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Suggested Citation:"Summary." National Academies of Sciences, Engineering, and Medicine. 2020. Improving the Safety, Health, and Productivity of Transit Operators Through Adequate Restroom Access. Washington, DC: The National Academies Press. doi: 10.17226/25960.
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Page 1
Page 2
Suggested Citation:"Summary." National Academies of Sciences, Engineering, and Medicine. 2020. Improving the Safety, Health, and Productivity of Transit Operators Through Adequate Restroom Access. Washington, DC: The National Academies Press. doi: 10.17226/25960.
×
Page 2
Page 3
Suggested Citation:"Summary." National Academies of Sciences, Engineering, and Medicine. 2020. Improving the Safety, Health, and Productivity of Transit Operators Through Adequate Restroom Access. Washington, DC: The National Academies Press. doi: 10.17226/25960.
×
Page 3
Page 4
Suggested Citation:"Summary." National Academies of Sciences, Engineering, and Medicine. 2020. Improving the Safety, Health, and Productivity of Transit Operators Through Adequate Restroom Access. Washington, DC: The National Academies Press. doi: 10.17226/25960.
×
Page 4
Page 5
Suggested Citation:"Summary." National Academies of Sciences, Engineering, and Medicine. 2020. Improving the Safety, Health, and Productivity of Transit Operators Through Adequate Restroom Access. Washington, DC: The National Academies Press. doi: 10.17226/25960.
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Page 5

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1 Introduction Employers in all industries must provide restroom access for their employees. Federal Occupational Safety and Health Administration (OSHA) regulations and practices define conditions and time limits for reasonable access that apply to mobile as well as fixed work- forces. Vehicle operators in the public transit industry and their employers face significant barriers, as multiple infrastructure limitations and service demands make adequate and timely restroom access hard to achieve. Many transit agencies are trying to establish policies and practices that support employee health and comfort, but there is still some distance to go. It is clear that the safety, health, and productivity of vehicle operators are keystones of transit system operations and economic viability as well as of system safety. In recent years, an enhanced industry focus on comprehensive integration of vehicle, passenger, and public safety, including the safety management system (SMS) approach, highlights the important influence of transit vehicle operator health, wellness, and morale. Bus operators around the United States and Canada have identified access to safe and clean restrooms as a major concern that affects their health, stress levels, and job satisfaction (Kessler and Gonzales 2014). As a mobile workforce providing tightly scheduled service, transit employees encounter barriers to using toilet facilities when they need them. Schedule demands and route design can impede restroom access even between runs, and facilities are not always adequate at terminal locations. Access is even more challenging for unscheduled restroom stops on the road. Transit vehicle operators have reported distress, anger, fear, and humiliation when unable to get to clean, safe facilities in a timely way (Kessler and Gonzales 2014). Similar problems have been described for taxi drivers, where the possible health effects include significant urological disorders (Burgel et al. 2012, Mass et al. 2014, Pérez and Dang 2008). Transit vehicle operators also believe they experience these health problem, so fear of future illness is added to the stress of having to hold while driving. Transit Stakeholders Take Restroom Access Seriously Around the United States and Canada, both transit agencies and the unions representing operators have recognized the serious impact of limited restroom access and begun to negotiate ways to address this problem. As early as 2009, TCRP Report 135: Controlling System Costs: Basic and Advanced Scheduling Manuals and Contemporary Issues in Transit Scheduling (Boyle et al. 2009) emphasized the importance of this issue for planners and schedulers. The 2015 Fixing America’s Surface Transportation Act (FAST) called for the S U M M A R Y Improving the Safety, Health, and Productivity of Transit Operators Through Adequate Restroom Access

2 Improving the Safety, Health, and Productivity of Transit Operators Through Adequate Restroom Access Secretary of Transportation to review industry standards related to scheduling fixed-route rail and bus service with adequate time and access for operators to use restroom facilities; no relevant standards were identified (Staes 2017). The National Institute for Occupational Safety and Health (NIOSH) has convened a group to study the potential impacts of limited restroom use on workplace health and safety, and transit vehicle operators were included in the recent blog on the subject as a workforce at risk of health problems and distraction (Johnson et al. 2019). TCRP Project F-25, “Improving the Safety, Health, and Productivity of Transit Operators Through Adequate Restroom Access,” followed up on these initiatives and recommenda- tions by investigating the range of approaches being taken by transit agencies. The project was designed to identify how operator restroom access affects vehicle operator health, service delivery, and costs in public transit agencies. The project team consisted of a researcher on transit workplace health and safety, the director and staff of a transit transportation management and operations firm, a work environment researcher, a transit operations researcher, and a urologist. Hundreds of transit agency staff people, industry experts, and several government economists and health researchers provided information, materials, and guidance. With this background, the project team explored current practices, policies, and limitations at more than 100 transit agencies across the United States and Canada. Restroom Access Is a Concern Across the Public Transit Industry What Is Going On? The results described in this report show a wide variation among transit agencies in the extent of problems related to restroom access and in the impact and the appropriate responses specific to each location. Given these findings, a customized approach to applying recommendations and using tools is essential; insisting on a single best solution would be unrealistic. Clearly, there is no one-size-fits-all approach to improving restroom access. At the same time, the concerns about restroom access discussed by the project sources and illustrated in campaigns and initiatives around the world are remarkably similar to those raised in the United States and Canada (Asian News International 2014, Leedham 2019, Paas and Hanley 2019, Unite the Union 2019). The industry experts who were interviewed all reported that restroom access is a problem that is pervasive and not well addressed around the world. This opinion was expressed most strongly by those with the longest experience in transit management. They also affirmed that restroom access is a human dignity issue and a basic right. In general, the industry experts felt that restroom access is at most rolled in to layover, recovery, or break time considerations during planning and scheduling. They focused on three areas that are most affected by restroom access needs: route planning and scheduling (done manually or using software), operations (service delivery, recovery, and break times), and work organization (policies, discipline). The industry experts had not encountered much concern about restroom access as a health issue, with the exception of the labor experts. For union representatives and their members, health was one of the most important aspects. The biggest barrier to improving restroom access was the anticipated cost for the transit agencies. One industry expert warned that concern about the potential financial implica- tions could be a major block to the adoption of otherwise sensible practices. At the great majority of respondent locations, transit agency practices usually supported bus operators in making unscheduled stops and using restrooms before and after runs and

Summary 3 at hubs; however, practices did not always match policies. Two primary types of issues were experienced: (1) restroom facilities at regularly scheduled locations were often not adequate or even available and (2) unscheduled restroom use was limited by schedule pressure and other factors. Overall, transit operators had the most trouble finding restroom facilities at ends of lines that were not associated with a transit property or with a large commercial location such as a mall. Smaller transit hubs and transfer points also posed problems, as did systems in which the main transit facilities closed before the end of bus service. Who Is Affected? Because of the size of the bus operator workforce, transit agencies have paid the most concerted attention to bus operators’ experience and less to that of fixed rail operators or paratransit. It may also be in part because bus operators are known to be at increased risk for metabolic syndrome and related diseases, to which stress and the physical demands of work are likely to contribute. However, train operators, conductors and paratransit drivers are also affected, and most of the project’s recommendations and tools can be applied to all vehicle operators. Access to restrooms was found overall to be better for fixed guide- way operators than for bus operators because vehicles on fixed guideways typically end in full-service terminals; however, it is harder for those operators to make unscheduled stops. Paratransit operators had more access at layovers than operators of other modes and less access when they had passengers in the vehicle. Other transit employees working alone or far from restroom facilities are also faced with limited restroom access. Employees who are in the field as part of their job duties reported that they often have difficulty finding adequate restroom facilities during early- and late- hour shifts. The transit employees affected, beyond vehicle operators, included bus and station cleaners, controllers and dispatchers, field supervisors, on-board evaluators, and station agents. What Is the Health Impact? A careful review of the literature shows that there are several significant areas where restroom access and operator health are connected. For example, there are reasons that limiting voiding might lead to illnesses such as urinary tract infections. For people with existing health concerns such as irritable bowel syndrome or pregnancy, access may be needed more frequently. The stress reported by vehicle operators could aggravate the impact of operator work demands and increase the risk for hypertension, among others. The distrac- tion of the urge to void might also contribute to vehicle accidents. However, it is not yet possible to establish direct causality. Health problems such as urinary tract infections may be caused or aggravated by limited restroom access, but because they are relatively common and influenced by many factors, it is difficult to show a statistical association. Transit agencies wanted to know just how often vehicle operators need to access rest- rooms. There is no established physiological or health-related time limit. Many people urinate three or four times a day, but that does not mean they can or should wait 6 or 8 hours in between. How long a person can wait after feeling an urge varies. OSHA’s position is that workers must be allowed to access a restroom within 10 minutes of needing one. The agency acknowledges that stopping service is a challenge in transit, but has cited employers who do not achieve this because of inadequate policies or incorrect practices. Assuring restroom access is likely to limit the risks of accidents, stress, and possible health effects and, in turn, improve transit agency safety records and operator turnover. TCRP F-25

4 Improving the Safety, Health, and Productivity of Transit Operators Through Adequate Restroom Access also sets the stage for further research on health outcomes and programmatic interventions that can improve operations policy and efficiency, promote health and prevent illness, and inform medical diagnosis and treatment for vehicle operators. Transit Employers and Unions Are Implementing Good Practices Practical, simple approaches have been adopted but are not in use at all transit agencies. The project identified many effective practices to help transit agencies of all types. Some were established by individuals taking the initiative to improve operations, and some were designed by teams tasked with addressing restroom access in the context of labor relations or even of workplace health violations cited by state labor departments or by OSHA. Following are a few examples of effective practices: • The time committed by self-identified or designated restroom access coordinators ranged from 10% to 100% full-time equivalent. Several large transit agencies employ release-time operators, possible on light duty, to identify and monitor restroom resources. A few agencies have assigned part- or full-time staff. • One operations team purchased a sturdy and comfortable structure with a restroom and crew area to be used while the agency was waiting for permanent restrooms to be constructed. They then moved it to other areas as needed. The saving in dwell time made up for the initial cost. • Many sources described the value of engaging with planners and schedulers early and frequently; these resources often became champions of the restroom issue. • One large transit agency worked with its vendor for planning and scheduling software to create an interface between its restroom access location data set, the access time parameters for scheduling, and information about deficiencies in access for route planning, as well as to generate reports, flag issues, and allow for manual input by users. • The International Transport Workers’ Federation released a charter report that covered the concerns of vehicle operators around the world and made recommendations for basic rights and improved conditions (ITF 2019). Report, Tools, and Resources TCRP Research Report 216: Improving the Safety, Health, and Productivity of Transit Operators Through Adequate Restroom Access describes the state of restroom access in the public transit industry and provides ideas for good practice in addressing specific concerns of transit agencies and vehicle operators. Each chapter covers one of the significant areas identified by the project sources and explains how to use the associated tools: • Chapter 1 establishes the context for developing effective restroom access policy and practice in transit agencies. It reviews the research literature on possible health effects and industry documents relating restroom access to organizational factors, infrastructure, planning, scheduling, and service delivery. • Chapter 2 discusses aspects of work organization related to restroom access, needs that may vary by size, modes and organizational characteristics, and resources that can be leveraged in different situations. It also explains the legal background in the United States and Canada and discusses collective bargaining language. • Chapter 3 defines the infrastructure considerations, including geography, the built envi- ronment, transit service interfaces, and capital planning.

Summary 5 • Chapter 4 walks through the connections between restroom access and route planning and scheduling. It provides ideas from a range of transit agencies about how and when stakeholders can communicate about their needs and interests and reviews the regulatory requirements for restroom access. • Chapter 5 follows up with a review of service delivery impacts and concrete steps to ensure that restroom access policy and practices support both on-time service and operator health and safety. • Chapter 6 finishes by considering approaches to evaluation and cost assessment. The tools developed for TCRP F-25 are available on the summary web page for TCRP Research Report 216 on the TRB website (trb.org). They are as follows: • Transit Operator Restroom Inventory Tools, • Transit Operator Restroom Access Planning Tools, • Transit Operator Restroom Access Cost Estimation Tools, and • Templates for Restroom Access Policies and Boilerplate Contract Language. The last of these tools is also included at the end of this volume. The report also provides an annex of supporting materials—case studies, a catalog of good practices, and a discussion of tools developed for TCRP F-25—and five technical appendixes: • Appendix A: Technical Report on Data Collection and Survey Results, • Appendix B: Summary of Health Literature, • Appendix C: Summary of the Literature on Restroom Access and Transit Operations, • Appendix D: Laws and Regulations About Restroom Access for Transit Vehicle Opera- tors, and • Appendix E: Collective Bargaining Agreement Restroom Language. Appendixes A through D are provided at the end of this report. Appendix E is an Excel file and can be accessed on the report’s summary web page on the TRB website (trb.org). Conclusion The restroom access approaches described in this report appeared to work best when transit agencies assess their own needs and tailor effective solutions. The report includes sections for all major stakeholders to work with directly, but also demonstrates where and how to recognize and accommodate the other contributing divisions whose interests and skills are vital to successful restroom access programs. Addressing restroom-related issues and the corresponding implications for economic, operational, and employee well-being is essential for a safe and successful transit system. As the public transit industry faces ongoing retention problems and a potential transit workforce shortage, initiatives that strengthen the organization’s safety culture may help by attracting employees and keeping operations personnel in the workplace longer (Cronin et al. 2013).

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Around the United States and Canada, both transit agencies and the unions representing operators have recognized the serious impact of limited restroom access and begun to negotiate ways to address this problem.

The TRB Transit Cooperative Research Program's TCRP Research Report 216: Improving the Safety, Health, and Productivity of Transit Operators Through Adequate Restroom Access presents a catalog of good practices, tools, and resources that provide a foundation for implementable strategies to improve restroom access, primarily for transit vehicle operators.

A toolbox accompanies the report and includes:

Transit Operator Restroom Inventory Tools

Transit Operator Restroom Access Planning Tools

Transit Operator Restroom Access Cost Estimation Tools

Templates for Restroom Access Policies and Boilerplate Contract Language

Also included as part of the report is Appendix E: Collective Bargaining Agreement Restroom Language.

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