Musculoskeletal concerns do not justify failure to use safer sequential trigger to prevent acute nail gun injuries

Am J Ind Med. 2015 Apr;58(4):422-7. doi: 10.1002/ajim.22426. Epub 2015 Mar 4.


Background: Acute nail gun injuries can be controlled significantly by using tools with sequential triggers and training. Concern has been raised that sequential triggers, which require that the nose piece of the gun be depressed prior to pulling the trigger, could increase risk of musculoskeletal problems.

Methods: We conducted active injury surveillance among union carpenter apprentices to monitor acute injuries and musculoskeletal disorders between 2010 and 2013.

Results: Acute injury risk was 70% higher with contact trip rather than sequential triggers. Musculoskeletal risk was comparable (contact trip 0.09/10,000 hr (95% CI, 0.02-0.26); sequential 0.08/ 10,000 hr (95% CI 0.02-0.23)).

Conclusions: Concern about excess risk of musculoskeletal problems from nail guns with sequential triggers is unwarranted. Both actuation systems carry comparable musculoskeletal risk which is far less than the risk of acute injury; there is clearly no justification for failure to prevent acute injuries through use of the safer sequential trigger.

Keywords: active surveillance; construction; injury prevention; musculoskeletal disorder; nail guns; occupational injury; residential carpentry; sequential trigger.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Construction Industry / instrumentation*
  • Construction Industry / statistics & numerical data
  • Equipment Design / adverse effects
  • Humans
  • Midwestern United States / epidemiology
  • Musculoskeletal Diseases / epidemiology*
  • Musculoskeletal Diseases / etiology
  • Occupational Health
  • Occupational Injuries / epidemiology*
  • Occupational Injuries / prevention & control
  • Population Surveillance*
  • Risk Factors
  • Surveys and Questionnaires
  • Wounds, Penetrating / epidemiology*
  • Wounds, Penetrating / prevention & control