** PRESS RELEASE **

November 1, 2007 
American Restroom Association identifies restroom availability as key U.S. public health issue

October 1, 2007 
Association calls on U.S. Department of Health and Human Services to fix public health policy

Power Point Presentation

FEDERAL PUBLIC RESTROOM REQUIREMENTS INITIATIVE

A CALL TO ACTION

PROBLEM

The U.S. Occupational Safety & Health Administration provides the necessary regulations to ensure that people in the work place will not suffer the adverse health effects that can result if toilets are not available(1) when needed.  The agency mandated to protect the public's health outside of the work place,  the Department of Health and Human Services, provides no similar regulation or even guidance. 

This lack of federal recognition makes it easy for:

• schools not to allow students to use the lavatories

• municipalities to close public restrooms

• transits systems to put their amenities off limits to passengers 

• airlines to deny passengers use of toilets throughout certain flights 
  

SOLUTION

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)

Since DHHS has the mandate to protect the health of all Americans, ARA requests that federal legislators take the necessary action to require DHHS to address their omission of the public health requirement for toilet facilities, at least the degree it has been addressed by OHSA.   We are NOT asking for new legislation, only that an existing mandate be met.

(1) http://osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPRETATIONS&p_id=22932 
(2) http://osha.gov/oshinfo/mission.html  
(3) http://www.hhs.gov/about/whatwedo.html/    

HEALTH IMPACT ON OTHERS  - 

Health impact to others when someone voids in locations not designed for sanitation. 
Ex: Transit station stairwells, doorways, school room trash receptacles 

Likely Agency -  DHHS's Center for Disease Control's (CDC) National Center for Infectious Diseases

COST ANALYSES

At the national level, heath codes typically reduce cost.  At the local level the scope of impact will vary.

Regulation preventing a school principal from punishing children by not allowing them to use the restroom may actually have a positive cost impact.  When proper toilet facilities are denied,  locations not design for sanitation are utilized.  Soiled stairwells and waste paper baskets are more expensive to clean then facilities designed for sanitation.

Existing State Building Codes require buildings to have the sufficient toilet facilities for all legitimate occupants of a building.   Legislation that would preclude 'restrooms are for employees only' would not require new fixtures but cleaning costs would be increased.   Most likely there will be not increase to business overall since people away from home must go somewhere.   

DISCUSSION POINTS
 

ADVOCACY APPROACH 

The Dept of Health & Human Services has a legislative mandate to protect the public health and the Dept of Labor has documented that 'holding it' too long impacts ones health. Nudging Congress to take action, while still a challenge, will likely be significantly easier  then getting new legislation.  We're our advocating for more complete implementation of existing legislation.  A few congressman asking in concert, or perhaps even just one, could get DHHS to better address the issue.

If DHHS had a clear-cut statement that forcing people to 'hold it' has a negative impact on their health it would help in almost every aspect of ARA's goals. While school restrooms are outside ARA scope, a clear DHHS mandate on the subject would provide much more power to those challenging school principals even if the schools were outside the scope of the Federal  mandate. 

Now, few people, including apparently some school principals, seem to understand there are health implications when people are forced to 'hold it' when they have an urgent need to void.