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The young man had been wheeled into Najma Ahmed's emergency room with a bloody, penetrating wound to the chest. Whatever was inside had pierced his left lung dangerously close to the heart. His sternum was also fractured.

"It looked like a bullet wound," said Dr. Ahmed, assistant trauma director at St. Michael's Hospital in Toronto. But it wasn't a bullet. It was a nail. It turns out that the man and a buddy had been playing around with a nail gun, and a 2½-inch stud had been fired accidentally into his torso.

Although the incident seems extreme, Dr. Ahmed said the trauma unit in recent years has been seeing more and more nail-gun injuries among do-it-yourselfers.

DIY enthusiasts are arming themselves with widely available power tools for home-renovation projects.

The trend in Canadian ERs is consistent with a U.S. study published yesterday showing that the annual rate of nail-gun injuries to consumers treated in U.S. hospital emergency rooms has soared in the past 15 years.

The Centers for Disease Control and Prevention report found that of 37,000 nail-gun injuries that occur annually on average, about 40 per cent of the victims were consumers. In fact, injuries to consumers shot up by about 200 per cent since 1991, while injuries to workers remained stable. Comparable Canadian figures aren't available.

Hester Lipscomb, an epidemiologist at Duke University in North Carolina and lead author of the study, said the actual number of injuries is probably much higher, as less severe injuries to the hands and fingers are not treated in emergency departments.

"I don't think it's that the tool is more dangerous right now than it has been, but it's just that these tools are so easily available. I mean, I can walk into a home-improvement store tonight on my way home and buy one and go use it."

Dr. Lipscomb said that just like a revolver that shoots bullets, nail guns should never be pointed at oneself or at others. They can shoot a three-inch nail into a dense piece of wood "in a split second."

The study showed that injuries to upper extremities, primarily the hands and fingers, were the most common, accounting for 75 per cent of injuries to consumers and 66 per cent to professional workers.

About 6 per cent of the ER patients were admitted for their injuries, which included nails embedded in the trunk, head, joints or bones; fractures from penetrated nails, and infections from untreated punctures.

"Some of them are really devastating injuries of people getting shot in the head or the face or the heart," Dr. Lipscomb said. "The thing that concerns me is that they're often portrayed as a rare event, as an accident, like they happened randomly. But they're not."

Dr. Ahmed at St. Michael's Hospital said the high velocity at which the nails are shot makes for some nasty injuries.

"They do a lot of tissue damage and they cause a very severe piercing," she said. In the hands, the force of the shot can easily fracture bones in the fingers and wrist. If they're shot into the chest, they can be lethal.

The number of injuries tends to be higher in the summer months. "I think it's related to the issue that more and more of us are doing home repairs, and to the whole growth industry in home improvements," she said.

"We can buy these very powerful, very lethal tools, and we are not educated in their safety."

Nick Cowling, a spokesman for Home Depot Canada, said more nail guns are being purchased in Canada as the do-it-yourself phenomenon continues to grow. They cost as little as $30.

"It's a lot easier than hammering a bunch of nails, so people are buying them a lot more."

But like any power tool, he stressed, "the No. 1 thing is you have to respect the tool. They're meant to go through everything -- metal, wood. And flesh isn't that strong."

Often, he said, more experienced do-it-yourselfers wanting to do the job faster will jam the front of the tool so it doesn't have to recoil after shooting each nail.

"Think about it," Mr. Cowling said. "You're holding the trim with one hand and you're holding the tool with the other. . . . You don't want your hands getting too close."

NAIL GUN INJURIES

Number of nail-gun injuries treated in hospital emergency departments, by body part, United States, 2005.

Consumers

Upper extremities: Includes lower and upper arm, elbow: 1,100

Hands/fingers: 8,900

Lower extremities: Includes ankles, feet and toes, lower and upper leg: 2,300

Other: *

Workers

Upper extremities: Includes lower and upper arm, elbow: 2,200

Hands/fingers: 16,600

Lower extremities: Includes ankles, feet and toes, lower and upper leg: 6,900

Other: 2,800

*Number does not meet minimum surveillance reporting requirements

SOURCE: U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES