Slovis, professor and chair of the department of emergency medicine at Vanderbilt University Medical Center, is no stranger to nail gun injuries.

"On Monday, I treated a gentleman who had a nail gun injury in which the nail just missed the optic nerve," Slovis says. "It did not cause any permanent damage, but it was within one-tenth of an inch from vital structures."

Slovis says his patient was a construction worker by trade. But he adds that consumers who use nail guns are just as apt to receive similarly ghastly wounds if they handle nail guns improperly.

"Some of the people who use these nail guns get rid of the safety so it can be fired rapidly," he says. "Occasionally, people sit on them. Occasionally, they'll go off in the holster and hit a leg. "In general, these are deep puncture wounds, though the nail occasionally embeds in bone," he says.

But why do so many of the patients injured by nail guns, such as Slovis', walk into the clinic with nails in their heads? The answer, as it turns out, comes down to teamwork.

"Often, a person is on the opposite side of the wall, and their partner or coworker misses the stud, and the nail goes straight through the wall into their head."

Telephone requests for comments from spokespeople from four major nail gun manufacturers -- DeWalt, Stanley, ITW and Senco -- were not immediately returned.

However, most would agree that no power tool is completely safe if used improperly. On this point, Lipscomb agrees.

And she adds that the availability of these tools in most major hardware stores makes it much more likely that consumers will be able to get their hands on one -- and possibly hurt themselves.

"I don't think these tools have gotten any more dangerous," she says. "It's more an issue of easier access."

But regulatory bodies have cited certain models of nail guns in the past for safety reasons. On June 29, 2006, the U.S. Consumer Product Safety Commission issued a public safety notice for a consumer-level nail gun, citing its potential to eject a nail unexpectedly. In the previous year, another type of nail gun was recalled after similar complaints were reported.

In order to prevent these accidental discharges, manufacturers have started incorporating design changes into nail guns intended to make them safer. In recent years, many nail guns have featured what is called a "sequential-trip trigger mechanism," which allows nails to be fired from the gun only when the nose of the gun has been firmly placed on the target.

Study authors say the report highlights not only a need for safer nail guns, but also for proper training and warnings for consumers.

"Just because these tools are easy to use doesn't mean people don't need training," Lipscomb says. "Because it is easy to use, it ends up in the hands of inexperienced workers and consumers. "I think we can devise a way to use safer tools and emphasize that people need to be trained to use them before they get them into their hands."

In response, John Kurtz, executive vice president of the International Staple, Nail and Tool Association, said in a statement to ABC News that the organization is continuing work to change industry standards on trigger mechanisms in nail guns.

"Noting the sharp increase in the use of power tools outside of the workplace, primarily by do-it-yourselfers, we will continue to work with all interested parties to increase safety, training and education, minimize risk, and reduce injuries for both workers and consumers," the statement reads.

Fortunately, there are already certain things that consumers can do to minimize their risk of injury when using nail guns.

Slovis says that consumers need to remember to respect a nail gun the same way that they would respect a handgun. This means never pointing the gun at anyone -- and always knowing what or whom is on the other side of the wall.

"In general, injuries from nail guns are based on unsafe use and a lack of understanding rather than the end user simply being a victim of the device," Slovis says. "These are safe when used properly."

Such respect for these tools could go a long way in keeping consumers out of the emergency room, Lipscomb says.

"There have been so many of these catastrophic injuries in the past four years or so in the U.S.," she says. "You see them on the news, and as unfortunate as these accidents are, it's not like we don't know anything about how they happen.

"We're smart enough that we ought to be able to prevent these accidents."

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