By Associate Prof Phillippa Carnemolla, Prof Simon Darcy, Barbara Almond, Farah Madon, Mark Relf AM
Public bathrooms are important places. The provision of accessible public bathrooms helps to ensure health, wellbeing and equitable access to our cities, public spaces, and communities. However, the real risk of falling off the toilet pan while reaching for toilet paper and avoiding public bathrooms altogether are two preliminary findings from a new research project “An Inclusive and Embodied Approach to Accessible Bathroom Design for Powered and Manual Wheelchair Users” by the University of Technology Sydney (UTS) Disability Research Network and industry collaborators Farah Madon & Mark Relf in partnership and codesigned with Spinal Cord Injuries Australia and Physical Disability Council NSW.
The new project explores how accessible bathrooms are used by wheelchair users (both manual and power chair). It also looks at the effects of the Australian Design for Access and Mobility design code (AS1428:1) on public bathroom design. The design code takes a prescriptive approach to public bathroom design while making many assumptions about how wheelchair users access the toilets including how they use, approach and transfer onto the toilet pan. Most often, wheelchair users are considered as a single homogenous user group.
The UTS research team shows that there is great diversity of accessible public bathroom use and preference within the wheelchair using community. The research team used a multimethod, evidence-based research design involving field studies and innovative technology to scan the built environment accessible public bathrooms. (Newton, Carnemolla, & Darcy, 2023). The research includes video footage of wheelchair users re-enacting their use of public accessible bathrooms, in-depth interviews of those wheelchair users post-video, and an online survey with 200 wheelchair users across Australia in the past 12 months.
The team designed the online survey in collaboration with industry experts with experience with the Australian Standards Committee for Access and Mobility (AS1428 Pt1-6) including those with lived experience as wheelchair users. The online survey used diagrams of bathroom layouts based on the Australian Standards for new buildings (Standards Australia, 2021). For example, Figure 1 identified six main types of transfer approach that wheelchair users and those with mobility disability may use in accessible public bathrooms. The research team also conducted in-depth interviews with participants recruited from Spinal Cord Injuries Australia (SCIA) and Physical Disability Council of NSW (PDCNSW) with a diversity of wheelchair types.
Figure 1: Main types of transfer approach to the toilet pan by wheelchair users
Source: developed for the online survey by Farah Madon
Mark Relf AM, Accredited Access Consultant and past President of ACAA (Association of consultants in Access Australia) notes that AS 1428.1 bathroom design requirements are based of 1970’s-1980’s data with “a few tweaks along the way — generally larger room size and door” and, more recently, the addition of the infamous backrest. Relf says the design has always favoured high functioning people with paraplegia and similar conditions, which has been at the expense of people with higher support needs who often use powered wheelchairs or other mobility aids.
“The more recent addition of the backrest was at the request of one member of ME064 committee of the Australian Standards responsible for the AS1428.1 which often causes inconvenience to many users,” Relf says.
Preliminary findings from the UTS research show wheel-chair users often avoid public accessible bathrooms due to poor access or maintenance. The risk of falling off the toilet pan is real. In fact, there are numerous stories about how poor design creates a higher risk of falls. For example, many toilet paper dispensers are so close to the ground that reaching for the paper means people risk overbalancing. Similarly, wet floors can be both unhygienic and treacherous making slipping a high risk if doing a sit-to-stand transfer. Participants also talk about the need for storage and shelving near toilets and sinks, particularly if they use catheters. Photo 1 shows an example of a typical accessible public bathroom including a toilet with a backrest and the positioning of other accessible features.
One person interviewed in the research said they “avoided disabled bathrooms due to limited space or lack of a clean space”. Another person said: “I dread leaving my home and limit my excursions.” These comments reflect the findings of other UTS research such as “Disability citizenship: An Australian human rights analysis of the cultural industries” which examines complaint cases made under the Disability Discrimination Act, 1992 involving access to and the inadequacies of the built environment including accessible public bathrooms (Darcy & Taylor, 2009).
Photo 1: Example of an accessible public bathroom toilet layout.
Photo: P. Carnemolla.
The new UTS research also identifies the different nature of the accessible public bathroom use by wheelchair users as set down by the Australian Standards for Access and Mobility and how their home residential bathrooms are far more tailored to their individual needs. One person said that public bathrooms are set up mainly for independent wheelchair users with good upper limb/hand function. Soap, paper towel, hand dryers, toilet rolls are often placed in inaccessible positions and/or in places where they obstruct the grab rail. “It’s very frustrating to have all the elements there, but you can’t reach them!”
This comment is backed up by this new UTS research on accessible public bathrooms at a major university shows that there is a high level of unsatisfactory placement of key access features as determined by the 3D scanning methodology used in the research. This is despite Australian Standards quite prescriptive guidelines as to the design and layout of accessible public bathrooms. Table X identifies that the access features with less than 50% satisfaction include door operation, door fittings/security, flush type, toilet shelf, other rubbish disposal, and evacuation notices in the research. (Newton et al., 2023). The findings of the 3D scanning methodology reinforce and support the research data.
Table 1: Key Features, ranking and ratings for accessible bathrooms
Source: Table 1 created by author from Newton et al. 2023.
One of the most striking preliminary findings has been the level to which wheelchair users meticulously plan their public bathroom visits or avoid public bathrooms altogether. This shows that well-designed accessible public bathrooms must feature in all, inclusive public spaces. Without accessible public bathrooms people with disability cannot undertake activities for work or recreation or for travel in comfort and safety. Indeed, some wheelchair users prefer to forgo social activities than be faced with public bathrooms that they cannot access.
Relf says the design requirements of AS 1428.1 “in some ways fail” as designers and building certifiers believe “this is the only way”, when in fact people are denied their preferred design simply because it varies from AS 1428.1. As a wheel-chair user himself, Relf believes strongly that there should be some latitude to customise design for the individual’s needs, rather than for a prescriptive AS 1428.1 template for a bathroom.
Photo 2: Example of an accessible bathroom layout. Source: Farah Madon.
The research ultimately demonstrates the diversity of preferences amongst wheelchair users themselves, and the need to expand the research further. The UTS team also has plans for peer-reviewed articles sharing the results and further engagement with architects, developers, facility managers and access consultants. In the end, it is much less cost to the community to get this right at the design stage, rather than attempting to retrofit public bathrooms, so that they serve their purpose in providing proper access and facilities that are truly accessible and used by all wheel chair users.
Acknowledgements and Funding
This work was supported by UTS Special Initiatives Grants [2712018 and 2748012].
The funding source was not involved in the conduct of the research and/or preparation of the article.
References
Darcy, S., & Taylor, T. (2009). Disability citizenship: An Australian human rights analysis of the cultural industries. Leisure Studies, 28(4), 419-441 https://www.tandfonline.com/doi/full/10.1080/02614360903071753
Newton, S., Carnemolla, P., & Darcy, S. (2023). Building information modelling and related technologies applied to the post occupancy evaluation of accessible bathrooms for people with disability. Smart and Sustainable Built Environment, (ahead-of-print) https://doi-org/10.1108/SASBE-04-2023-0075.
Standards Australia. (2021). AS 1428.1 Design for access and mobility – General requirements for access – New building work with amendments (5th ed.). Homebush, NSW: Standards Australia.