BACKGROUND: Adult-sized changing tables allow individuals with disabilities or medical conditions related to toileting to change with or without assistance. These tables are rarely found in public restrooms, and as a result, those who need them are often changed on floors, in vehicles, or are unable to stay in public spaces for more than a few hours.
OBJECTIVE: This study aimed to understand how individuals who utilize adult-sized changing tables, or self-advocates, and caregivers for disabled people, access public restrooms and to report recommendations to improve inclusivity of public restrooms.
METHODS: We virtually interviewed five self-advocates and sixteen caregivers in February and March 2023. We performed a qualitative analysis of the interview transcripts using MAXQDA 2022.
RESULTS: Four major themes arose during interviews: social consequences, health effects, caregiver effects, and inaccessibility of restrooms in the healthcare setting. All caregivers have changed disabled individuals in vehicles, and 11 on public restroom floors, experiencing guilt and stress, and often receiving injuries. Several respondents reported limiting intake of fluids or using suppositories to prevent the need to toilet during unavoidable outings. Respondents most need height adjustable changing tables in healthcare settings, airports, and large recreational facilities.
CONCLUSIONS: Without adult-sized changing tables, individuals with disabilities are forced to risk their health and dignity to utilize public spaces.

Objectives. There are rising concerns about the health of classroom teachers in the USA, including stress, hypertension and frequent urinary tract infections. Teacher working conditions are likely a contributor to their health concerns. Many teachers report that they cannot easily take a restroom break at work, and therefore they consume minimal water or other fluids. This study investigated the relationship between restroom access and fluid consumption and the prevalence of renal and cardiovascular health complications in classroom teachers. Methods. The responses of 844 teachers (92% women, 8% men; 65.1% between age 26 and 45 years) to an online survey about restroom accessibility, fluid consumption and health were analyzed using descriptive statistics, χ2 analyses and logistic regression. Results. Fifty-nine percent of teachers could not easily take a restroom break, and 54.7% consumed fewer than 2 cups of water per workday. Furthermore, 44.8% reported being pre-hypertensive and 4.9% reported being hypertensive. Teachers with insufficient restroom access were significantly more likely to report frequent urinary tract infections. Conclusions. This study demonstrates a relationship between restroom access, fluid consumption and renal/cardiovascular health in classroom teachers. Future research should directly investigate how teacher work environment impacts renal and cardiovascular health.