Make a ranking of high-risk occupations, and the job of circulation-desk clerk at Phoenix Public Library would surely fall very low on the list. Aside from the occasional paper cut, the off chance of dropping a book on the foot and the potential threat of asphyxiation from gamey odors wafting through the building during the high-traffic summer months, what industrial mishap could possibly befall these tireless toilers of the tomes?

Try a rubber due-date stamp. That's the unlikely occupational hazard that's being held responsible for carpal tunnel syndrome, tendinitis and other wrist-trauma disorders that have reportedly plagued circulation-desk clerks at the library's central location in recent years.

It's also the same instrument of destruction responsible for a new library policy. In an effort to save wear and tear on staffers' wrists, book-borrowers are now required to stamp their own due dates on material they've just checked out.

Sound silly? To anyone who's never suffered from a repetitive-motion injury, it almost certainly does.

"You've got to be kidding!" stammers one longtime librarygoer, echoing what is a common reaction to the faddish recogniotion of carpal tunnel syndrome and related injuries. "If I wanted to stamp books, I'd have become a librarian!"
But Charles C. Keever, safety analyst for the city's Parks, Recreation and Library Department, argues that health benefits to library employees far outweigh whatever small inconveniences the new system may cause patrons. (Circulation clerks will continue to "wand" bar codes and desensitize security strips.)

"I realize that stamping a library book doesn't sound like a lot of physical exertion," explains Keever, who recommended the "U-Stamp" program after researching how other libraries across the country were handling growing numbers of work-related injuries. "But imagine doing that same motion hundreds of times a day, year after year.

"That's why they call this an accumulative trauma disorder; the problem builds up over the years." The library's problem with repetitive stress injuries first came to Keever's attention a year ago, when more than a half-dozen circulation-desk staffers were treated for hand- and wrist-related injuries. According to Keever, the injuries (which include pain, tingling and numbness in the hands and wrists, and, in some severe cases, difficulty in performing even simple manual tasks) were attributed to performing the same hand movements over and over for hours on end, irritating tendons and nerves. Today, stamp-your-own books. Tomorrow, flip-your-own Big Macs?

Probably not. But according to the owner and president of a Tempe consulting firm that troubleshoots potential physiological health hazards in work environments, virtually no field of employment is immune to the glut of complaints about work-related aches and pains American business has witnessed in the past several years. Bryson Meineke, owner and president of Ergonomiks, traces the new awareness of repetitive-motion injuries to 1990, when health problems of workers in meat-and-poultry processing plants received wide media coverage.

"The health environment has changed," he says. "The reality of personal well-being has changed."
In the past, some of the jobs now associated with repetitive motion and cumulative trauma didn't even exist. "Thirty years ago, people weren't sitting at a computer terminal for eight hours," explains Meineke. And what about the practitioners of those jobs--say, library desk clerk--that haven't changed all that much over the years? Why weren't they suffering like their present-day counterparts?

"Maybe they were," counters Meineke. "Thirty years ago, problems like these weren't receiving the same publicity they are today. And they were handled differently--if someone complained, they'd probably hear something like, 'What's the problem? You weak?'" In the case of the central library (which currently employs the equivalent of 47 full-time clerks, circulating more than 5.8 million books last year), the problem appears to be volume. The average clerk stamped in excess of 120,000 books annually. Assuming that each of those high-impact transactions involved first hitting the stamper on the stamp pad, then stamping the date-due slip, the clerk had, in essence, pounded his or her fist on a desk almost a quarter-million times over the course of a year.

Investigating solutions to the problem, Keever discovered that Phoenix was one of the last major library systems in the country still requiring its employees to stamp books manually. In most other cities, clerks now insert date-due slips into books, issue itemized date-due receipts or give patrons the option of stamping books themselves.

Ironically, the Phoenix library had used date-due slips for years and didn't even switch to manual book-stamping until several years ago--a switch variously attributed to ecological consciousness, cost-saving measures and/or librarygoers' dissatisfaction. Keever claims it's too early to draw any conclusions from Phoenix's "U-Stamp" program, still less than two weeks old. (So far, so good," reports one circulation-desk staffer during her first shift under the new policy. "I've been here 45 minutes, and no one's tried to shoot me yet.") But Glendale librarians give high marks to a similar stamp-'em-yourself program that's been in effect in that city's libraries for 18 months. The policy was instituted after a circulation-desk employee developed carpal tunnel problems so severe that multiple wrist surgeries forced her to leave the job.

"I was able to see a difference right after we made the change," says Su Westberg, circulation public service supervisor for Glendale's main branch. "Several of our people have problems related to repetitive motion, and in one case it went away; in others it improved. Obviously, you can't eliminate all those motions in the type of job we do, so we chose something that's not an absolute necessity.

"Wanding the book with a light pen is a necessity if you're working the desk; stamping a date-due stamp isn't."
Although the new system was an immediate hit with children (high breakage because of overenthusiastic young readers forced the purchase of a cheaper brand of stamper), Westberg initially fielded a number of irate phone calls from older patrons who believed that library employees were simply trying to shirk their duties.

"My response was that there was a problem, and I didn't intend to injure my staff," explains Westberg. "I told them that if workers' compensation is having to pay a claim on one of those injuries, that directly impacts the city's insurance policies, so that directly affects you taxpayers, as well. Overall, though, we didn't encounter nearly as much negativity as we'd anticipated."
Still, Meineke, the ergonomics expert, warns that a self-serve date-due stamper isn't necessarily a miracle cure for a librarian's medical woes.

"You've got to take a look at the whole picture," says Meineke. "Sometimes, what's happening at work is just part of the problem. What are these long-term librarians doing when they get home?"
Last year, Meineke received a surprising answer to that question, when his company conducted a study for the Scottsdale Public Library system. Puzzled that one employee was suffering from carpal tunnel syndrome in spite of a work station that evidently posed no physical challenge, someone asked the woman how she spent her off-duty hours.

"It turns out that she wired bird cages for a hobby," says Meineke. "She'd take wire and needle-nosed pliers and weave the wire through the bars and bend it. Every night when she got home, this is what she'd do for four hours."
Says Meineke, "This was the same motion we were trying to avoid in her work station.

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