Improving the Safety, Health, and Productivity of Transit Operators Through Adequate Restroom Access (2020)

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193 Jonathan Dropkin Hofstra Northwell School of Medicine with Nathan Bubash RLS & Associates, Inc. Robin Mary Gillespie City University of New York School of Labor and Urban Studies Corresponding author: robin.gillespie@slu.cuny.edu. Contents 194 Methods 194 Organizational Literature 198 Industry-Level Interest 199 Infrastructure Literature Summary 199 Transit Agency Examples of Assessing and Improving Infrastructure 199 San Francisco Municipal Transportation Agency 200 Washington Metropolitan Area Transit Authority 200 King County Metro 201 Transport for London 201 Tools for Tracking Infrastructure Resources and Demands 202 Infrastructure Issues Are Complicated by Social Factors 202 Planning and Scheduling Literature Summary 203 Service Delivery Literature Summary 204 Conclusion 204 References 206 Costs and Evaluation Bibliography A P P E N D I X C Summary of the Literature on Restroom Access and Transit Operations

194 Improving the Safety, Health, and Productivity of Transit Operators Through Adequate Restroom Access Methods A literature search was conducted on the impact of restroom access on operations in the tran- sit industry. It looked at six databases: • The Transportation Research Board’s TRID (Transport Research International Documenta- tion), which combines the TRIS (Transportation Research Information Services) and ITRD (International Transport Research Documentation) databases; • The Bureau of Transportation Statistics (U.S. Department of Transportation); • Elsevier Transportation journals; • Google Scholar; • Web of Science; and • PubMed. Keywords used included “restroom” (and variants such as “toilet”) combined with variants of vehicle operator (e.g., “bus driver”) and then with other relevant terms such as “public transit,” “infrastructure,” “service delivery,” “planning,” “scheduling,” and “scientific.” Other transit-funded technical reports from government as well as nongovernment and industry organizations and labor and trade industry web-based documents were also collected. Finally, the principal investigator’s personal library, comprising almost 1,000 transportation-related references compiled since 2007, completed the search. The literature review was filtered to iden- tify work organization factors and considerations related to four interdependent domains that interact with operator restroom access: infrastructure (including capital planning), route plan- ning, scheduling, and service delivery. Overarching transit agency (TA) concerns, consisting of costs and evaluating outcomes, are also considered within each domain. The search results in 56 useful references. Table C-1 lists their distribution areas in the order they are discussed here. This report reviews the literature related to organizational, infrastructure, planning and scheduling, and service reliability and provides a bibliography with abstracts of the literature in the area of evaluation and costs. Organizational Literature Labor expenses in the transit industry due to absenteeism and the potential for limited avail- ability of transit operators are major concerns among transit agencies, and should be connected with employee safety and health. In TCRP Synthesis of Transit Practice 33: Practices in Assuring Areas Number of Sources Organizational factors 11 Infrastructure 16 Planning and scheduling 5 Operations 5 Service delivery 9 Costs and evaluation 10 Total 56 Table C-1. Restroom access and transit operations references.

Summary of the Literature on Restroom Access and Transit Operations 195 Employee Availability,” Volinski (1999) addresses practices and policies transit agencies have implemented to reduce absenteeism. These include (1) preventive measures designed to reduce the occurrence of absences and (2) management interventions to control absenteeism. Volinski found that transit agencies have lowered absenteeism by improving employee health through wellness programs, health screenings, ergonomic equipment, employee assistance programs, and flexible scheduling. However, while transit agencies may acknowledge the link between attendance and a supportive social environment between managers and operators, there remain substantial disconnects between them, in which managers appear unaware of the pressures and unfavorable working conditions within the public transportation industry (Volinski 1999). For example, Volinski (1999) found that operators consistently report inadequate supervisor support, dirty facilities, and unrealistic schedules. Indeed, tight schedules often deplete recovery times for operators at end of routes; operators often have no time to use restrooms. Operators also cite problems with accessing restrooms; on some routes, no restroom facilities are avail- able at layover points, while on other routes, restrooms are too distant for operators’ use; these issues are particularly problematic for female operators. Operators also report there is little or no follow-up on their suggestions, with bulletin boards cluttered and unhelpful in terms of highlighting important information. Other operators corroborated past findings: they noted problems with insufficient support, little communication, tight schedules, and inaccessible rest- rooms (Volinski 1999). In an audit by the City of San Francisco, California, of the San Francisco Municipal Transpor- tation Agency’s (SFMTA’s) absence management programs, illness and absence were attributed to the inability to use a restroom when needed. Calling in with unscheduled restroom needs led to conflict with the control center and supervision. Bus operators suggested that both service delays and stress could be reduced by better and more flexible planning that acknowledges rest- room access (SFMTA 2016). Other TCRP reports address similar occupational safety and health factors relative to costs, such as balancing cost, work assignments, and performance, including how health and safety influence performance. The objective, when creating runs, is to build the lowest cost within work assignments that cover trips required by service plans and work rules (Gertler et al. 2002). How- ever, some work assignments are more fatiguing than others. In addition to creating cost-effi- cient runs, other factors that should be considered (and that affect cost) in transit operations are fatigue linked with accidents, lost productivity, employee absenteeism and turnover, and poor morale. In TCRP Report 81: Toolbox for Transit Operator Fatigue, Gertler and coworkers (2002) address strategies to reduce fatigue. They frame restroom breaks within the context of “rest breaks,” which they characterize as 10- to 15-minute breaks, consisting of a complete break from all tasks and vehicle operations, including having the ability for the operator to leave the vehicle. The rest break would allow operators to use the restroom or exercise in “break rooms.” The authors postulated that the availability of break rooms would improve the “restorative value” of rest and recovery, reduce fatigue, and maintain vigilance, but that time of day, work hours, and individual preferences would likely affect these factors. They further reported that little research has been performed on rest breaks in terms of their timing and length and on which types of physical activity would be effective in promoting healthy work (Gertler et al. 2002). Recruitment and retention of qualified employees is a persistent concern for many transit agencies. The transit industry is experiencing increased shortages of skilled, experienced opera- tors due to population aging and operators retiring. Studies suggest that novel, systematic approaches to addressing workforce recruitment and retention are important; these approaches should include strategies for attracting new, nontraditional candidates for careers in public transportation (Cronin et al. 2013). The public transportation industry is further constrained due to low unemployment and the negative perception of transit working conditions such as

196 Improving the Safety, Health, and Productivity of Transit Operators Through Adequate Restroom Access split shifts, long workdays, and stressful contact with the public. Potential new hires can often find less physically, psychologically, and cognitively demanding work with adequate pay and benefits. Within this context, TCRP Report 162: Building a Sustainable Workforce in the Public Trans- portation Industry—A Systems Approach (Cronin et al. 2013) examined existing strategies for attracting and retaining a public transportation workforce and the impact demographic and economic trends will have on recruitment and retention; they also sought to develop workforce development, retention, attraction, and capacity-building tools for transit agencies. Their goal was to analyze effective tools to establish state-of-the-art work practices to improve business outcomes, support integrated organizations, and improve psychosocial factors, such as making work rewarding. To achieve this goal, TCRP Report 162 provides a roadmap for building a sus- tainable workforce in the public transportation industry using four methods: • Providing workforce strategies to enhance organizational processes; • Using research-supported, public-transportation–relevant performance measures to evaluate these strategies; • Implementing image management techniques to improve perceptions of public transporta- tion; and • Conducting benchmarking processes for continuous organizational (process) improvement. Whether restroom access concerns affect potential recruits’ employment decisions or lead to termination among existing vehicle operators is unknown. There is some evidence that poten- tial hires are discouraged by public reports of assault and other factors such as stress that make driving jobs less attractive (Cronin et al. 2013, p. 3.5). Structured entry interviews with focused questions for new recruits about their workplace health and safety concerns could begin to address these concerns and could also allow candidates to determine whether they are a good fit for the organization (Cronin et al. 2013, p. 1.12). Similarly, exit interviews might be effective in determining why operators leave the organization; for example, they could help determine patterns that may require change in certain work practices. SFMTA used a collaborative research approach to tackle restroom concerns, in a similar effort to address working concerns that affect employee retention as well as operations. The SFMTA project began from a job stress and hypertension study of its operators that pointed to inadequate restroom access as a potential contributor (Ragland et al., 1987). In establishing a joint Operator Restroom Task Force and eventually implementing the Operator Convenience Facility Project, SFMTA relied on strategies that enhance organizational processes and manage- ment techniques that support recruitment and retention (SFMTA 2012, 2017). This project is discussed in more detail in the section on infrastructure. However, as Volinski (1999) noted, the disconnect between operators and management is substantial and persistent. In 2016, the San Francisco Examiner reported that SFMTA pro- posed tracking the number of times bus operators take breaks (Rodriguez 2016). The Transport Workers Union of America (TWU) local union president described how potential disciplinary approaches by the SFMTA made employees feel their privacy was being violated and that man- agement might retaliate if operators used restrooms while on duty. Thus, despite the implemen- tation of the SFMTA Operator Convenience Facility Project, a divide remained between transit agencies’ labor expectations and bus operators, who do not want their health and the safety of their customers to be placed at risk due to rigid transit scheduling, surveillance, and lack of avail- able restroom access (Rodriguez 2016). A study of factors that contribute to unscheduled work absences among TriMet operators examined associations between work absence and individual characteristics, employment status, aspects of assigned work, service delivery and performance indicators, temporal factors, and

Summary of the Literature on Restroom Access and Transit Operations 197 customer feedback. The researchers reported that work absence is statistically related to speeding, which represents a potential safety threat; the factors associated with speeding included extended layover times, departing from the route origin late, and “highballing it” to get back on schedule, all potentially related to restroom access (Strathman et al. 2009). The researchers further noted that with “good” schedules, the largest variability affecting running times on routes was indi- vidual differences in driving habits (Strathman et al. 2009), which has implications for work absence and may have implications for tight scheduling with respect to restroom access. For example, the likelihood of work absence among operators who consistently departed late from time points was about 1.5% as compared with peers driving the same route at the same time. In their report on unscheduled absence, Strathman and colleagues (2009) state that manage- ment and labor often disagree on how operating conditions and work assignments influence work absence. Volinski (1999) found in focus groups that while managers do not report links between work absence and stressful working conditions, operators consistently report that tight scheduling was an important reason for work absence. Despite the disconnect, some organizations strive to improve psychosocial exposures and organizational work environments. One example is the Utah Transit Authority (UTA); in the 1990s, disputes could only have been decided at the top of the hierarchy (Stevens 2006). How- ever, if strategic work and planning for the future were to be accomplished, UTA needed inter- departmental collaboration, including improved relationships with the union. Its new strategy was to reorganize the agency into a flatter structure and deliver better service by responding more quickly to its customers. A UTA review, performed during this time, also found that orga- nizational barriers inhibited work performance in some divisions. On the basis of the flatter structure, which was designed to improve relationships with the union, employees were asked to develop action plans to reduce the barriers. UTA also created a culture in which employees could contribute to policy development; employee task teams were also created to address strategic UTA goals and improve employees’ quality of working life (Stevens 2006). Another goal of the UTA reorganization was to create improved relationships with labor in the organizational design process (Stevens 2006); the union, too, redesigned itself to operate more effectively and better serve its members. The redesign of the union’s relationship with UTA allowed labor concerns to be addressed quickly rather than have stakeholders wait until contract negotiations (Stevens 2006). A more specific example of the UTA’s reorganizational change is characterized in TCRP Report 77: Managing Transit’s Workforce in the New Millennium (McGlothlin Davis, Inc., and Corporate Strategies, Inc., 2002). This report describes the development at the UTA of macro- level strategic priorities in the late 1990s; one important priority was to consider employees as assets. One measure of the program’s success was lower turnover for new bus operators: in 1999, the first year of the program, the turnover rate for new hires was 35%, while in 2000 the turnover rate was 27%; in the beginning of 2001, bus-operator attrition for new hires was seven to nine employees per month, but by midyear, only four to five operators left the agency each month. UTA also implemented computer-based training that focused on the physical and mental well-being of operators and on driving knowledge and skills. Similarly, its Wellness Program, designed to improve quality of life and promote wellness and healthy lifestyles, includes health evaluations, a fitness facility at each worksite, and health education. The UTA general manager also conducts scheduled, individual meetings at all facilities, where he addresses questions and concerns of employees. Employee involvement, a major focus at UTA, is called “partnering.” In 1998, bargaining teams for UTA and ATU spent time during labor-contract negotiations that resulted in organi- zational improvements such as work-scheduling practices. Family Day, another initiative based

198 Improving the Safety, Health, and Productivity of Transit Operators Through Adequate Restroom Access on UTA reorganization for new hires, addresses flexible schedules, the extra-board and split- shift requirements, and job stressors of operators. Lastly, in 2000, UTA created a Bus Operator Restroom Task Team to address the insufficient number of restroom facilities along bus routes. The task force comprised bus operators and supervisors; its goal was to identify convenient bathroom locations throughout routes. On the basis of the team’s recommendation, UTA also hired a full-time comfort station coordinator who liaises with businesses and building owners on routes to locate and secure bathroom facility agreements for operators. Despite success stories addressing restroom access in the transit industry, organizational changes remain a challenge for stakeholders. As Stevens (2006) notes on the basis of the “TCRP New Paradigms” literature, to address socioeconomic changes taking place in the United States, challenges in U.S. industry due to globalization, and the lagging ability of transit agencies to adopt new technologies due to rapid technological change, transit agencies must make funda- mental organizational changes. Stevens also discusses methods of promoting change, including active executive and management support of employees. As an example of models of change, Stevens (2006) cites the occurrence of reengineering within transit agencies, which involves, in part, analyses and redesign of workflow and processes. Industry-Level Interest In addition to specific TA concerns, industry groups such as APTA have raised the issue with increasing frequency. In 2014, the safety roundabout session Providing Adequate Break Time to Ensure Operator Safety & Wellness, held at the APTA Bus and Paratransit Conference, brought together a small group of people with both concerns and experience in addressing restroom and other breaks issues (Staes et al. 2015). The importance of restroom access relative to safety is discussed in the recent FTA Report to Congress on 2015 Section 5314 Projects: Review and Evaluation of Public Transportation Safety Standards (Staes 2017). The FTA report lists a “Compendium of Transit Safety Standards” in Section 2, and provides a “Summary of Public Comments and Responses.” In response to a public comment, “Are you aware of standards within other industries that could be used in the public transportation industry to reduce risks,” FTA was unable to identify standards or pro- tocols with respect to adequate restroom access within route schedules for operators. Another public comment included operational considerations related to public restrooms at transit centers and park-and-ride lots. In the section on the efficacy of transit safety-related standards and safety standards with public transportation, Staes (2017) notes that although there is insufficient data to fully evaluate safety standards and protocols in the transit industry, a number of topics to examine, including whether transit operators have adequate time for restroom breaks with respect to scheduling, are evident from comments. The author also states that, through ongoing standards efforts combined with industry input, FTA will perform an analysis of restroom access to determine whether FTA should address this issue through regulation (Staes 2017). In 2019 the Transit Advisory Committee for Safety (TRACS) published a list of 25 safety focus areas (TRACS 2019), including the following: Transit scheduling/operator break times Transit scheduling and vehicle operator break time are gen- erally driven by customer service considerations and collective bargaining agreements. Schedules that are “too tight,” coupled with an emphasis on schedule adherence can have safety implications and potentially compromise safe operations. Many transit operators complain that schedule delays lead to limited time at the end of a trip to address personal needs like visiting the restroom. This area is ripe for additional research and standards development. (TRACS 2019, p. 2)

Summary of the Literature on Restroom Access and Transit Operations 199 Infrastructure Literature Summary Three important restroom access factors that affect on-time service delivery and are largely determined by the available infrastructure were identified as significant for planners and sched- ulers: restroom location, type, and travel time (Boyle et al. 2009). Infrastructure encompasses restroom resources on TA property, in commercial locations, and in the public sector. The built environment—existing business, residential zoning, bridges, tunnels, highways—plays a role in what is available. Finally, the local geography, such as hills, rivers, and flood zones, has an impact on where and how often operators can stop their vehicles. Infrastructure development can be coordinated with transit capital planning or linked to transit-oriented development. To understand the overall impact on operations and to make smart decisions that support service reliability and operator health and comfort requires an assessment of the available resources: Where are the restrooms? What shape are they in? Where are facilities being planned, or where might they be added to development? Where are changing demographics or other factors going to have an impact, and when? On the basis of that evaluation, development steps may include renovating facilities owned by the TA, building new facilities, coordinating with community partners, and upgrading portable restrooms. Transit Agency Examples of Assessing and Improving Infrastructure Several TAs have addressed restroom access in the context of infrastructure in a broad and systematic manner. For example, in 2007 the Maryland Transit Authority (MTA) hired a con- sulting group to assess the approximately 140 designated comfort stations for bus operators (H. Zelefsky, MTA Bus Operators Comfort Station Assessment, MTA, unpublished report, 2008). The survey included a safety and security review of each site. They also held interviews with transit operators, collected 51 brief survey cards from others, and interviewed six transit agencies around the country. They developed recommendations for the system as a whole and for each route evaluated, with a focus on operating and capital costs as well as improved access. The following TAs doing systematic evaluation have published reports describing their pro- cesses: SFMTA, the Washington Metropolitan Area Transit Authority (WMATA), King County Metro, and Transport for London. San Francisco Municipal Transportation Agency SFMTA, working through an Operator Restroom Task Force with management and union involvement, implemented a planning project to increase restroom access for SFMTA operators. In response to its investigation showing pervasive problems pertaining to restroom availability, with some routes requiring driving 85 minutes, it created a three-phase planning process that included adjusting routes, constructing prefabricated restrooms throughout the city in locations close to restroom access problem areas, and obtaining the subsidiary use of business leases or public restrooms. The several phases of this project to identify and build needed restrooms have been described in a series of online reports. For example, the presentation SFMTA Operator Restrooms: Overview for PAG (SFMTA 2012) discusses details of the implementation and selec- tion of specific types and locations of restrooms, and the web report “Operator Convenience Facility Project” (SFMTA 2019) provides information on the decision process as well as project progress. The remainder of this discussion of SFMTA activities is based on the online report The SFMTA Operator Restroom Program and Operator Convenience Station Project (SFMTA 2017). The goal of the Operator Convenience Facility Project was to promote the health and safety of SFMTA (Muni) operators, improve Muni on-time service performance and transit reliability, and reduce unplanned service disruptions (the lack of available restrooms at terminals required operators to leave routes, which created unplanned service disruptions).

200 Improving the Safety, Health, and Productivity of Transit Operators Through Adequate Restroom Access Public participation plays an important role in the success of the project. Before SFMTA could construct an Operator Convenience Station, a lengthy approval process was required involv- ing city agencies, the board of supervisors, commissions, and the community (SFMTA 2017). Stakeholder involvement allowed for a dialog to be created between the community, the city, and Muni operators in which feedback could be given so that safe and secure restroom facilities could be built and service reliability could be improved. To ensure success, the task force creates neighborhood-based communication plans written for the language and public transporta- tion needs of each community. Each site proposal is unique; each is a small project involving a number of TA and community participants and partner agencies that could directly affect the outcome. Information about the project is published on SFMTA websites, and fact sheets are available at community meetings. Community meetings allow individuals in communities to review the presentation when entering the meeting, and have the opportunity to interact with staff before the presentation about the project’s purpose. The SFMTA methods enable project team members to build relationships with the commu- nity and district supervisors, as team members are available to answer questions, reevaluate a station location, or work with a partner agency to find solutions to fit the neighborhood. The project remains a work in progress. For example, in one scenario, community members, city agencies, and partner stakeholders wanted additional information on how the proposed loca- tion would actually serve operator’s needs. To address this concern, the task force developed fact sheets that included service time and length of bus lines, ridership statistics, number of emergency restroom breaks requested by operators, and service time lost due to breaks. On the basis of stakeholder input, team members were also able to modify some stations to include water-tolerant landscaping, additional external lighting, and street intersection improvements surrounding the site. Washington Metropolitan Area Transit Authority The Washington Metropolitan Area Transit Authority (WMATA) in Washington, DC, hired a consulting group to carry out an extensive assessment of restroom access and restroom con- ditions across its system and defined the benefits and drawbacks of types of restrooms. This project was, like SFMTA’s, based on an active and collaborative restroom access committee developed with and supported by the vehicle operators’ local union. WMATA’s experience is documented in reports containing generalizable recommendations as well as its own specific practices (WMATA 2017, 2018). Highlights include a detailed analysis of the types and relative advantages of restrooms, recommendations for establishing relationships with businesses and other partners, and a library of restroom components. King County Metro The restroom access program of King County Metro, Seattle, Oregon, is tied in closely to the infrastructure development and contracting process. Restroom access is explicitly defined and required in planning: The Transit Facilities Guidelines are a resource developed by King County Metro (Metro) to help jurisdictions, property owners, developers, architects, landscape architects, and engineers involved with the design, permitting, and construction of Metro’s transit facilities. These guidelines are used inter- nally and provide a framework for Metro in development of its facilities. . . . New construction and planning efforts that include layover space for operators must also provide comfort station access. The Comfort Station Coordinator must have the opportunity for collaboration on each station’s placement, plan reviews, and number of units to ensure compliance with policies of the Occupational Safety and Health Administration (OSHA), Washington State Department of Labor & Industries (L&I), and other related agencies. Any revisions to layovers that affect operator access to the comfort station by distance, hours, or capacity must include early planning review with the Comfort Station Program Coordinator. (Parametrix 2018)

Summary of the Literature on Restroom Access and Transit Operations 201 Transport for London When the Mayor of London, son of a bus driver, realized the extent to which the city’s geog- raphy and economics made it difficult for drivers to use restrooms, he supported a significant campaign known as Bus Driver Facilities Improvements to remedy the problems reported by workers and their union. The program had three main arms. The first was to inventory and improve existing restroom resources. Transport for London (TfL) now publishes an online pamphlet-sized subway system map of where restrooms are available and where they are not. The extensive catalog of locations includes considerations of walking time, maintenance, hours, and others to guide planners and to help drivers find congenial facilities. This led to a program to install 40 permanent outside restrooms at underserved locations with funds committed by the Mayor’s Office. The third arm takes a kind of community affairs approach. They are attempt- ing to build support for the program among those who are inconvenienced by transit delays. They have also struggled with public perception of the restroom structures (BBC 2018). Like all public entities in London, TfL publishes minutes of meetings and regular reports online (Safety Sustainability and Human Resources Panel 2018). TfL publishes a system map with public restrooms marked (Transport for London 2020). Links to most of these reports are found in the reference section below. Tools for Tracking Infrastructure Resources and Demands In addition to the TA initiatives already described, there are many resources for identifying restroom facilities and linking them to TA planning programs, both written and software-based. The Florida Transit Information System of the Florida Department of Transportation devel- oped an Automated Transit Stop Inventory Model (ATSIM) to track transit stop facilities and their amenities, including the presence of a restroom. It recently added a restroom query to its search fields. This package, free for affiliated TAs and available for purchase outside of Florida, includes guidance on how to safely and efficiently collect bus stop data. Its focus is on the health, safety, and maintenance of bus stops and data are entered for each specific user: the TA or the municipality. The data from different users are not merged and are not open to view. While TAs typically inventory their bus stops, this was the only identified example of a completed inventory interface that was freely available. There are many on-line restroom-aggregating phone or tablet applications. The American Restroom Association attempts to catalog these source on its Public Restroom Locators (ARA n.d.). The aggregators most likely do not include important information for drivers such as space for parking, and data are not systematically collected. Some sites rely on crowd-sourcing, but others are run by municipalities. TAs reported online complaints and suggestions systems that help staff monitor restroom conditions. Several are planning or close to completing hand-held data collection prototypes, and one or two already use tablets specifically for restrooms. Given the interest in restroom times on the part of TAs using on-the-ground data collection, this is an area where working together across TAs and working closely with software designers could avoid replicated cost. Community research produces some relevant information for those doing a complete assess- ment and trying to be efficient at the same time. For example, comparison of on-foot and inline digital measurements of walk time does not show different results; however, walking is still better for small details (Pliakas et al. 2017). As TA planners and others increase their interest in using automated and digital informa- tion systems, there is a downside for vehicle operators. When passengers have real-time infor- mation about when to expect a ride, the reaction against a delated operator can be even worse

202 Improving the Safety, Health, and Productivity of Transit Operators Through Adequate Restroom Access (Ji et al. 2014). Similarly, in the less-formalized transit system in Nairobi, Kenya, the public’s cell phone data are also recruited for bus schedule planning and monitoring. Infrastructure Issues Are Complicated by Social Factors Portables are an attractive nuisance in many places. There is a lot of discussion in the news about people living in toilets, fouling them, and other problems that interfere with vehicle opera- tor needs. In an attempt to discourage drug use around portable toilets, one agency installed blue lights to make it harder to see the vein. One result was that users injected into large veins in the neck, which are quite easy to find by hand. However they are also prone to more serious infections than other areas. Some research considers restroom planning as it intersects with gender identity (Ramster et al., 2018). OSHA has issued guidelines (OSHA 2015). As public agencies make infrastructure decisions to accommodate gender variety, the transit industry will likely follow suit (Gillespie 2018). Restroom infrastructure may also have an impact on ridership. One study found that riders were discouraged and returned to using private cars when restroom facilities were inadequate (Washington 2014). Planning and Scheduling Literature Summary The planning and scheduling literature does not address directly unscheduled restroom access, but more generally acknowledges the health, morale, and planning benefits of adequate scheduled breaks or the use of extraboard drivers to ensure continual service while allowing breaks. The essential importance of integration of route planning and scheduling was defined in the Training Manual for Transit Service Planning and Scheduling (Cevallos 2015): The manual stresses the integration of service planning and scheduling. The service planner must understand the fundamentals of scheduling, as the schedulers need to be familiar with the service plan- ning process. It is important that service planners and schedulers interact with each other through the entire service and schedule development process rather than being two disconnected functions. TCRP Report 135: Controlling System Costs: Basic and Advanced Scheduling Manuals and Contemporary Issues in Transit Scheduling (Boyle et al. 2009) defined five arenas where good scheduling decisions affect system costs. Restroom stops, when needed and as part of sched- uled breaks, put demands on each arena. The first arena is the general impact of efficiency on costs. The second is the constraints and accommodations engendered by contracts and labor relations—this would include both specified breaks and system flexibility for unscheduled stops. The third is the importance of the schedule reliability as well as timing in customer service, which can be adversely or positively affected by schedule decisions among other TA policies. The fourth is the importance of schedules in maintaining a healthy and acceptable work environment. Finally, the scheduler has to know how to best use computerized schedul- ing packages to bring this all together. Significantly, planners and schedulers need information about practical and contractual layover and rest break constraints from all stakeholders. An important element of making a route work operationally is running time. The scheduler’s goal is to find the happy medium between too much and too little scheduled running time to ensure reliability and efficiency in daily operations. Practical concerns such as identifying restroom opportunities at the ends of routes are also important in route design. (Boyle et al. 2009, p. 2.5) Scheduling efficient routes, a perennial transit challenge, is compounded by the unscheduled restroom access that is required for the health and comfort of vehicle operators. Schedules have

Summary of the Literature on Restroom Access and Transit Operations 203 tightened with the use of scheduling software and vehicle location data, leaving less flexibility for unplanned restroom access. As driving conditions change—for example, reductions in urban speed limits—operators may be expected to maintain the same schedule and running times until schedules catch up (Volinski 1999). Even with dedicated dwell or layover time, buses or trains are often late for reasons beyond the operator’s control. Average recovery or layover times reported in the literature are typically about 10% of run- ning time (Boyle et al. 2009, p. 3.5). In Volinksi’s interviews, operators reported that in some places there were no restroom facilities; in other situations, restrooms were too far away for the operator to travel there and back and leave on time. Predictably, operators who had to stop the bus in the middle of a route to use the restroom suffered passenger criticisms and complaints. Tight schedules can also consume recovery time for operators at the end of routes. They often have no time to use restrooms or take just a short breather from their work. Two operators recounted times when they had to urinate into a cup while inside the bus, because they had no time to relieve themselves at the layover point. In the opinion of one operator, “Management doesn’t care about these needs. They treat us as if we aren’t humans.” (Volinski 1999, p. 18) The important roles of schedulers in supporting the health and comfort of operators are described in scheduler training manuals (Cevallos 2015, Pine et al. 1998). These explained ways to think about fitting rest time into schedules without wasting unneeded minutes: understand- ing where the balance of dwell and layover times is affected by the time of day, factoring in time requirement associated with vehicle positioning at break locations and transfer centers, and using measured times rather than average times, as average times may overestimate the time required for some runs, resulting in inefficiency, or underestimate it, cutting down on scheduled recovery periods that operators need (Boyle et al. 2009). Service Delivery Literature Summary There were no simple solutions in the literature to the problem of the unscheduled breaks that have the biggest impact on service delivery. Service reliability depends on having enough time to make the scheduled runs, enough vehicles to send out, and enough operators to drive them. It is affected by the time of day, traffic conditions, weather, changing passenger load, and individual driver needs. A schedule that avoids excessive or insufficient running times can also reduce safety risks. Excessive running times are a cost sink, while with insufficient running times, on-time per- formance deteriorates. This may increase scheduling pressures among operators and promote risky behaviors, such as increased operating speeds (Diab et al. 2015). An anticipated guide- book on improving bus transit reliability (TCRP Project A-42, https://apps.trb.org/cmsfeed/ TRBNetProjectDisplay.asp?ProjectID=3929) may provide additional insight into addressing restroom access needs in efficient planning for reliable service: Bus service reliability is a key quality-of-service issue for passengers, an important driver of bus opera- tions costs for transit agencies, and a health and safety issue for bus operators. . . . From the bus operator point of view, unreliable service can lead to adverse effects such as increased assaults, operator fatigue, and fewer opportunities to use facilities. This condition may result in lost time, directly affecting operator availability and, ultimately, service reliability. In statistical modeling of factors affecting travel time, “results showed that bus dwelling time has the strongest impact to bus travel time while intersection delays have the lowest significant impact” (Evans et al. 2019). The authors did not consider dwell time related to restroom use, which is affected by distance to facilities, ease of access, and other route constraints; however, the findings do support the importance of adequate layover times and of finding restrooms near routes. For rail, unplanned dwell time could similarly be reduced by identifying and maintaining station facilities and providing relief drivers at target locations. Communications

204 Improving the Safety, Health, and Productivity of Transit Operators Through Adequate Restroom Access technology can mediate the impact of unscheduled restroom needs. For example, extra drivers can be sent to layover points or subway stations to provide relief for operators along routes (Strathman et al. 2012). Technology can also affect TA service delivery and reliability. In a study on automatic vehicle location data provided to transit operators, drivers improved real-time reliability by speeding up or slowing down, within reason, to arrive at the next stop at the right time, or adjust their dwell time (Ji et al. 2014). The information is an assist when the timing issue is resolvable, and the operators in this study were either neutral or positive about using transmitted data in this way. In contrast, Dutch bus drivers have reported feeling increased pressure not to use a restroom as needed when they know exactly how late they are (Paas and Hanley 2019). Factors that may be caused or aggravated by restroom access problems can themselves affect availability and, hence, service. For example, in one study, on-time performance was related to attendance, with operators who are consistently late in departures from time points more likely than others to have unplanned absence (Strathman et al. 2009). Other stress or delay factors that affect absence likelihoods are higher volumes of passenger movements and lift operations and customer complaints about the timeliness or availability of service (Strathman et al. 2012). As discussed in Appendix B, “Summary of Health Literature,” health conditions that are not accommodated could also affect attendance. Conclusion While there is some literature on the importance of addressing the restroom access needs of transit vehicle operators and how they may influence operator health, recruitment, absenteeism, and retention, it is usually considered with respect to the financial impact of unscheduled breaks and to the need to provide timely, efficient service. This summary suggests additional areas to consider when initiating or improving restroom access campaigns. The transit agencies and industry experts who have considered restroom access typically find it an important contributor to operator health, operations and service delivery, and labor–management relations. References American Restroom Association (ARA). (n.d.) Public Restroom Locators. https://americanrestroom.org/ restroom-locations/. BBC. (2018). Bus Driver Toilet Is a ‘Hideous Surprise’ for Residents. Dec. 12, 2018. BBC.com. https://www.bbc.com/ news/uk-england-london-46471578. Boyle, D., Pappas, J., Boyle, P., Nelson, B., Sharfarz, D., and Benn, H. (2009). TCRP Report 135: Controlling System Costs: Basic and Advanced Scheduling Manuals and Contemporary Issues in Transit Scheduling. Trans- portation Research Board, Washington, DC. http://www.trb.org/Publications/Blurbs/161864.aspx. Cevallos, F. (2015). Training Manual for Transit Service Planning and Scheduling. http://www.nctr.usf.edu/ wp-content/uploads/2017/02/TrainingManual_FinalReport.pdf. Cronin, C. B., et al. (2013). TCRP Report 162: Building a Sustainable Workforce in the Public Transportation Industry—A Systems Approach. http://www.trb.org/Main/Blurbs/169592.aspx. Diab, E. I., Badami, M. G., and El-Geneidy, A. M. (2015). Bus Transit Service Reliability and Improvement Strategies: Integrating the Perspectives of Passengers and Transit Agencies in North America. Transport Reviews, 35(3):292–328. Evans, D., et al. (2019). Analyzing Factors Impacting Transit Bus Travel Time. Presented at 98th Annual Meeting of the Transportation Research Board, Washington, DC. Gertler, J., Popkin, S., Nelson, D., O’Neil, K (2002). TCRP Report 81: Toolbox for Transit Operator Fatigue. Transportation Research Board, Washington, DC. http://www.trb.org/Publications/Blurbs/153765.aspx. Gillespie, R. (2018). Orlando Building Florida’s First Multi-Stall, All-User Restroom in Government Building. Orlando Sentinel. https://www.orlandosentinel.com/news/orange-county/os-orlando-transgender-bathroom- 20180807-story.html.

Summary of the Literature on Restroom Access and Transit Operations 205 Ji, Y., He, L., and Zhang, H. M. (2014). Bus Drivers’ Responses to Real-Time Schedule Adherence and the Effects on Transit Reliability. Transportation Research Record: Journal of the Transportation Research Board, 2417:1–9. McGlothlin Davis, Inc., and Corporate Strategies, Inc. (2002). TCRP Report 77: Managing Transit’s Workforce in the New Millennium. Transportation Research Board, Washington, DC. http://onlinepubs.trb.org/online- pubs/tcrp/tcrp_rpt_77.pdf. Occupational Safety and Health Administration (OSHA). (2015). A Guide to Restroom Access for Transgender Workers. Best Practices series. Washington, DC. https://www.osha.gov/Publications/OSHA3795.pdf. Paas, B., and Hanley, L. (2019). Restroom Breaks for Bus Driver in the Netherlands. Facebook webinar, June 1, 2019. https://www.facebook.com/ATUInternational/videos/1658801727488339/. Parametrix. (2018). Transit Facilities Guidelines. kingcounty.gov/∼/media/depts/transportation/metro/about/ planning/pdf/2011-21/2018/transit-facilities-guidelines.pdf Pine, R., Niemeyer, J., and Chisholm, R. (1998). TCRP Report 30: Transit Scheduling: Basic and Advanced Manuals. Transportation Research Board, Washington, DC. http://www.trb.org/Main/Blurbs/153847.aspx. Pliakas, T., S. Hawkesworth, R. J. Silverwood, K. Nanchahal, C. Grundy, B. Armstrong, J. P. Casas, R. W. Morris, P. Wilkinson, and K. Lock. (2017). Optimising Measurement of Health-Related Characteristics of the Built Environment: Comparing Data Collected by Foot-Based Street Audits, Virtual Street Audits and Routine Secondary Data Sources. Health & Place, 43:75–84. Ragland, D. R., M. A. Winkleby, J. Schwalbe, B. L. Holman, L. Morse, S. L. Syme, and J. M. Fisher. (1987). Prevalence of Hypertension in Bus Drivers. International Journal of Epidemiology, 16(2), 208–214. Ramster, G., C. Greed, and J.-A. Bichard. (2018). How Inclusion Can Exclude: The Case of Public Toilet Provi- sion for Women. Built Environment, 44(1):52–76. Rodriguez, J. F. (2016). Muni Slams Brakes on Excessive Breaks. San Francisco Examiner, May 24, 2016. http:// sfexaminer.com/muni-slams-brakes-excessive-breaks. Safety Sustainability and Human Resources Panel. (2018). Bus Driver Facility Improvements. Transport for London. http://content.tfl.gov.uk/item07-bus-driver-facility.pdf. San Francisco Municipal Transportation Agency (SFMTA). (2012). SFMTA Operator Restrooms: Overview for PAG. https://archives.sfmta.com/cms/cmta/documents/6-15-12PAGOperatorRestroomupdateopt.pdf San Francisco Municipal Transportation Agency (SFMTA). (2016). Absence Management Efforts Can be Enhanced Through Improved Organizational Culture and More Effective Program Management Tools. https:// sfcontroller.org/sites/default/files/Documents/Auditing/SFMTA%20Absence%20Management%20 Audit%20Report%20-%2012.22.2016.pdf. San Francisco Municipal Transportation Agency (SFMTA). (2017). The SFMTA Operator Restroom Pro- gram and Operator Convenience Station Project. https://www.sfmta.com/projects/operator-convenience- facility-project#:∼:text=The%20Operator%20Convenience%20Facility%20Project,and%20reduce%20 unplanned%20schedule%20interruptions. San Francisco Municipal Transportation Agency (SFMTA). (2019). Operator Convenience Facility Project. https://www.sfmta.com/projects/operator-convenience-facility-project. Staes, L. (2017). FTA Report to Congress on 2015 Section 5314 Projects: Review and Evaluation of Public Trans- portation Safety Standards. FTA Report No. 0103. Center for Urban Transportation Research, University of South Florida, Tampa. https://rosap.ntl.bts.gov/view/dot/39034. Staes, L., et al. (2015). Safety Roundabout: Providing Adequate Break Time to Ensure Operator Safety & Wellness. Presented at APTA Bus and Paratransit Conference, Fort Worth, TX, May 3–6, 2015. Stevens, R. C. (2006). Beyond Best Practices: Implementing Fundamental Change. Presented at 2006 APTA Bus and Paratransit Conference, June 11–14, 2006, Orange County, CA. Strathman, J. G., J. P. Broach, and S. Callas. (2009). Evaluation of Short-Duration, Unscheduled Absences Among Transit Operators: TriMet Case Study. Transportation Research Record: Journal of the Transporta- tion Research Board 2111(1). Strathman, J. G., S. M. Kwon, and S. Callas. (2012). Extraboard Performance: Trimet Case Study. Transportation Research Record: Journal of the Transportation Research Board 2274(1). Transit Advisory Committee for Safety (TRACS). (2019). TRACS List of 25 Safety Focus Areas. U.S. Depart- ment of Transportation, Federal Transit Administration. Washington, DC. http://www.transit.dot.gov/ regulations-and-guidance/safety/tracs-list-25-safety-focus-areas-march-2019. Transport for London. (2020). Toilets Tube Map Online. http://content.tfl.gov.uk/toilets-map.pdf. Volinski, J. (1999). TCRP Synthesis of Transit Practice 33: Practices in Assuring Employee Availability. Transpor- tation Research Board, Washington, DC. http://www.trb.org/Main/Blurbs/153662.aspx. Washington, K. M. (2014). Go Before You Go: How Public Toilets Impact Public Transit Usage. PSU McNair Scholars Online Journal, 8(1), Article 5. Washington Metropolitan Area Transit Authority (WMATA). (2017). Station Area Planning Guide. https:// www.wmata.com/business/real-estate/upload/Station-Area-Planning-Guide-October-2017.pdf. Washington Metropolitan Area Transit Authority (WMATA). (2018). Metrobus Restroom Planning Guide. https:// www.wmata.com/initiatives/plans/upload/Metrobus-Restroom-Planning-Guide-FINAL-REPORT.pdf.

206 Improving the Safety, Health, and Productivity of Transit Operators Through Adequate Restroom Access Costs and Evaluation Bibliography Many of the sources listed above address costs and evaluation measures. The following references could provide additional insight. Brauninger, D. (1998). Personal Sanitation for a Mobile Workforce. International Bridge, Tunnel and Turn- pike Association 1998 Committee Meeting Proceedings: Maintenance Committee Fall Conference. https:// trid.trb.org/view/655566. This paper presents highlights from an American Innotek Health and Safety Seminar that addressed some of the concerns and options with regard to meeting the restroom needs of the mobile workforce. Both acceptable and unacceptable options are listed; potential health risks, potential safety risks, and legal and regulatory risks from unsafe facilities and practices are enumerated; and current options for on-site rest- room facilities are given. Florida Department of Transportation. (2014). Best Practices in Evaluating Transit Performance: Final Report. Tallahassee. To assist Florida transit agencies in improving performance evaluation, the Florida Department of Transportation, Public Transit Office, researched best practices for urban fixed-route systems in evaluat- ing transit performance in the United States and made recommendations as to how these practices can be adopted and implemented by Florida transit agencies. This study identifies the most-common effective performance measures and data sources so that agencies can pick and choose the most-appropriate metrics for their agencies. . . . This report describes activities conducted in support of an exploration of best prac- tices for transit performance measurement and is organized into four chapters. Kittelson & Associates, Inc., Urbitran, Inc., LKC Consulting Services, Inc., MORPACE International, Inc., Queensland University of Technology, and Y. Nakanishi. (2003). TCRP Report 88: A Guidebook for Devel- oping a Transit Performance-Measurement System. Transportation Research Board, Washington, DC. This guidebook will be of interest to transit managers and others interested in developing or improving performance-measurement systems for transit agencies or incorporating transit performance measures into regional decision-making processes. The guidebook provides a step-by-step process for developing a perfor- mance-measurement program that includes both traditional and non-traditional performance indicators that address customer-oriented and community issues. The guidebook begins with a discussion of the need for performance-measurement programs, discusses the importance of customer satisfaction, describes the characteristics of an effective performance-measurement system, and shows how performance measures are used by service industries in the private sector. The guidebook is accompanied by a CD-ROM (CRP-CD-25) that includes an electronic version of the guidebook that is extensively hyperlinked, allowing users to jump immediately to related material and to navigate the performance measure selection menus. CRP-CD-25 also contains a background document that includes additional case studies and an annotated bibliography of nearly 200 documents relating to transit performance measurement, a library of related TCRP documents, and other resources on performance measurement. Taylor, B. D., Garrett, M., and Iseki, H. (2000). Measuring Cost Variability in Provision of Transit Service. Transportation Research Record: Journal of the Transportation Research Board 1735(1):101–112. This analysis addresses many of the limitations of cost-allocation models typically used in practice by developing a set of models that account for marginal variations in vehicle-passenger capacity, capital costs, and time-of-day costs. . . . This analysis is unique, in that it combines a number of previously and separately proposed improvements to cost-allocation models. In comparison with the model currently used by the Los Angeles MTA, it was found that the models developed for this analysis estimate (a) higher peak costs and off-peak costs, (b) significant cost variation by mode, and (c) lower costs for incremental additions in service. The focus is on the limitations of the rudimentary cost-allocation models employed by most transit operators and not on the Los Angeles MTA per se. This analysis found that an array of factors addressed separately in the literature can be incorporated simultaneously and practically into a usable cost-allocation model to provide transit systems with far better information about the highly variable costs of producing service. Transit Advisory Committee for Safety (TRACS). (2017). Safety Data and Performance Measures in Transit. 16-02 Final Report. https://www.transit.dot.gov/sites/fta.dot.gov/files/docs/regulations-and-guidance/ safety/64016/safety-data-and-performance-measures-transit-tracs-16-02-final-report.pdf. The Federal Transit Administration (FTA) tasked the Transit Advisory Committee for Safety (TRACS) with developing recommendations for FTA on the functional requirements and data elements of a com- prehensive safety data collection and analysis framework to support improvements in the transit industry’s safety performance. Representatives from state and local transit agencies, labor unions, state safety oversight agencies, research organizations, and national transportation associations worked together to create rec- ommendations for FTA to guide improvements in safety performance data collection and analysis. These

Summary of the Literature on Restroom Access and Transit Operations 207 recommendations address improvements in safety performance measures, granularity in data collection efforts, and a reporting and analysis framework. This report begins by introducing safety performance measurement and how safety performance measurement informs the safety management system approach and then discusses improvements in safety performance measurement, the functional reporting and analysis requirements of an improved reporting platform, and leading and lagging safety performance indicators that may be of interest to transit agencies. The report then presents safety performance measures in public transportation; detail in data collection, reporting, and analysis requirements; and, finally, suggested data outputs to aid in setting national safety goals and agency peer reporting. Finally, the report presents TRACS’ recommendations on the functional requirements and data elements of a comprehensive safety data collection and analysis framework to support improvements in the transit industry’s safety performance.