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A CUP OF HEALTH WITH CDC
Power Tools: Nail Down Safety First
Nail-Gun Injuries Treated in Emergency Departments — United States, 2001–2005
June 22, 2007

[Announcer] This podcast is presented by the Centers for Disease Control and Prevention. CDC
– safer, healthier people.

[Matthew Reynolds] Welcome to A Cup of Health with CDC, a weekly broadcast of the
MMWR, the Morbidity and Mortality Weekly Report. I’m your host, Matthew Reynolds.
Speed, ease of use, and availability have made air-powered nail guns a common tool
for construction professionals and do-it-yourselfers, alike. But nail guns can cause
serious injuries. Researchers from NIOSH, the National Institute of Occupational Safety
and Health, have recently collaborated with colleagues at Duke University on a study
that examines the rate and causes of nail gun injuries. Dr. Hester Lipscomb, an
occupational safety expert at Duke University who worked with NIOSH on this study, will
discuss the study and what they learned. Dr. Lipscomb, welcome to the show.

[Dr. Lipscomb] Thank you, Matthew. It’s a pleasure to talk with you.

[Matthew Reynolds] Dr. Lipscomb, this topic is very timely. During the summer, many
homeowners or “weekend warriors” take on a variety of home improvement projects,
some basic and others that are complicated. One thing many of these projects have in
common is the use of power tools, which can include air-powered nail guns. Your study
found that there are many people injured while using nail guns, some very seriously.
What did you and your colleagues learn about the frequency and nature of injuries
caused by nail guns?

[Dr. Lipscomb] We looked at injury data from the Consumer Product Safety
Commission and NIOSH, which is the worker health and safety arm of the CDC. These
data allowed us to look at consumers and workers who were treated in emergency
rooms for nail gun injuries. Currently, there are about 37,000 nail gun injuries treated in
emergency rooms each year in the U.S., and that translates to about 100 injuries per
day. While that sounds like a lot of injuries, it’s important to realize that we only
collected information on injuries treated in emergency departments and there probably
many more injuries that are treated at home or in other medical settings.

[Matthew Reynolds] That number is surprising, to say the least. What are some of the
other highlights you found from the study, Dr. Lipscomb?

[Dr. Lipscomb] Well most of the injuries that we saw are to construction workers and
others whose work includes the use of these tools. The number of injuries to
professionals has remained pretty steady over the past several years. But in contrast,
the number of injuries to consumers has gone up dramatically since 1991 with a 200%
increase. In recent years consumers are accounting for nearly 40% of emergency room
visits caused by nail guns. As you might expect, most often these injuries occur in men
in their mid-20’s to mid-30’s, although injured consumers are somewhat older.

[Matthew Reynolds] I’ve read newspaper articles and seen television news coverage
about people who’ve had accidents with nail guns and wound up with nails in their head.
Is this not the typical injury? I’m assuming it isn’t.

[Dr. Lipscomb] No, the common nail gun injury is a puncture wound or nail embedded
in a hand or finger. Other common injuries include similar wounds to the arms, the legs,
and the feet. Less often, people are injured with a nail or nail embedded in their head,
face, or chest. Nail guns can cause eye and dental injuries, but most people with
injuries are treated in the emergency room and sent home. Some injuries are serious
enough to require hospitalization and even surgery. Deaths are rare but they can occur
and in fact, there has been a recent news report of the death of a young carpenter in
Idaho who sustained a head injury from a nail gun.

[Matthew Reynolds] It seems to me that a person using a nail gun would be really
careful, but apparently that’s not always the case. So how are these injuries happening?

[Dr. Lipscomb] These tools are powerful and they fire rapidly and that makes them
very convenient for work; but it’s the same speed and power that are the features that
can result in injuries. Hands or feet that are too close to where nailing is being done is
one way that injuries can occur. Improper use, disabling safety features are other
factors that can result in injuries. Locking the trigger and inadvertently touching the nose
of the nail gun to a body part can result in nails being discharged unintentionally.

[Matthew Reynolds] Has anything been done to make nail guns safer to use?

[Dr. Lipscomb] There have been improvements to nail guns but despite this, injuries
still happen. Since 2003, nail gun manufacturers have begun to comply with a voluntary
industry standard that calls for equipping nail guns with a safer sequential trip trigger
that’s designed to prevent inadvertent discharge of nails. Unfortunately, there’re still nail
guns being sold that don’t have this feature, and many older nail guns are still in use.
Even the newer tools are often shipped with the older, more dangerous contact trip
trigger in the same box and this can be really confusing to users. An inexperienced user
may not know for sure whether the nail gun they planned to use is equipped with the
newer safety features.

[Matthew Reynolds] Well then, let’s say that I go to my local home improvement shop
and buy a nail gun. How do I determine the type of trigger mechanism on the nail gun?

[Dr. Lipscomb] First, ask before you buy, and if the staff there can’t help you, then
shop somewhere else. If you already own a tool, there’s a fairly simple test that you can
do to determine what type of trigger mechanism you have. With the nail gun readied for
safe nailing, the user can aim the nail gun at a thick board without the tip of the gun
actually touching the board. While holding down the manual trigger, then touch the nose
piece to the board. If a nail discharges, the gun has the more dangerous contact trip
trigger. In contrast, if you place the nose of the gun down first and then pull the trigger to
discharge a nail, the tool has the safer sequential trigger. Regardless of the trigger
mechanisms, if a nail gun ever discharges a nail without being pressed against an
object or seems to be misfiring, it should be repaired before using or discarded.

[Matthew Reynolds] What can nail gun users do to prevent injuries to themselves and
to others?

[Dr. Lipscomb] First, they should always choose the safer sequential trip trigger
mechanism. If the user is uncertain about the trigger mechanism, employees at a local
hardware or home improvement center should be able to check out the tool for safety
features. If you already have a nail gun that’s equipped with the contact trip trigger, the
user should replace it or upgrade the nail gun so it’s equipped with the safer sequential
trigger mechanism. Those who work with nail guns as part of their job and consumers
who only occasionally use a nail gun for home projects should recognize that even
though these tools are easy to operate, they still need training in safe nail gun use.
Some home improvement centers, vocational schools, and local industrial arts
programs offer such training. And lastly, everyone who uses them needs to treat them
like guns—use them with care and don’t disable the safety features.

[Matthew Reynolds] That is really helpful information and I’m sure our listeners have a
better understanding of some of the dangers of using nail guns. Thank you for taking
the time to talk with us today, Dr. Lipscomb.

[Dr. Lipscomb] Thank you very much for inviting me. We appreciate your interest in
getting information out about this public health problem.

[Matthew Reynolds] That’s it for this week’s show. Don’t forget to join us next week.
Until then, be well. This is Matthew Reynolds for A Cup of Health with CDC.

[Announcer] To access the most accurate and relevant health information that affects you, your
family and your community, please visit www.cdc.gov.