Lipscomb Hester J, Dement John M, Nolan James, Patterson Dennis
Department of Community and Family Medicine, Division of Occupational and Environmental Medicine, Duke University Medical Center, Durham, NC 27710, USA.
Am J Ind Med. 2006 Jul;49(7):505-13. doi: 10.1002/ajim.20325.
Nail guns increase residential construction productivity but their use is associated with risk of injury.
Active surveillance data from 772 apprentice carpenters were used to document the injury risk associated with the use of nail guns and the potential impact of modifiable risk factors. Using reported work hours and nail gun injuries injury rates per 200,000 hr worked in the past year were calculated. Using estimates of hours of tool use, Poisson regression was used to calculate adjusted rate ratios for injury associated with time in the trade, trigger mechanism on the tools and training prior to injury.
Forty-five percent of these apprentices had sustained a nail gun injury; injury rates in the past year based on hours of work were considerably higher than previously recognized. Those with less than 1 year in the trade compared to those with more than 5 years experience (RR = 2.7; 95% CI 1.2, 5.9) and those with no training in tool use (RR = 2.9; 95% CI 1.9, 4.4) were at greatest risk. After adjusting for experience and training, the rate of injury was twice as high with tools with a contact trip trigger compared to those with a sequential trigger (RR = 2.0; 95% CI 1.2, 3.3).
Preventive measures should include change to the safer sequential trigger that prevents unintentional firing and early training in safe tool use. Because of the high prevalence of use of tools with contact trip triggers the greatest number of injuries among these apprentices could be prevented with an engineering solution.
射钉枪提高了住宅建筑的生产率，但使用射钉枪存在受伤风险。
利用来自772名木工学徒的主动监测数据，记录与使用射钉枪相关的受伤风险以及可改变风险因素的潜在影响。根据报告的工作时长和射钉枪受伤情况，计算过去一年每20万工作小时的受伤率。利用工具使用时长的估计值，采用泊松回归计算与行业工作时间、工具触发机制以及受伤前培训相关的受伤调整率比。
这些学徒中有45%曾遭受射钉枪伤害；根据工作时长计算的过去一年受伤率远高于此前的认知。从业不到1年的人与从业超过5年的人相比（相对危险度=2.7；95%可信区间1.2，5.9），以及未接受工具使用培训的人（相对危险度=2.9；95%可信区间1.9，4.4）受伤风险最高。在对经验和培训进行调整后，与采用顺序触发装置的工具相比，采用接触式触发装置的工具受伤率高出一倍（相对危险度=2.0；95%可信区间1.2，3.3）。
预防措施应包括更换为更安全的顺序触发装置以防止意外发射，并尽早进行安全工具使用培训。由于使用接触式触发装置的工具非常普遍，通过工程解决方案可预防这些学徒中最大数量的伤害。
