Let Your People Go
As leaders evangelize wellbeing, workers are deprived of decent bathroom breaks
When told that the call center’s employees complained of not having time to go to the bathroom, I couldn’t tell if it was meant as a boast or a confession.
An executive assistant shared this tidbit while giving me a tour of the worksite, where, in my role as employee wellness manager, I’d been hired to implement health promotion activities like stress management, physical activity, and healthy eating. Yet I knew these efforts were futile if employees couldn’t even find time for a basic human need like using the restroom.
I reported my concern to the Chief HR officer: Job demands were so excessive workers had to “hold it in” all day. She was seemingly alarmed, but not enough to raise the issue with her C-suite peers.
Reflecting back, I’m struck by the many times I’ve encountered workers denied such a fundamental workplace right. Outside of professional-class office environments, the problem is pervasive.
You’ve likely heard about cases that grab the headlines…
… like retail warehouse workers…
“More than half of workers surveyed — 54% at Amazon and 57% at Walmart— reported that their production rate makes it hard for them to use the bathroom.” — Oxfam
… and chicken processors…
Poultry workers struggle to cope with this situation. They urinate and defecate while standing on the line; they wear diapers to work; they restrict intake of liquids and fluids to dangerous degrees; they endure pain and discomfort while they worry about their health and job security. And they are in danger of serious health problems. — Oxfam
While lower-wage and trade workers are most likely to be denied bathroom breaks (or denied bathrooms), the problem surfaces across a spectrum of occupations. Sometimes it’s lack of access, sometimes it’s job demands so intensive that time doesn’t allow.
Bankers
In 2016, for example, I wrote about telemarketers — employed by a major bank that touted “our culture supports team members wherever they are on their health and well-being journey” — who complained of stomach ailments because they were denied bathroom breaks.
Healthcare Workers
I met with a wellness leader at a large health care organization who said — again, seemingly boasting, as if having achieved some twisted productivity deliverable — that some of their nurses didn’t have time to go to the bathroom. Turns out, this is a well known phenomenon, investigated, for example, in a study called Infrequent Voiders Syndrome (Nurses Bladder). Prevalence Among Nurses and Assistant Nurses in a Surgical Ward.
You know you’re dealing with an occupational risk — nurses bladder — when it’s named after your occupation.
Work From Home
Were it not for the well publicized news stories and my own observations, we might be tempted to think that bathroom breaks aren’t an issue for office workers, especially now that many work from home. How could a WFH employee be deprived of a bathroom break? Enter a WFH help desk representative I’ll call Leslie:
“We have 10 minutes a day to use the bathroom, get water, etc. We get two 15-minute breaks and a lunch. If I use the bathroom to pee it’s 3-5 minutes; if it’s the other it can be my whole 10 minutes. If you go over you get half a point, and getting up to 10 is termination. If our combined breaks go over 70 minutes in a day we’re marked red for the day, which can be used for termination. When I brought it up, management said we can change break times to when you normally have to go. I should spend every break in the bathroom I guess?”
Leslie is located in a southern state and earns $22 an hour. Asked why they don’t just run to the bathroom between calls, Leslie explained:
“Calls come in automatically. Once someone hangs up we have 10 seconds to enter follow-up or the next one comes. We get in trouble for missing calls or taking a long time on ticket follow up. It’s so busy you have to use the personal time to go.”
Teachers
The National Education Association writes:
“Holding in a half-liter of pee through reading, math, and science, or back-to-back-to-back block periods, can have lifelong consequences… There’s a reason that urologists call it ‘teacher bladder.’”
You know you’re dealing with an occupational risk when you’re vying with another profession, like nursing, for bladder-ailment naming rights.
In a 2015 survey of 30,000 teachers, The Atlantic reports, roughly half said they get inadequate restroom breaks, while just as many said they’re unable to use the breaks they do get.
Professional Drivers
Last year, I interviewed a truck driver, who shared:
“Yes, I pee in bottles… Sometimes shippers and receivers don’t have bathrooms for truckers. Sometimes you get to a rest area and the bathrooms are closed. Sometimes truck stop bathrooms are closed…”
A 2014 analysis coined yet another name for health problems related to delaying urination:
“Taxi cab, livery, truck, and other drivers all objectively and subjectively may have more voiding dysfunction, infertility, urolithiasis, bladder cancer, and urinary infections as compared with nonprofessional drivers; this is called taxi cab syndrome.”
An updated name, like “taxi and rideshare driver syndrome,” may be needed as the problem persists for gig workers like Uber and Lyft drivers.
Bus Drivers
The Healthy Work Campaign’s Bathroom Access for Bus Drivers in the US and Canada summarizes the risks of having to delay bathroom visits:
“Bus drivers, and other workers such as teachers, nurses, agricultural processing workers, and taxi drivers, have jobs where bathroom access is restricted, and in some cases, even denied. This has led such workers to delay bathroom visits, and to cope by not drinking water or other fluids. This is stressful for anyone in this situation, and even more stressful for pregnant workers…”
[Related: Steering Thru Stress: What Bus Drivers' Working Lives Teach Us About Wellbeing]
Women in Occupations Dominated by Men
Linemen
In a forum for linemen (like those who work on electrical distribution lines), a member wrote:
“Female lineman here. I hold my wee until I can’t and then I use a shewee.”
Another added:
“I’m a lady substation designer. I’m not in the field nearly as much, but when I am, peeing is my #1 issue… I almost always have to hide behind my car and pop a squat. I keep seeing these ‘shewees’ mentioned. Imma look into that.”
[For pros and cons of shewees, see The Guardian’s The Shewee Revolution: How 2020 Has Changed Urination.]
Miners
Based on her experience in Australia’s coal mines, where she was often the only woman of 1000+ workers, Kristy Christensen wrote:
“The toilets are only an elevated seat with a capture tank below. It is unwelcoming, can stink to high heavens and is a daunting prospect to use. So, I wouldn’t drink water on my whole 12-hour shift… It may seem silly, but is common because the complications of going to the bathroom while kitted out in a lamp and heavy belt, in overalls that are hard to remove and leave you exposed and when you are in areas with lots of people, is tough. Even the boys hated using it and would urinate anywhere but there and make sure number twos were before or after shift.”
Kristy went on to found a company that sold shewees (and services to support gender equality). “These devices are not a substitute for better toilet facilities,” she emphasized. “I advocate for toilets any chance I get.”
In February 2022, Kristy — once named one of the 100 most influential women in the mining industry — died of cancer at age 37.
[Related: Groundbreaking: Q&A with a Salt Miner]
Solutions
Strategies to ensure adequate time and facilities to use the bathroom should be devised in collaboration with workers. These typically entail proper staffing that allows more flexible scheduling; providing additional restrooms; manager training; and redesigning jobs to moderate workloads.
A full discussion of solutions is beyond the scope of this article. These resources are a starting point:
• The Healthy Work Campaign describes examples of union achievements and other approaches to address bathroom access.
• The National Education Association proposes solutions for teachers, emphasizing the effectiveness of collective bargaining, but adds that, in the absence of collective bargaining rights, teachers have persuaded lawmakers to guarantee duty-free time for educators in 24 states.
• A NIOSH Science blog post summarizes the issue with brief sections on how employers can help workers get the bathroom breaks they need and a couple of bullet points on what workers can do if they get too few bathroom breaks.
The Federal Standard (US)
The Occupational Safety and Health Administration requires employers to:
Permit workers to leave their work area to use the restroom as needed;
Provide an acceptable number of restrooms;
Avoid unreasonable restrictions on bathroom use;
Ensure restroom restrictions don’t cause extended delays.
Exceptions are built in for mobile crews, employees in unattended worksites, and farmworkers.
OSHA’s standard is silent regarding frequency or duration of restroom breaks.
[Nothing in this article should be considered legal advice.]
Let Your People Go
Wellness professionals, HR influencers, and other business leaders must prioritize workers’ basic needs. Only then can we credibly address the loftier goals we say we can deliver: resilience, physical and mental health, motivation, engagement, productivity, and whatever the personal development fad du jour is.
Committing even a portion of the time we typically spend — on programs, policies, culture, and content — to the employees in greatest need, and speaking out against exploitation masquerading as productivity (like treating “no time to pee” as a badge of honor), is our best hope for transforming employee wellbeing from rhetoric to reality.