http://www.sacbee.com/101/story/850428.html This story is taken from Sacbee / Our Region Investigative Report: Nail gun safety under fire as injuries soar Dangerous models sold despite years of warnings Andrew Mcintosh firstname.lastname@example.org Published Sunday, Apr. 13, 2008 With a 2 1/2-inch nail deep in his chest, construction worker Manuel Murillo slid into a pickup truck, bracing himself for a desperate seven-mile drive down a snowy Sierra road. His friend and co-worker, Salvador Cardenas, was driving. When they finally got cell phone reception, Murillo, 30, called his wife in nearby Portola to tell her there had been an accident. He had shot himself with a nail gun while working on a mountain cabin. And he was going to die. "I love you," he said, before hanging up. Murillo had been struck down by a popular tool of his trade - the air-powered nail gun - equipped with a mechanism that allowed automatic firing. As the tool's popularity surged during the building boom of the 2000s, a Sacramento Bee investigation found, nail gun injuries also took off despite decades of warnings from researchers and doctors that the guns are dangerous, especially in the automatic mode known as "contact trip." Driven by compressed air, the brawniest nail guns can blast 30 nails a minute that travel up to 490 feet per second, qualifying the nails as low-velocity missiles. In contact trip mode, with one pull of the trigger, they fire those missiles whenever the muzzle makes contact with a surface - including heads, hands, eyes and even chests. Yet the tool's hazards have been largely unaddressed by regulatory agencies. Inspectors charged with protecting the state's workers at Cal-OSHA visit a fraction of active work sites to see whether nail guns are being safely used. The agency more typically investigates after an accident has occurred - as it did with Murillo. Cal-OSHA's efforts to promote safer firing systems also have been derailed. Meanwhile, the federal Consumer Product Safety Commission has done little, even as its staff documented the growing injury toll among nonprofessionals. Novice construction workers and journeymen carpenters, home do-it-yourselfers and even passers-by are among those getting hurt. California companies reported 1,890 nail gun injuries leading to missed work days from 2003 to 2006, according to the U.S. Bureau of Labor Statistics. That tally includes a small portion of those injured in part because undercounting is widespread, according to a 2006 report by the state Legislative Analyst's Office. A more comprehensive national estimate found that 42,000 people with nail gun injuries - more than 100 a day - show up at U.S. hospital emergency departments annually. Others are treated at clinics or at home. Treating the wounds costs the United States at least $338 million a year in emergency medical care, rehabilitation and workers' compensation, according to a Consumer Product Safety Commission estimate. That's 10 times the cost of treating jigsaw, power sander or band saw injuries, and double that for handsaws. Who gets hurt Injury victims and their relatives accuse manufacturers of sacrificing safety to boost the sale of the guns and the nails that go with them, which load into magazines or come in coils. The faster the tool, the greater its appeal - and the more nails it uses. That allegation is among those made by Manuel Murillo's widow, Brenda, who is raising the couple's three children. Her wrongful death lawsuit against toolmaker Hitachi-Koki U.S.A. accuses Hitachi of selling Murillo a finishing nail gun that was negligently designed, defective and of "dangerous character and condition," according to a complaint filed in July in Los Angeles Superior Court. Hitachi Vice President Benjie Hopkins declined to respond, citing the pending litigation. On April 19, 2006, Murillo was installing pine paneling inside a remote vacation home owned by Michael James Flynn, a Rancho Santa Fe attorney. Cardenas was helping and Murillo's oldest son, Carlos, 10, had tagged along. Working on scaffolding 7 feet off the ground, Murillo and Cardenas shared the Hitachi gun. At one point, Cardenas recalled during a tearful interview, he heard the tool fire and Murillo yell. When he turned to look, Murillo was grabbing his chest. Murillo had bought the gun just a few weeks before at a local hardware store, according to a Plumas County Sheriff's Department report. It had two firing modes, a contact trip and a semiautomatic single shot, with a toggle switch between the two. Murillo's gun was switched to contact trip, according to the state investigation into his death. The gun was hanging from the end of the scaffolding, at chest level. Cardenas thinks that as Murillo turned sideways to pass the gun, he accidentally bumped into it. Rushing down the unplowed Plumas County road, Cardenas said he temporarily lost control and hit a pine tree - then recovered and continued. "I wanna hear you breathe," he told Murillo, as his eyes rolled back in his head. Finally, at an intersection, they met the ambulance called by Murillo's wife. Murillo stepped out of the truck - and collapsed. By the time paramedics loaded him into the ambulance, he had stopped breathing. When the ambulance reached Eastern Plumas District Hospital, Murillo was blue. Nurses revived him, getting a faint pulse. But during surgery to remove the nail from a coronary artery, Murillo's heart stopped again. For the next 45 minutes, doctors worked to save him. In the tiny hospital's waiting room, Murillo's wife, sister, mother and other relatives waited for news. When Brenda Murillo learned the white sheet had been pulled over her husband's body, a Plumas County sheriff's report states, she was so overwhelmed she could not speak to police officers. Police notified Flynn, the cabin owner, who flew up the next day. A friend to Murillo and godfather to one of his children, Flynn later gave the eulogy at Murillo's funeral, attended by more than 300. "It was an unspeakable tragedy," Flynn said. "He was literally one of the best human beings and the hardest-working people I ever met." Murillo's death would strike a familiar chord for four doctors in Truckee, who had saved another man nearly killed in a similar accident in the early 1990s. Leading that man's treatment at Tahoe Forest Hospital was Dr. Kenneth W. Kizer, then with the UC Davis School of Medicine. Kizer went on to become director of the California Department of Health Services. The doctors removed a 3 1/4 -inch nail from the man's lung. Later, in the Journal of Trauma, they urged a review of nail gun design features to reduce injuries. Although they had saved their patient, the doctors wrote, "It is easy to see how it might not have turned out this way." Kizer, who now lives in Orange County, was saddened that his team's prediction had come true. But "given the environment in which these are used, which is largely uncontrolled," he said, "the number of injuries is not surprising." Contact guns targeted Emergency room physicians, forensic engineers, attorneys and occupational safety researchers believe that a majority of nail gun injuries could be prevented by limiting the guns to a one-at-a-time sequential firing system. Ed Jazlowiecki , a Connecticut attorney, in December won a $3.4 million jury verdict against nail gun manufacturer Stanley Bostitch Inc. on behalf of a man partially paralyzed after being shot in the head with a nail that had bounced off metal after being fired by a contact trip gun. Jazlowiecki accused Bostitch of continuing to sell contact guns knowing that sequential guns - which it also sells - are safer and despite being hit with 25 lawsuits over two decades from nail gun users who suffered brain injuries, 20 of which Bostitch acknowledges settling out of court. "They're taking the same approach as Ford did with the Pinto," Jazlowiecki said, referring to Ford's reticence to retire the 1970s-era car amid evidence its gas tanks exploded when hit from behind. "They set aside money for lawsuit payouts," he said of Bostitch. "They make so much money from the nails." "Nobody at this company thinks that way," countered Ted Morris, the assistant general counsel for Stanley Bostitch. The company is appealing the ruling in Jazlowiecki's suit, saying the worker misused his tool. Morris acknowledged that sequential guns have a safety advantage over contact trip guns and said his company would comply if contact guns were outlawed. But, for now, most customers prefer them, Morris said. "We are not required to offer only the safer alternative under product liability law," he said. "The Pinto had a defect. There is nothing defective about Bostitch nailers." Mark Ezra and the late H. Boulter Kelsey Jr., a team of St. Louis-based forensic engineers, studied nail guns for years. Their research concluded that the contact trip feature, together with the trigger's location on most nail guns, contribute to serious injuries. Despite nail gun makers' warnings not to carry the tool by the trigger, many users do just that - and it's easy to see why, Kelsey said in an article published in the Journal of the National Academy of Forensic Engineers. "The center of gravity of the tool is just above the trigger," he wrote. "This configuration of the handle and trigger vis-à-vis the center of gravity ... encourage the user to maintain the holding grip on the tool with the same fingers that are used to actuate the trigger." Industry flip-flopped Following repeated calls for safer firing mechanisms and millions of dollars in legal payouts to injury victims, the nail gun industry in 2003 started to make semiautomatic guns that require users to pull the trigger each time they fire. "No one wants to see injuries," said John Kurtz, executive vice president of ISANTA, the International Staple, Nail and Tool Association. "It's a no-brainer." The industry group also agreed to ask manufacturers that sell the larger framing guns to ship them with an even safer system, which shoots a nail only when the muzzle is placed on a target and the trigger is pulled - in that sequence - known as a sequential mode. Yet many manufacturers continue to ship those guns with a kit to convert them back to the more dangerous contact mode. In addition, some companies have ignored ISANTA's voluntary standard, continuing to ship only the contact trip systems. The Bee found that for years before those changes, the nail gun industry acknowledged that contact trip tools were dangerous. At least two companies long ago invented and patented safer trigger designs, federal patent filings show. In 1972, Stanley Bostitch introduced a sequential trigger nail gun to replace its contact trip guns, touting its safety, court documents in one lawsuit show. Morris, the Bostitch attorney, said the company offered the design free to competitors. A year later, Bostitch reintroduced the contact trip option after company officials said sales had suffered and that customers were finding dangerous ways to alter sequential guns to fire on contact or simply with the pull of a trigger. Duo-Fast started selling a fully sequential nail gun in the mid-1990s called "First Place." Its slogan was "helps protect humans from human error." Brochures touted the gun as "A lasting solution to the vicious cycle of injuries, human tragedy and financial losses." Today the company, owned by Illinois Tool Works since 1999, sells more than a dozen nail guns that use up to six firing systems; four are contact trips or include a contact trip option. In Duo-Fast's user manual, consumers are told that the contact trip is "the standard system" and that the sequential mode "may reduce the risk of personal injury" and is "preferred where precision fastener location is more important than speed of operation." However, Ezra and others challenged the assumption, also common among builders, that contact guns are significantly faster. He cited studies by engineering experts and carpenters that show they aren't much faster and reduce the labor cost of an average house by a couple of hundred dollars. Those savings, Ezra maintains, are offset by the cost of more injuries and higher insurance rates. Ban is urged Hester Lipscomb, an occupational epidemiologist at Duke University in Durham, N.C., has spent a decade studying nail gun injuries. "When people get shot, the cases are portrayed in the media as bizarre accidents," Lipscomb said. "I never call nail gun injuries 'accidents.' That implies they couldn't be prevented and that's not true." Her research has found that between half and two-thirds of injuries would not have happened with sequential guns. In her published research reports and at recent construction safety conferences, Lipscomb has urged federal officials to ban contact guns using the federal Occupational Safety and Health Act's "general duty clause." It says employers have a duty to provide a workplace free of known hazards that may cause death or serious injury. Such a ban likely would have prevented the injury of Highway Patrol Officer Ronald Harris Jr., who becameone of an estimated 550 bystanders injured annually by nail guns. Driving home from the gym on May 16, Harris was hit in the eye by a stray nail that had traveled 75 feet from a house being built on the other side of the Riverside County road - and through his open car window. Two framers for Quality Structures Inc. were assembling a wall frame on the second floor of the Temecula house. Both had their nail guns in contact mode, according to a subsequent Cal-OSHA investigation report. State investigators surmised that Harris likely was hit by a nail from a double fire, in which the device kicked back and fired a second nail, the state report said. After being knocked sideways into his passenger seat, Harris pulled over to call for help. At first he was so dazed he could not remember the code to unlock his cell phone. "You got hit by a nail, you said?," one police dispatcher asked incredulously, in a tape of his 911 call. "I got a freaking shot to the head," an agitated Harris told a second dispatcher. Today, Harris, 36, has a damaged left pupil and has had to adjust his work schedule to avoid the midday sun. "On a bright sunny day, it gives me a washout," he said. Harris' doctor has ordered glaucoma tests every six months after he turns 40. Harris has hired a lawyer. Quality Structures, the framing subcontractor, denies responsibility for the incident. "I consider myself very fortunate that I'm not permanently disabled," Harris said. Harris was fortunate. In 1988, Eugene Doran, 40, of Andover, Md., became a quadriplegic while getting a haircut. A carpenter in a neighboring store had fired a 3-inch nail through a wall, severing Doran's spine. Doran received a settlement of $15.35 million from the nail gun manufacturers Amca International Inc. and Desa Industries Inc., the company that had rented the carpenter the gun, and its franchisee. Statistics elusive Nobody in California collects comprehensive data about nail gun injuries, a void that has favored those contractors and nail gun manufacturers who adamantly oppose government efforts to regulate firing systems - and have even lobbied against calling it a gun. Injury data from the federal Bureau of Labor Statistics - based solely on private employers' self-reporting from 2002 to 2006 - found California annually had between 310 and 540 nail gun injuries causing missed work, said labor bureau spokesman Shane Stephens. But if injuries are not recorded on a company's injury and illness log, they don't make it into the bureau's data. And, if a company has fewer than 10 employees, the bureau does not count their injuries. It's as though they never happened. That was the case for Arcadio Rendon, who had a nail ricochet off a metal bracket and into his left eye in Temecula in November 2000. Four years later, Rendon received a settlement of $60,000 after claiming his employer, who picked him up as a day laborer and paid him cash, never provided safety goggles or a face shield, according to documents his lawyer filed with the Department of Industrial Relations. Rendon's case was never reported to Cal-OSHA, even though it is part of the same department. Nationally, the labor bureau survey identified between 2,970 and 3,810 nail gun injuries a year between 2002 and 2006. Among those cases, The Bee identified four nail gun misfire deaths in addition to Murillo's - in Florida, Massachusetts, Maryland, and a 2007 tragedy in Idaho, where Roseville-born Damon Huhtala was killed after tripping and firing a nail into his brain. Lipscomb, using data from the federal Consumer Product Safety Commission's National Electronic Injury Surveillance System, sets the number of nonfatal injuries far higher. In an April 2007 report for the Centers for Disease Control and Prevention, Lipscomb estimated that nail gun injuries seen by hospital emergency departments had increased more than threefold in a decade, from about 12,000 in 1995 to about 42,000 in 2005. Looking at just the nonprofessionals in that group, the trend was similar, with emergency room visits rising from 4,200 in 1991 to 14,800 in 2005. Lipscomb said her data highlight the need not only for safer firing control systems and better training, but also for improved consumer safety information at tool rental companies and hardware stores. The federal Consumer Product Safety Commission has raised some of those concerns over the years. In 1998, commission officials met with representatives from ISANTA, the industry group, to discuss the growing number of injuries from contact trip guns. ISANTA and its member companies argued that nail guns were professional tools without significant consumer use, giving the commission no jurisdiction, meeting minutes show. The commission countered that consumers could buy or rent nail guns. Since then, annual sales of nail guns and other pneumatic tools to nonprofessionals have exploded, hitting $1.3 billion in 2006, up from $850 million in 2001, according to market research firm Mintel International Group Ltd. During that explosion, Cal-OSHA officials became concerned about the "ever-increasing number of nail gun injuries" at California construction sites, saying in one report that "almost all accidents" were due to human error and citing improper handling and carelessness, along with "the conflicting demands of production versus safe work practices." In July 2004, documents show, a safety engineer proposed prohibiting the use of contact trip guns for carpentry, except for nailing roof tiles or attaching sheets of plywood to roof trusses. That proposal was diluted two years later, when an industry advisory committee met in Sacramento. Written minutes indicate that Conrad Tolson, a senior safety engineer with the Cal- OSHA Standards Board, said his review of California nail gun accident reports found that "workers were typically carrying the tool with their finger on the trigger and the accident occurred when the workpiece accidentally made contact with another worker or the worker's own body." "Therefore, it appeared to (Tolson) that sequential activation would help reduce accidents," the minutes say. The nail gun industry and framing contractors resisted, saying the injury problem was exaggerated and that enforcing a ban on contact guns would be impossible. Their solution? More training. Cal-OSHA had proposed changing the title of its regulations from "pneumatically driven nailers and staplers" to "nail guns" - to reflect what workers call them. Contractors and the tool industry group fought that plan, too. Explaining why, Kurtz, ISANTA's vice president, told The Bee: "It's not a firearm. It's a tool." Because the standards board operates on a consensus basis, all that was approved in December was a plan to make companies develop a "Code of Safe Practices" for nail guns and require safety training for new hires. Novices vulnerable Many of the California injury cases The Bee reviewed involved novice, nonunion carpenters or other new hires who received little training of any sort. Miguel Ramirez, then 20, and on his first day with Enterprise Builders in Rancho Cucamonga, blasted a nail off a metal bracket and into his skull in March 2005. Cal- OSHA inspectors found that Ramirez hadn't been given a face shield at the San Bernardino County job site. After Ramirez started to faint with "a hole in his face," co-workers rushed him to Loma Linda Medical Center, where the nail was removed. Three days later, Ramirez couldn't recognize his brother. Five months later, because of his head injury, he still remembered little about the accident, state documents show. Lipscomb's research confirmed that rookie nail gun users face a high risk. When she studied nail gun use by 772 apprentice carpenters in 2005, 347 or 44.5 percent of them reported injuries. After adjusting for experience and training, however, Lipscomb found that contact trip users had an injury rate twice as high as those working in sequential mode. Contractors argue that many nail gun injuries are minor. Lipscomb agrees that most are categorized as minor but adds: "Ask a guy who nailed two fingers together if it is minor." In addition, seemingly minor puncture wounds may turn out to be anything but. Fairfield carpenter Jack Sperduto fired a nail into his hand at Travis Air Force Base in 1998. The wound left behind nerve damage and pain so excruciating that years of treatments, surgeries and drugs didn't relieve it, leaving his hand useless and his head filled with suicidal thoughts, medical reports show. Sperduto sued Senco, the manufacturer, and won $960,000. Pressure to produce Production demands have contributed to the rise in injuries, according to a 2006 report by the Cal-OSHA Standards Board - particularly where the state's housing boom was most intense. Some construction workers are jury-rigging the guns so that they fire faster by removing an easily accessible safety spring. Rental outlets say guns occasionally are returned minus the spring. Isidro Mejia Lopez, then 39 and working on a house in Palmdale, made newscasts around the world in 2004 after a co-worker fired six large nails into his face, neck and skull. Lopez was shot when he got tangled up with another worker and, as the two fell, Lopez hit the co-worker's nail gun muzzle in midair. Cal-OSHA later determined that the co-worker had removed his tool's safety spring, allowing it to pump out six nails. Lopez survived, but even after extensive rehabilitation, his speech is slurred. Some safety-savvy workers have come under pressure to adopt dangerous work methods, too. Edward Ramos was a carpenter with Ralph Rocca Construction Inc. in Apple Valley in June 2005 when his boss directed him to use his nail gun to attach metal hurricane straps to wood trusses, a state investigation report says. Ramos told crew leader Randy Cannon that the smaller palm hammer was better for the job because big nail guns are awkward in tight angles. Cannon said the palm hammer was "in the shop," Cal-OSHA documents state. Ramos repeatedly said he didn't want to use the nail gun. He had no safety glasses or other eye protection. Cannon responded that he had "faith that (Ramos) could get it done using the nail gun." A short time later, Ramos felt something slam into his face. His right eye started bleeding. A co-worker drove Ramos to Victor Valley Hospital. From there, he was airlifted to Loma Linda University Hospital, a nail lodged in his brain. Call The Bee's Andrew McIntosh at (916) 321-1215. ------------------------------------------------------------------------------------------------------------ -- This story is taken from Sacbee / Our Region Decades of research and calls for more nail gun safety Andrew Mcintosh Published Sunday, Apr. 13, 2008 April 1987: University of British Columbia medical researchers John Le Nobel and Peter Wing identified 1,977 nail gun injuries between 1973-1982 from claims filed with British Columbia's Workers Compensation Board. They investigated 32 cases where men shot nails into their knees, reporting their findings and expressing concerns in Clinical Orthpaedics. A third were hurt during their first week using the tool. The researchers called for more training and "stricter regulation," recommending: "a triggering method that would permit only single firing of nails, rather than a rapid succession, would improve safety." October 1992: Drs. Nick Kenny, PR Kay, and JF Haines of the Orthopaedic Surgery Department at Trafford General Hospital in Manchester, England, report in the British Journal of Hand Surgery on three cases of nail gun injury to the non-dominant hand. They stress the tool's hazards and discuss possible complications of surgical nail removal. December 1993: Drs. Kenny, Haines and Donal O'Donaghue, report that during a 14- month period, the emergency department saw 12 patients with industrial nail guns injuries. "Some patients said that the contact pressure required to activate the gun was low, and occasionally a gun would misfire with simple movement through space and without being in contact with a solid structure." "All patients required surgical removal of the nails, which in some cases had penetrated deeply. ... All patients stated that they had received training in the use of nail guns but they considered it inadequate. "The pattern of these injuries ... suggest that the safety mechanisms on the guns and the protective clothing worn by operators of the guns do not prevent injuries. We call for a review of operator training and the design of both the safety mechanisms and the protective clothing worn by operators." March 1995: Doctors at the Tahoe Forest Hospital in Truckee, writing in the Journal of Trauma, discuss the case of a 32-year-old man who shot himself in the heart, lung and aorta with a nail gun after a co-worker accidentally hit his nail gun with a beam. Authors (Kenneth W. Kizer, then of the UC Davis School of Medicine, and three others) conclude: "Given the remote settings in which these devices are often used, we would concur with (Dr. Nick) Kenny's suggestions that increased attention be directed toward the prevention of nail gun injuries through enhanced operator training and a review of the device's safety mechanisms." September 1996: Two doctors from the University of Texas Health Science Center report four consecutive cases of nail gun injuries to the eye. Three of four recovered good vision after surgery. They nevertheless recommend using safety glasses and adhering to safety precautions, saying such injuries can have "disastrous visual consequences." July 1997: In the Journal of Trauma, Dr. Giampiero Alberico of the Emergency Department of S. Massimo Hospital in Penne, Italy, describes the case of a 54-year-old hurt while trying to attach metal plates to a wall in his yard with a nail gun. The man felt a sharp pain in his neck and fell to the ground. He thought he was hit by concrete fragment, but an X-ray found a nail entered his neck and became lodged in his lung. "Additional safety mechanisms should be introduced to reduce the risk of injuries," he wrote December 1999: Drs. Anne-Corinne Beaver and Michael L. Cheatham of the Surgical Education Department at the Orlando Regional Medical Center in Florida report in the American Surgeon that during a 20-month period, eight patients were admitted to their Level I trauma center with potentially life-threatening nail gun injuries to their brain, eye, neck, heart, lung and femoral artery. They say that nail guns have "significant potential for causing severe debilitating injury and death." These findings, they add, indicate a need for improved safety features and user education. They also predict: "The incidence of nail gun injuries will likely continue to rise with increased use of these tools by both the construction industry and the weekend do-it-yourselfer. ... Manufacture of nail guns with permanent safety features and improved training of nail gun operators is warranted." That same month, the Washington State Department of Labor and Industries publishes a detailed technical report on the prevalence of nail gun injuries in that state between 1990- 1998. For the nine years, it finds, there were 3,616 accepted state fund claims for nail gun injuries. No fatalities were reported, but total costs were $6,232,392 or about $692,488 a year. To reduce the number and severity of nail gun injuries, the report recommends: "Use the sequential trigger ... manufacturers should work with users and health and safety professionals to better balance the speed and productivity of using 'bump' mode with the accuracy and potential of fewer acute trauma injuries using the 'sequential' mode." (Bump mode is firing the nail gun by bumping the safety bracket along the work piece while holding down the trigger.) Their research was published by the American Society of Safety Engineers magazine in January 2001. December 2001: The Atlanta Journal-Constitution reports that up to a dozen patients that year showed up at Grady Memorial Hospital, Georgia's busiest trauma center, with eye and facial nail gun injuries. A high number of them are Latinos. Dr. Geoffrey Broocker says the number of injuries is considerably higher than in previous years. Many eye injuries happened to workers who were not wearing eye protection. Some delayed getting medical attention because they were not citizens and had no health insurance - delays that can permit infection to develop and severely damage an eye. The paper reports that the Mexican consul, Remedios Gomez Arnau, has started to work with OSHA to curb an increase in injuries to Latino workers nationwide. March 2002: Canadian Medical Association Journal Editorial Fellow Eric Wooltorton reports that nail guns have a ballistic potential comparable to conventional firearms and warns they have caused direct and indirect nail gun injuries to children and innocent bystanders after passing through walls. Recommends the safe storing and securing of nail guns and cartridges "as they would any firearm and ammunition." November 2002: Dr. Gregory Buchalter of the University of Utah Phoenix Indian Medical Center, writing in the Ear, Nose & Throat Journal, offering a contrary view to Beaver et al. from 1999: "Any physician who is called on to manage a nail gun injury to the head or neck should understand that most likely the patient will have sustained a surprisingly limited amount of tissue injury, owing to the relatively low velocity of the projectile compared with that delivered by firearms." However, Buchalter notes that: "Most nail guns are designed with a safety mechanism to prevent unintentional firing. ... When a nail gun is carried with its trigger depressed, an inadvertent firing can occur if the switch is accidentally engaged." That same month, Graeme Johnstone, state coroner for Victoria, Australia, publishes a 12-page report about the 1998 nail gun-related death of worker Peter Sullivan, who died of deep venous thromboses after a nail injured his left thigh. Noting with concern that there had been 94 traumatic nail gun injuries and scores of workers compensation claims between 1998 and 2002, Johnstone called for a government and industrywide review of nail gun design features and work practices. "The safety features of the particular gun used by Mr. Sullivan (a Hitachi NT65AB) did not avoid the accidental discharge into his leg," Johnstone wrote, adding that seemingly "minor injuries" like Sullivan's need to be considered "a major injury" because of the blunt force of the power tool. May 2003: Writing in Applied Occupational and Environmental Hygiene, a trade publication, John M. Dement and Hester Lipscomb, of the Duke University Medical Center and University of North Carolina at Chapel Hill, studied nail gun injuries among 21,000 union carpenters in Ohio and North Carolina. The Ohio injries took place between Jan. 1, 1994, and Sept. 30, 1997; those in North Carolina between July 1996 and November 1999. The cases were matched them to workers' compensation claims. The authors found that nail gun injuries accounted for 4 percent of compensation claims and that paid time off work cost an average of $9,237 per case. Their data also found 80 to 89 percent of injuries were puncture wounds, and the researchers suggested that 69 percent of the puncture injuries were caused by inadvertent gun discharge or misfire, "preventable in large part by the use of sequential triggers." June 2003: Using data that estimated there were 32,000 nail gun injuries in the United States that were treated in hospital emergency rooms in 2001, the Consumer Product Safety Commission pegged the total cost of nail gun injuries at $338 million. June 2004: A five-year study of 600 nail gun-related injuries by emergency medicine specialist Dr. Jonathan Knott of Australia's Royal Melbourne Hospital, reported in Occupational Health News, finds that 75 percent of the injuries occurred in the construction industry. Three-quarters of the accidents involving injuries to the hand and finger, mostly on the non-dominant hand, were linked to "bump firing." The common method using the tool - with bump firing - may be increasing the risk of injury, Knott reports, adding that while bump firing speeded up construction, it increased the dangers. "It's not clear how much training is given," Knott writes. "Maintenance of adequate workplace standards, education and training may decrease the risk of related injury and avoid potentially lethal outcomes." June 2005: Writing in the journal Injury Extra, Drs. Timothy A. Pritts, Douglas Knight and Bradley Davis of the University of Cincinnati Medical School review the case of a 23-year-old man who shot himself in the heart with a nail gun. He survived after the nail was removed and his heart was surgically repaired. The researchers examined 20 reported cases of nail gun shots to the heart; they found an 80 percent survival rate. They note that even "presumed minor" nail gun injuries to the hands and fingers "are associated with significant social and economic effects since the majority of these injuries result in significant amount of lost work." Despite improvements in nail gun safety that aim to prevent misfires, the device's safety nozzle does not completely remove the risk of accidental injury, and they say, "Continued efforts at (injury) prevention are required that will hopefully lead to a significant reduction in these potentially fatal injuries." June 2006: Writing in the American Journal of Industrial Medicine, Duke University researchers Hester Lipscomb and John Dement team up with St. Louis carpenters James Nolan and Dennis Patterson to report that 45 percent of carpenter apprentices had suffered a nail gun injury in the past year, a rate considerably higher than previously recognized. After adjusting for experience and training, they also discovered that the injury rate for workers using contact trip nail guns was double that for workers using safer sequential triggers. "These data clearly indicate that measures currently in place to prevent injuries from nail guns are not adequate to protect apprentice carpenters," they write. "Prevention of nail gun injuries in this population should focus on advocating for, or perhaps regulating, the use of the safer sequential trigger preventing unintentional firing and early training in tool use. "Because of the high prevalence of these tools with contact trip triggers the greatest number of injuries among these apprentices could be prevented with an engineering solution. It is unfortunate that an existing engineering control for this common tool is not the norm on most residential work sites." April 2007: A Centers for Disease Control and Prevention report notes that consumer nail gun injuries skyrocketed 200 percent between 1991 and 2005, corresponding to an increase in availability of inexpensive nail guns and air compressors in home hardware stores. In 2005, 13,400 consumers and 28,600 workers were hurt and visited emergency rooms for treatment, the report noted, including 1,200 women. That number represented an increase of 39 percent for workers from 2004. Of the 28,600 workers, 1,500 were hospitalized for puncture wounds or after having embedded nails removed. Because consumers use the tools for far fewer hours than professional carpenters, their actual injury rate might be much higher, the report states. The CDC report states that training that emphasizes safe working practices might help reduce injuries among workers, but says use of sequential triggers is likely to be more effective, particularly for consumers who do not usually receive training in tool use. May 2007: Advanced Safety & Health, LLC, an occupational safety and health consulting company with offices in Kentucky and Pennsylvania, publishes a newsletter for its clients titled, "A Call for Gun Control." They weren't talking about firearms, but nail guns. The newsletter emphasizes the grim numbers in the CDC report, discusses the safer sequential trigger and urges clients to review nail gun safety to avoid serious injuries and even death. That same month, Dr. Stephen Monteith presented his study of a dozen brain injuries caused by nail guns to colleagues at the Royal Australasian College of Surgeons annual meeting. He raised the possibility of limiting the sale and use of the tool to builders only. June 2007: Drs. George Testerman and Laura Dacks, writing in the Southern Medical Journal, report that penetrating brain injury resulting from nail gun use has become "a well-characterized entity, one that is increasing in frequency as the guns become more powerful and more readily available to the public." November 2007: Drs. Brandon R. Horne and Fred Corley at the University of Texas Health Science Center's Orthopedics Department, write in the journal Injury that they reviewed 88 nail gun injuries at their San Antonio hospital over a four-year period and found the majority were to hand and knee (38.6 percent and 28.1 percent) respectively. They note that the "increased productivity" in construction work has come "with an increasing number of injuries associated with the device." -------------------------------------------------------------------------------- This story is taken from Sacbee / Our Region Safety first at capital contractor Otto Construction restricts riskier nail gun, requires training for new hires -- and virtually eliminates injuries. Andrew Mcintosh email@example.com Published Sunday, Apr. 13, 2008 For Scotty DuPriest, the safety and risk manager for Sacramento-based general contractor Otto Construction Inc., it was a puzzling problem. His company had cut its work accidents overall, yet 11 workers had suffered nail gun injuries over three years, ranging from minor puncture wounds to more serious damage. "This was very disturbing and required us to take a much closer look at nail gun safety," DuPriest said. He interviewed workers involved in each of the incidents and found that the bulk of injuries came from contact trip nail guns. He also found that even though various types of nail guns were available at Otto Construction sites, workers were not necessarily grabbing the safest one for the task at hand. After discussing the problem with a shop foreman, he came up with a solution: Paint safer semiautomatic nail guns with single-shot triggers bright red and require that these alone be used for framing walls, restricting contact trip guns to roofing jobs. The paint allowed construction foremen to see at a glance whether workers were using the appropriate guns and it helped workers pick the right tool for their job. Those measures were coupled with mandatory nail gun safety training for new hires. The company also developed a nail gun safety poster for work sites and work trailers. Since then, Otto's nail gun injuries have been virtually eliminated, a fact confirmed by Cal-OSHA records. "You have to take care of (your workers) and keep them as safe as possible, "DuPriest said. "I want them to go home at night with all of their digits. I care about every one of these guys." Call The Bee's Andrew McIntosh at (916) 321-1215. This story is taken from Sacbee / Our Region Hitachi model dominates market, injury reports Powerful tool is implicated in more serious work accidents in state than any other brand Andrew Mcintosh firstname.lastname@example.org Published Sunday, Apr. 13, 2008 Once touted by retailers as the nail gun that built the West, the Hitachi NR83A framing nail gun has been implicated in more serious workplace injuries reported in California than any other brand or model. So powerful is Hitachi's tool that its nails have pierced workers' hard hats, nailing them to their skulls. Yet the reason for its legacy of injuries is something of a riddle. Theories range from the lack of a company safety video for users, which are offered by some of its competitors, to the tool's strong recoil - and its popularity. Hitachi Koki U.S.A. Ltd. suggests the volume of accidents involving the NR83A and its successor, the NR83A2, might be explained by the model's widespread use in the California construction trade. Company Vice President Benjie Hopkins estimated that among round head nail framing nailers, the Hitachi model holds 30 percent of the market nationally and up to 35 percent on the West Coast. In 125 reports of serious nail gun injuries reported to Cal-OSHA by employers in the past decade, The Bee was able to identify the model and brand in 74 cases. Of those, 51 involved Hitachi nail guns, primarily the NR83 series. In court documents filed in response to lawsuits from injury victims, attorneys for Hitachi Koki have consistently maintained that the NR83A and its other nail guns are safe. Like other nail gun manufacturers, they suggest that people seriously hurt or killed have misused the tool or failed to follow instructions spelled out in user manuals. Hitachi's framing nailer has earned praise from tool reviewers for its design and reliability. It is among the largest on the market and can shoot nails up to 3 1/2- inches long at great speed and in rapid succession. Users buy Hitachi nails in strips, allowing them to load more than 60 at a time into the gun's metal magazine. The original NR83A came with only a contact trip firing system, the type implicated in the majority of nail gun injuries caused by all brands. The newer NR83A2 has a switch that allows users to select whether to use the contact or a semiautomatic single shot system. A fully sequential firing system conversion kit is available, but must be ordered as a separate part and installed by the user, according to the 50-page multilingual Hitachi manual. Hitachi - like one of its rivals, Duo-Fast - does not provide a Web video or an abbreviated tip sheet. By contrast, Stanley Bostitch includes a safety tip sheet with its guns and on its Web site offers an amusing video featuring a football referee monitoring work practices at a construction site. When the referee sees an unsafe practice, he throws a flag, blows his whistle and announces details of the penalty. Senco Products has downloadable product safety sheets, safety reminders and a special e- mail link to its product safety manager. Porter Cable offers online tips on nailing and an "ask the expert" interactive feature. California Division of Occupational Safety and Health officials have not studied serious nail gun injuries by brand or model, according to Larry McCune, a Cal-OSHA safety engineer based in Oakland. But one Cal-OSHA inspector did highlight the Hitachi NR83A's potential to seriously hurt people. Last August, paramedics rushed William Pennell, 20, of Stockton to the John Muir Medical Center in Walnut Creek after his co-worker blasted a nail into his eye, state records show. Pennell, a carpenter's apprentice, did not return telephone messages on the advice of his lawyer. However, his fiancée, Kimberly Brooks, said he lost almost all the vision in his left eye, now seeing only shadows in bright light, and has ongoing pain and headaches that doctors are trying to alleviate. "The nail tore into his head. They had to do a craniotomy (bore a hole in his skull) to get it out," Brooks said. "He has a plate in his skull now. He doesn't remember much. It's a blur. He remembers the pain." After investigating the case, Cal-OSHA inspector Barbara Godsill concluded that Pennell should have been wearing eye protection, even though he wasn't using the tool himself. But she did not let Hitachi completely off the hook: "It is obvious to this inspector that the Hitachi nailer has had issues in the past with unwanted nails being driven .... It is obvious to this inspector that these unwanted nails have caused serious injuries." The company's manuals for the NR83A and NR83A2 do warn users that the nail gun can be dangerous, adding: "improper or unsafe use will result in death or serious injury!" Yet that assumes workers have read the manual. Builder Shane Johnson says he doesn't think Pennell ever read the Hitachi manual. When his construction company hired Pennell, Johnson said it gave the apprentice a two-page code of safe practices. Cal-OSHA officials later found there was no evidence that Pennell had read even that code. "Therefore, it is unlikely that he understood the reasons for wearing the safety glasses nor the hazards associated with use of a nail gun in the vicinity of where he was working," Godsill's report added. Johnson denied that assumption, saying he taught Pennell work safety on the job every day. Even workers with documented nail gun safety training and protective equipment are being shot with Hitachi guns. Milton Anaya, then 26, was working on a garage at The Rivers project in West Sacramento for CDC Construction in May 2006. He was using his Hitachi NR83A2 while 8 feet off the ground, working on a garage wall. It fires nails so fast that one nail he blasted hit another he'd already driven - and thwack, it bounced back and hit him in the cheek. Cal-OSHA would later determine that Anaya had received safety training and was wearing safety goggles - neither of which prevented his injury. Call The Bee's Andrew McIntosh at (916) 321-1215. ------------------------------------------------------------------------------------------------------------ - This story is taken from Sacbee / Our Region Safety tips for using nail guns Published Sunday, Apr. 13, 2008 1. Pick a firing system suited for your job. Avoid a contact trip nail gun if you're mostly firing single shots. If space is too tight for a big nail gun, use a hammer. 2. Read the manufacturer's operating manual before you turn it on. Don't let an inexperienced worker, relative or friend use a nail gun without training. 3. The nail gun user and everyone working at the site should wear safety glasses. A hard hat, protective footwear and hearing protection also should be worn. 4. Keep your finger off the trigger when not firing nails. Keep your hands and feet away from the muzzle of the nail gun. 5. Never rest the nail gun against any body part, or try to climb a ladder with the gun cradled against your body. Never point a nail gun at anyone. 6. Watch out for other crew, family members or friends working nearby. 7. Never use bottled gas to power air-powered nail guns. 8. Always disconnect the nail gun from its air or electrical power source before reloading nails, trying to free a jammed nail or carrying the device out of your work area. 9. Never use your foot or knee to support wood you are nailing. 10. Never use a nail gun with a missing push lever and muzzle safety spring.