Public Access to Restrooms in the United States: The Failure of Federal Regulatory
Oversight and a Call to Action
American Restroom Association’s Federal Public Restroom Requirements Initiative: A
Call to Action
Abstract
Public restrooms in the United States are disappearing. The lack of clean safe accessible public restrooms can ultimately be traced to policy gaps at the national, or federal, level.
The federal Department of Labor regulates workplace restrooms throughout the individual states through the U.S. Occupational Safety & Health Administration, or OSHA. OSHA provides the necessary regulations to ensure that employees will not suffer the adverse health effects that can result if toilets are not available when needed.
The United States Department of Health and Human Services (HHS) is agency mandated to protect the health of the general public beyond the workplace. This federal agency is silent on the health benefits of restrooms nor on the threat to health if facilities are not available.
This lack of federal recognition makes it easy for
 public schools to prevent students from using the lavatories
 municipalities to close public restrooms
 transit systems to put their amenities off limits to passengers
 airlines to deny passengers use of toilets throughout certain flights
Since HHS has the mandate to protect the health of all Americans, the American Restroom
Association is launching a call to action. The group is calling on Congressional legislators to insist that HHS pay attention to the public health imperatives as they relate to toilet facilities.
HHS must address their omission at least to the degree it has been addressed by OHSA. The
ARA is NOT asking for new legislation, only that an existing mandate be met.
The paper references numerous case studies where the basic human right of restroom access has been denied. It proposes specific steps for public education and legislative advocacy and refers readers to basic tools for action.
Background: The Federal System of Governance
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[Brief intro for general readers and introduction of terminology.]
US Constitution Branches of Government
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Federal government and state governments
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Illustration / Oraganogram showing relationship among DOL, HHS, and DOJ.
Health and Human Services
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Huge agency with a budget larger than a majority of the other federal departments combined - FY07 budget $698 billion.
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Administers Medicare health insurance for 1 in 4 Americans in collaboration with the
Social Security Administration
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Funds programs of state and local governments, either directly or though grants to private sector organizations.
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Operates important agencies such as the National Institutes for Health, the Centers for
Disease Control, and Food and Drug Administration.
Department of Labor

The Department of Labor fosters and promotes the welfare of the job seekers, wage earners, and retirees of the United States by improving their working conditions, advancing their opportunities for profitable employment, protecting their retirement and health care benefits, helping employers find workers, strengthening free collective bargaining, and tracking changes in employment, prices, and other national economic measurements. In carrying out this mission, the Department administers a variety of
Federal labor laws including those that guarantee workers’ rights to safe and healthful working conditions; a minimum hourly wage and overtime pay; freedom from employment discrimination; unemployment insurance; and other income support.
The Department of Labor administers a number of programs including OSHA.
The Occupational Safety and Health (OSH) Act is administered by the Occupational
Safety and Health Administration (OSHA) . Safety and health conditions in most private industries are regulated by OSHA or OSHA-approved state programs, which also cover public sector employers. Employers covered by the OSH Act must comply with the regulations and the safety and health standards promulgated by OSHA. Employers also have a general duty under the OSH Act to provide their employees with work and a workplace free from recognized, serious hazards. OSHA enforces the Act through workplace inspections and investigations. Compliance assistance and other cooperative programs are also available.
Department of Justice
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What it is
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How they enforce regulations
The Problem: The Policy and Regulatory Gap and the Pubic Restroom Crisis
Elaborate on the following…?
The mission of the Department of Labor's (DOL) Occupational Safety & Health
Administration (OSHA) is to assure the safety and health of America's workers.(2) Per its mission, OHSA recognized that a person's health is jeopardized when they are not able to use the toilet. OSHA promulgated 29 CFR 1910.141(c)(1)(i): Toilet Facilities "...which requires employers to provide their employees with toilet facilities so that they will not suffer the adverse health effects that can result if toilets are not available..." (1)
Unfortunately, the authority of the Department of Labor does extend beyond the workplace.
The Agency that DOES have the authority to address the adverse health effects that can result if toilets are not available is the Department of Health and Human Services (DHHS). DHHS is the principal agency of the United States Government for protecting the health of all Americans. (3)
There appear to be no DHHS regulations or guidance-based recognition that lack of access to restrooms is a serious health issue. This is ironic since the DOL used research published by the
National Institutes of Health, a DHHS agency for conducting medical research, as support for their Code of Federal Regulation (A CFR is federal law that is enforceable by the Justice
Department)
Situation Analysis
Closure of public restrooms by local governments
Denial of school restroom access
Transit systems to put their amenities that forbid passengers to

Policies of commercial airlines that deny passengers use of toilets
Special Issues? autism
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The ADA?
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Disabled citizens and caregivers
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Family restrooms
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Aging American and restroom need
The Health Benefits of Restrooms: The Clinical View JUST USE OHSA
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Summarize ailments citing medical literature
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Physician co author?
Public restrooms serve the “restroom challenged”. The American Restroom Association uses the term “restroom challenged” to refer to two types of people. First are those who have to go frequently; this is defined as every hour or so. Second are those for whom the need to go comes suddenly and urgently.
The Health Benefits of Restrooms: A Wellness Perspective
Adverse health effects may result from voluntary urinary retention .
Mental health suffers when people want to be out and about with their families but cannot because of the lack of restrooms.
Most of us are “restroom challenged” at some time in our normal lives .
The “restroom challenged” also include people with normal or temporary conditions: pregnancy, young age, old age etc. They also include people with a wide range of medical conditions, which are usually invisible. The “restroom challenged” make up a large and somewhat silent segment of the society.
Public access to restrooms can promote both physical fitness and public safety. One of the attractions of private gyms is access to facilities. Putting restrooms outside in public areas can promote fitness while re-animating public areas and providing safetyenhancing “eyes” on the street.
Restrooms in transit centers help people out of cars and onto mass transit. Access to convenient
Restrooms is a factor in converting people to mass transit. Some walkers and bicycle commuters need to map amenities along the way; if they are not available, they will drive.
Public restrooms help revitalize downtown neighborhoods. People are comfortable strolling in downtown when there are public facilities. For visitors to a neighborhood or to an establishment, the restroom is often the place where first and lasting impressions are made. Therefore, restrooms play a role in physical and mental health and well-being.
A Call to Action
Sort of a formal statement which focuses the advocacy campaign
Tools for Advocates
A list of suggested actions plus reference to online references and
Sources, Resources and Tools
(1) http://osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPRETATIONS&p_id=2293
2
(2) http://osha.gov/oshinfo/mission.html
(3) http://www.hhs.gov/about/whatwedo.html/

Glossary
American Restroom Association
Code of Federal Regulations (CFR) The codification of the general and permanent rules and regulations that are enforceable by the United States Department of Justice.
Department of Health and Human Services (HHS) A cabinet-level agency of the executive branch of the United States government.
Department of Labor (DOL) A cabinet-level agency of the executive branch of the United
States federal government.
National Institutes of Health (NIH) A large medical research body and part of the Department of
Health and Human Services,
Occupational Safety and Health Administration (OSHA) DIvision of the Department of Labor with the authority to enforce the Occupational Safety and Health Act.
Public restroom
Public access to restrooms
Public Restroom Initiative