Bathroom Breaks

Although workers may assume that they will have access to bathrooms at work, many workers in a wide range of industries and occupations say they cannot take the bathroom breaks they need while working.^1-6

Insufficient bathroom breaks are an important health and safety consideration for many jobs, such as those involving patient care or specific production schedules.^4,7 Pregnant workers, older workers, and workers with certain medical conditions might also need to use the bathroom more often than other workers.^1,8 According to workers, some reasons they have too few bathroom breaks at work include inadequate staffing, not enough breaks, breaks that are too short, no nearby bathrooms, too few bathrooms at work, bathroom uncleanliness, or fear of harassment or fear for their safety when using bathrooms.^1,4-6,9

When people get too few bathroom breaks, they may be at risk for urinary tract infections and incontinence, as well as other bladder, bowel, and kidney problems.^10,11 Limited bathroom access may make it difficult for people with certain chronic diseases to take medications that may result in the need to use the bathroom more often.⁸ Research shows that holding a full bladder makes people hurry through their work and pay less attention — meaning that workers distracted by a full bladder may be more likely to injure themselves or others.^12,13

Without regular bathroom breaks, workers cannot perform necessary biologic functions. Some workers have reported wetting their clothes in front of coworkers, bosses, or customers because they did not get enough bathroom breaks.^1,6,14

Workers in many types of jobs may not get the bathroom breaks they need.

• Teachers often cannot leave their students unsupervised to take a bathroom break. An Iowa survey found that half of teachers avoided drinking water or other beverages to enable them to last longer without using the bathroom.³
• One in three poultry processing workers in Minnesota said they get no bathroom breaks in an average week, according to a 2016 survey by the Greater Minnesota Worker Center.¹⁵ Poultry processing workers without bathroom access commonly avoid drinking during the workday, wear diapers to work, or wet themselves.¹
• Bus operators often have no bathrooms on their routes. According to a 2018 survey by the Amalgamated Transit Union, 68% of Connecticut bus operators avoid drinking or eating to cope with restricted bathroom access, and 1 in 4 had soiled themselves at work because they could not get to a bathroom. The union also expressed concern that drivers distracted by a full bladder could pose a hazard on the road.¹⁴
• Taxi drivers may have voiding problems, urinary tract infections, and kidney stones caused by infrequent bathroom use during the workday, as reported by urologists in New York.¹⁶ Although some taxi drivers have access to taxi relief stations, ride-sourcing drivers and other drivers for hire do not, and often have trouble finding public bathrooms to use.¹⁷
• Nurses report bladder symptoms that might be the result of delaying bathroom use at work. Nurses said they delayed using the bathroom because of patient demands, too few women’s bathrooms for the number of women in the workplace, and long distances to the bathroom.⁴

Federal standards “require employers to make toilet facilities available so that employees can use them when they need to. The employer may not impose unreasonable restrictions on employee use of the facilities.”¹⁰ The Americans with Disabilities Act may also apply to workers who need accommodations, such as more frequent bathroom breaks, because of a medical condition; other laws may cover pregnant workers.^18,19

Despite these protections, many workers say they cannot use the bathroom when they need to.^1-4 Health and safety inspectors do not routinely ask about bathroom breaks and workers may be afraid to report lack of bathroom access to inspectors. These issues are potential reasons why bathroom access regulations are rarely enforced.²

Meat and poultry processing workers interviewed for a 2017 U.S. Government Accountability Office report said that their requests to use the bathroom at work were routinely denied.² According to the report, “One industry representative told us they believe some supervisors in meat and poultry plants deny bathroom access in order to maximize production output.”

How can employers help workers get the bathroom breaks they need?

• Follow federal and state legislation allowing for bathroom breaks at work, such as those from the U.S. Occupational Safety and Health Administration (OSHA).
• Work with employee groups or unions to find solutions to problems with bathroom access in the workplace.
• Schedule adequate rest breaks throughout the workday.
• Stagger breaks to avoid all workers using the bathroom at the same time.
• Make breaks long enough for workers to not only use the bathroom, but also walk to and from the bathroom at a safe speed—rushing through the workplace, hurrying when taking off or putting on equipment, or skipping proper handwashing can cause injury or illness.

What can workers do if they get too few bathroom breaks?

• Discuss improving bathroom breaks with their company, union, or worker representative.
• Contact their state health department or OSHA for more information about bathroom access requirements in their workplace and to learn how to file a report if bathroom breaks are being denied.

Researchers are continuing to study barriers to bathroom access at work and how restricted bathroom access can affect bladder health and work productivity. Organizations like the National Academies of Sciences and the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium are working on these topics.^11,20 We encourage researchers to join them in asking questions about bathroom breaks, evaluating employers’ efforts to improve bathroom access, and publishing their results.

The NIOSH Health Hazard Evaluation (HHE) Program helps employees, union officials, and employers learn whether health hazards are present at their workplace and recommends ways to reduce hazards and prevent work-related illness, including health problems resulting from restricted bathroom access. Learn more about the HHE program and how to request an evaluation here.

What solutions do you have at your workplace to ensure that workers can use the bathroom when they need to? Tell us in the comments below.

Candice Johnson, PhD, is an epidemiologist in the NIOSH Division of Field Studies and Engineering.

Cammie Chaumont Menendez, PhD, is an epidemiologist in the NIOSH Division of Safety Research.

Doug Trout, MD, MHS, is Chief of the Hazard Evaluations and Technical Assistance Branch and leads the Health Hazard Evaluation program in the NIOSH Division of Field Studies and Engineering.  

This blog has been translated into Spanish.

References

1. Oxfam America. No relief: denial of bathroom breaks in the poultry industry. Boston, 2016.
2. U.S. Government Accountability Office. Better outreach, collaboration, and information needed to help protect workers at meat and poultry plants. 2017.
3. Nygaard I, Linder M. Thirst at work — an occupational hazard? Int Urogynecol J Pelvic Floor Dysfunct 1997;8(6):340-343.
4. Pierce H, Perry L, Gallagher R, Chiarelli P. Culture, teams, and organizations: A qualitative exploration of female nurses’ and midwives’ experiences of urinary symptoms at work. J Adv Nurs 2019;75(6):1284-1295.
5. Linder M, Nygaard I. Void where prohibited: rest breaks and the right to urinate on company time. Ithaca, NY: Cornell University Press, 1998.
6. Linder M. Void where prohibited revisited: the trickle-down effect of OSHA’s at-will bathroom-break regulation. Iowa City, Iowa: Fanpihua Press, 2003.
7. Linder M. You’ve got the right to go when you gotta go. Labor Notes 2003;August:11-12.
8. Amalgamated Transit Union. Transit operator bathroom breaks: a matter of human dignity and respect. https://www.atu.org/action/bathroom-breaks. 2019.
9. Occupational Safety and Health Administration. A guide to restroom access for transgender workers. https://www.osha.gov/Publications/OSHA3795.pdf. 2015.
10. Occupational Safety and Health Administration. 29 CFR 1910.141(c)(1)(i) Toilet Facilities: OSHA Letter of Interpretation (April 6, 1998). https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=interpretations&p_id=22932. 1998.
11. Markland A, Chu H, Epperson CN, Nodora J, Shoham D, Smith A, Sutcliffe S, Townsend M, Zhou J, Bavendam T, Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium. Occupation and lower urinary tract symptoms in women: a rapid review and meta-analysis from the PLUS research consortium. Neurourol Urodyn 2018;37(8):2881-2892.
12. Lewis MS, Snyder PJ, Pietrzak RH, Darby D, Feldman RA, Maruff P. The effect of acute increase in urge to void on cognitive function in healthy adults. Neurourol Urodyn 2011;30(1):183-7.
13. Jousse M, Verollet D, Guinet-Lacoste A, Le Breton F, Auclair L, Sheikh Ismael S, Amarenco G. Need to void and attentional process interrelationships. BJU Int 2013;112(4):E351-7.
14. Amalgamated Transit Union. Letter to Connecticut Department of Transportation Commissioner James P. Redeker. https://www.atu.org/atu-pdfs/JPRedeker-CDOT-10-15-18.pdf. 2018.
15. Greater Minnesota Worker Center Organizing Committee. Striving for a just and safer workplace: Central Minnesota’s poultry industry and its disposable workers. http://www.mygmwc.org/wp-content/uploads/2016/04/Striving-for-a-Just-and-Safer-Workplace-Final-04262016.pdf. 2016.
16. Mass AY, Goldfarb DS, Shah O. Taxi cab syndrome: a review of the extensive genitourinary pathology experienced by taxi cab drivers and what we can do to help. Rev Urol 2014;16(3):99-104.
17. Glaser A. “I’m pretty sure that I’m losing money at the end of the day”: two Uber and Lyft drivers explain why they went on strike. https://slate.com/technology/2019/03/uber-lyft-strike-ipo-los-angeles-san-francisco.html. 2019.
18. Washington State Office of the Attorney General. Pregnancy accommodations. https://www.atg.wa.gov/pregnancy-accommodations. 2017.
19. U.S. Equal Employment Opportunity Commission. Enforcement guidance: reasonable accommodation and undue hardship under the Americans with Disabilities Act. https://www.eeoc.gov/policy/docs/accommodation.html. 2002.
20. Transportation Research Board. Improving the safety, health, and productivity of transit operators through adequate restroom access. https://apps.trb.org/cmsfeed/TRBNetProjectDisplay.asp?ProjectID=4119. 2017.