Introduction
  Policy Issues
  Site Design
  Building Circulation
  Toilet Rooms
  Accessible Housing
  Communication in Buildings

Toilet Rooms

Planning Access
Circulation Space
Water Closets, Toilet Stalls and Grab Bars
Lavatories and Mirrors
Dispensers and Receptacles
In Conclusion

Summary of Design Criteria

  Site Design
  Building Circulation
  Toilet Rooms
  Accessible Housing
  Communication in Buildings

Conflicting code criteria, small spaces, special products with special prices and the constraints of existing structures make the design of toilet rooms one of the most difficult aspect of accessible design. At the same time, it is also one of the most important to people with disabilities because lack of accessible toilet rooms can lead to physical discomfort and embarrassment. The need to go long distances to use a toilet room also reduces the time available for productive work and breaks.

Planning Access
In a building with more than one toilet room, there must first be a decision on which ones are to be accessible. If there is only one toilet room for each sex, then both must be made accessible. If both can be converted to unisex toilet rooms, only one needs to be accessible in an existing building. If a building has toilet rooms on more than one floor or wing, then only one accessible toilet room may not be an appropriate solution.

As a rule of thumb, all public toilet rooms in new buildings should be accessible. In existing buildings, general access to toilet rooms should be examined carefully giving consideration to the feasibility of conversion for each type of toilet room. The selection of retrofit targets should be based on a careful evaluation of the need for close bathrooms, the feasibility of modification and the availability of strategic locations.

In some existing buildings with many toilet rooms, such as dormitories and hospitals, a particular wing or floor might be chosen as the location for services to people with disabilities. All the toilet and shower rooms serving those areas should therefore be accessible but in other parts of the building only a few strategically located facilities may be needed to accommodate guests and visitors. In new construction or major renovation, this approach is not acceptable because it leads to segregation of individuals with disabilities. Full integration is the goal and accessibiliity to all bathrooms the universal design ideal.

There should be at least one accessible water closet and lavatory in each accessible toilet room. In new construction, men’s toilet rooms should also have at least one accessible urinal. Many men who use wheelchairs prefer to use urinals since they do not have to transfer.

There is a new type of toilet room that is becoming more common in commercial and recreational occupancies. It is called the “family restroom” and it is provided as a third option to men’s and women’s rooms. The idea behind the family restroom is to remove the awkwardness, embarrassment and potential legal problems caused by the presence of a child or older adult with a caregiver of the opposite sex. Family restrooms should all be accessible because they are very likely to be needed by people with disabilities who need assistance for toileting or grooming. These rooms should have more than the minimal amount of space necessary for access because more space is needed for the caregiver. A changing table should be provided for infant care as well.

Circulation Space
All accessible fixtures should be along an accessible path of travel from the entry to the room - no stairs, adequate clearances and maneuvering room at doors. They must also have adequate space to position a wheelchair for convenient use of the fixture. A common error in attempts to make restrooms accessible results in the “wheelchair trap,” akin to the lobster trap. Satisfactory clearances are provided to allow passage of a wheelchair into the room. However, once inside, there is either no room to turn a wheelchair around or the entry door has insufficient maneuvering clearances to allow opening the door from inside the restroom.

Although some codes require a 60-inch diameter turning area in the toilet room, a wheelchair can be turned around in spaces with shapes that are not circular as well, e.g. a T-shaped space. Moreover, clear space under lavatories can be used as part of the turning area.

Water Closets, Toilet Stalls and Grab Bars
An accessible stall should be large enough for a wheelchair transfer to be made with the chair parallel to the water closet. The parallel transfer position is preferred by many wheelchair users. Some rehabilitation experts feel that an angled position where the chair is facing the water closet is safer and more convenient, particularly when chairs do not have removable armrests. Many people who use wheelchairs transfer with a perpendicular approach. These people usually have the ability to stand and pivot. The same sized stall can accommodate all three approaches but, there are a variety of stall designs that help some individuals more than others.

Dimensions of 60 in. wide by 56 in. deep are required by many codes because they provide enough room for all three transfer styles. Semi-ambulatory people need support from grab bars while sitting down and standing up; for them, a narrow stall 36 in. wide is best because bars can be close on either side. Thus, some codes are now requiring two types of accessible stalls, one 60 x 56 in. (“wheelchair accessible”) and one 36 in. x 56 in. with bars on both sides(“ambulant accessible”). As the population ages, demand for this second type of stall will no doubt increase.

The 60 in x 56 in. stall has several advantages. First, narrower stalls need to be at least 66 in. deep to accommodate wheelchair users. Even then, a parallel transfer will be impossible. Narrower stalls should only be used in renovation work and should be 48 in. wide minimum to allow at least two types of transfers. Second, the 60- by 56-in. stall can have a door located on the side instead of at the end. This is an advantage in space planning. Finally, in renovation work, the space for two conventional stalls can be combined to make an accessible stall without increasing the depth of one stall.

Stalls wider than 36 in. must have the water closet located close to one side, leaving a wide transfer space on the other side. In a 60-in. stall, a grab bar is only needed on the near side. Codes also require a bar at the rear of the water closet to provide additional assistance to semi-ambulatory people, although many experts think that this bar has dubious value.

Tank-type water closets have standardized valve locations which limit options for right- or left-handed stalls. The flush valve should be on the open side. A person who can transfer onto a water closet in one direction, should also be able to transfer off it in the other direction. Logically, this means that handedness should not be an issue for access. However, in practice, there are many people who report that they can transfer easily to and from a toilet in one direction but may not be able to transfer without assistance in the other. This difference in ability may be related to learned skills in one’s own home rather than actual abilities. But, wherever possible, provision of both left and right handed stall designs in a building would provide added usability.

Wall-hung water closets are shorter in length than tank type units and they provide extra toe clearance, allowing a closer wheelchair approach. Thus, when floor-mounted fixtures are used, 3 in. should be added to the depth of a stall. Another advantage of wall-hung units is that their mounting heights can be flexible. Some floor mounted water closets are 19-21 in. to the top of the seat. Rehabilitation specialists often recommend toilet seat heights that are similar to wheelchair seat heights (with cushions). This may be as high as 20 in. However, most people find their legs dangling and some have difficulty maintaining balance at heights like these. Research has demonstrated that seat heights of 17-19 in. are most comfortable. Eighteen inches can be used for a compromise height. Nineteen inches is preferable for people who have difficulty bending. There is talk in some code groups of requiring stalls with both high and low seat heights to accommodate these different needs. The high seat would be in the “ambulant accessible stall.”

Grab bars come in a great variety of shapes and sizes. There are some that approximate the shape of pretzels! Vertical and diagonal bars are helpful in pulling oneself up to a standing position but are not as useful for preventing a fall or transferring to a wheelchair. They also are more difficult to use for stabilization. The horizontal bar provides the greatest safety. It is less likely that one’s grip will slip and forearms can be used to provide added support. Wall mounted bars should be mounted at a height of 33 in. on center, start at a point no more than 12 in. from the back wall of a stall, and be at least 40 in. long.

There are some manufacturers who make pivoting bars. They have been used widely in Europe for many years. These can be helpful in providing additional assistance to semi-ambulatory people on the open side of a 60-inch-wide stall. When added to the standard accessible stall, they can eliminate the need for an “ambulant accessible stall.” But if they are heavy and awkward to move, they can be an obstacle to the wheelchair user. Many of these bars are too short to provide much help in transferring off the toilet. Pivoting bars should be mounted closer to the water closet and lower than wall mounted bars (15 in. on center is recommended by one company). In these positions, they provide more support for pushing up, like an armchair.

Bars attached to toilet seats are useful to some people. However, they do not project beyond the toilet far enough and they are usually too low. Their height is often determined by the clearance required to open the seat fully for bowl cleaning rather than usability for support. Moreover, being fixed in position, these bars are an obstacle to wheelchair transfers.

Grab bars should be 1 1/4 - 1 1/2 in. in outside diameter for optimum gripping. Smaller diameter bars can be used if they have plastic grips along the top where the bar is gripped.

All doors to toilet stalls should swing out to provide the necessary maneuvering room and allow rescuers to open the door if a person has an accident inside.

Lavatories and Mirrors
The “wheelchair lavatory” is an example of an accessible product designed initially for the health facility market. Many designers and rehabilitation specialists recommend the use of these lavatories because they have a much narrower profile and are much longer than conventional models. However, they are really not necessary. Goose neck spigots and wrist blade faucet controls, which often come with “wheelchair lavatories” are also not necessary.

Many conventional lavatories are acceptable if mounted high enough to provide adequate knee and toe clearance. The mounting heights of conventional lavatories vary. A typical height is 31 in. to the rim. Research on preferences demonstrates that ambulatory people prefer a height of 34 in., which ironically, is often specified for accessible lavatories. A 32 in. height is better for wheelchair users. Such a mounting height can be obtained in conjunction with adequate knee clearance if a sink (or counter)with a fairly narrow leading edge and a shallow bowl profile is used. Legs must be protected against burns and scrapes from the plumbing and the underside of lavatories. Some paraplegics and quadriplegics have no feeling in their legs, so they can easily damage their skin without knowing it. Lavatory faucet controls can be any lever design or push-type unit. The best are the electronically activated types that don’t require a grip at all.

Gang-type wash basins can be acceptable as well. If spigots or water spray come close to the leading edge, the knee clearance required for lavatories can be reduced.

Another accessibility product from the health care field is the tilted mirror. If they are fixed in a tilted position, such mirrors cannot be used by ambulatory people - they see only their stomachs. Adjustable tilt mirrors are a good solution in some installations. In public restrooms where vandalism is a problem, adjustable mirrors are not recommended. A higher mirror with its lower edge mounted at 40 in. minimum from the floor is satisfactory, although a full height mirror is preferable.

It is clear that providing accessibility to lavatories and mirrors does not require special equipment.

Dispensers and Receptacles
There are two basic accessibility concerns regarding dispensers and receptacles. The first is selecting a product that can be operated by people who have difficulty using their hands, and the second is locating the items where they can be reached easily from a wheelchair. Dispensers that require two hands or awkward manipulations to use or unclog should be avoided.

Toilet paper dispensers should be installed on the near wall of accessible stalls. They should be no more than 36 in. from the back wall and located to insure that the paper is accessible and access to the bar is not blocked. A simple roll is better than a roll with a paper-saving device. Some people may have great difficulty with folded paper dispensers if they clog easily. Toilet paper dispensers should not be so bulky that they clutter the stall or make sitting on the toilet awkward. Some oversized dispensers and those with extra roll compartments present real elbow-room problems and obstacles to proper use of grab bars.

Towel and soap dispensers and garbage receptacles should be located with their highest operable part no more than 48 in. from the floor. Codes do allow a 54 in. minimum height if there is enough room to use a side reach from a wheelchair. This is a more convenient height for tall ambulatory people when eye-hand coordination is needed to perform a task, e.g., a telephone call. But, most toilet room equipment could be used by ambulatory people when mounted with the highest operable part at 48 in. This is generally a much more accessible height for wheelchair users and people of short stature. If dispensers and receptacles are mounted over counters or lavatories, their height must be even lower for convenient use - codes require 44 in. maximum to the highest operable part. Even this height is too high for many people. Forty in. for height over counters and lavatories is much better. In general, there is usually no need to mount some equipment lower than others even if the 48 inch mounting height is used. But some types of dispensers can become very inconvenient for tall ambulatory people, expecially if the bulk of the device obstructs the line of sight to the operating mechanism and thus, two separate dispensers at two different mounting heights may be necessary.

In Conclusion
Since toilet rooms are such a critical personal concern for people with disabilities, accessibility issues should be a particularly important priority during building design. Architects who are knowledgeable about the human factors needs will have less difficulty meeting the requirements. In renovation projects, literal compliance with codes sometimes cannot be achieved within the budget available. However, knowledge of options and alternative approaches can help architects provide at least a minimal degree of accessibility. The most difficult problems are caused by tight circulation at entries and around toilet stall doors. With the exception of grab bars, larger toilet stalls, and underside protection of sinks, there are no special requirements for people with disabilities as long as the basic space clearances and reaching limits are adequate. Enough space can usually be provided by removing superfluous partitions. Unfortunately, some building regulations often require special toilets, sinks, mirrors and unreasonable high or low mounting heights for fixtures. Also, a restrictive interpretation of the turning space required (e.g., 5 foot turning radius clear of all fixtures) can make modification of small toilet rooms difficult.

There are many so-called “accessible toilet rooms” that really aren’t accessible. Designers and code reviewers sometimes have inadequate knowledge about how the regulations should be applied in the toilet room. Seemingly insignificant features such as a 2-inch difference in toilet height or where the toilet paper dispenser is located, can ruin all the good intentions of the code or the designer. Getting approval of regulatory authorities is not enough. Designers must become fully aware of the issues and the many ways in which accessibility can be accomplished.

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