Construction Occupational Health Program

Lack of Sanitary and Handwashing Facilities on Construction Sites: An Issue of Health and Dignity


Presenter: Susan Moir, MS
Director of the Construction Occupational Health Project (COHP) University of Massachusetts Lowell

Panelists: Dr. Lenore Azaroff
HASWIC Project Coordinator, COHP
University of Massachusetts Lowell

Elizabeth Skidmore
Organizer, N.E. Regional Council of Carpenters
Chair, Women’s Regional Advisory Committee to the Carpenters
Chair of the Board of the Boston Tradeswomen’s Network

Address to the National Association of Women in Construction (NAWIC), Boston Chapter, World Trade Center, May 18, 1999

Thank you very much for inviting us to attend your meeting today and for giving us the opportunity to speak to you about sanitary and handwashing facilities in construction, an important, and often overlooked, health and safety issue in the industry.

For those of you who are unfamiliar with the Construction Occupational Health Project, the COHP, located at UMass Lowell, I would like to begin by giving you a brief overview of the research project on which Lenore and I work and by telling you a little about the action research project with construction tradeswomen that Elizabeth has participated in over the past two years.

The COHP began in 1992 as a project of the work environment department at UMass Lowell. We are just one of over 15 research centers around the country that are funded by the national institute for occupational health (NIOSH) and by the building trades department of the AFL-CIO. We conduct research into health and safety problems in construction. The initiative for this research began in the late 1980’s when the unions recognized the problem of lack of research into construction health and safety.

Since its establishment in 1970 as the governmental agency responsible for occupational research, NIOSH has funded research to understand and prevent illness, injury and death in the country’s factories, mines, hospitals, offices and other workplaces. I ask you to make a guess as to what percent of that research was done in construction in NIOSH’s first 20 years. The answer is less that one quarter of one percent.

As recently as 1988, federal funding for safety research averaged $0.08 per construction worker, compared with $2.16 per manufacturing employee.

Almost no research was conducted in construction:

  • Despite the recognized fact that construction is one of the most hazardous industries in the U.S.
  • Despite the fact that it is widely believed that construction workers die 10 years earlier than other workers.
  • Despite the fact that one out of every 10 construction workers is injured every year.
  • Despite the fact that estimates of the direct and indirect financial costs of illness, injury and death in construction rise into the billions of dollars per year.

Under the leadership of the center to protect workers rights, the research arm of the national building trades unions, this trend was reversed in 1990. Over this past decade, researchers throughout the country have worked with contractors and the unions to understand the hazards of construction and to begin to develop effective and workable solutions.

Research has been done on:

  • Lead,
  • Silica,
  • Falls,
  • Motor vehicle accidents,
  • Dermatitis,
  • Stress,
  • Asphalt fumes,
  • Drywall sanding,
  • Electrocution,
  • Excavation and trenching,
  • Roofing,
  • Scaffolding,
  • Paints and solvents,
  • Effectiveness of personal protective equipment,
  • Ergonomics including evaluation of heavy lifting and awkward postures
  • Work organization,
  • And the effectiveness of health and safety programs and of training.

The COHP at UMass Lowell has been a national leader in studying respiratory hazards, ergonomics, health and safety programs and effective training. We have also been in the forefront of understanding the health and safety issues of women in construction.

That is the research that I would like to focus on for the rest of my time today.

In 1994, a working group of OSHA was organized to look at issues of "health and safety for women in construction" (H-A-S-W-I-C). This group of nine women called itself the HASWIC workgroup. In 1997, they produced a document called "Women in the Construction Workplace: Providing Equitable Safety and Health Protection." This has come to be known as the OSHA HASWIC report. In this report six issues were identified as prime concerns of tradeswomen:

  • Hostile workplace culture,
  • Insufficient sanitary and handwashing facilities,
  • Poorly fitting personal protective equipment,
  • Ergonomic design for male body size and strength,
  • Reproductive hazards and
  • Inadequate health and safety training.

A seventh issue raised by the workgroup suggested that more research needed to be done on tradeswomen’s concerns. That’s when the COHP got involved. We had been looking for an area of research to pursue with tradeswomen. Boston is very fortunate to have two organizations that represent the interests of tradeswomen, the Boston Tradeswomen’s Network and Women in the Building Trades. We had consulted with both groups and approached them again after the OSHA HASWIC report came out. With their assistance, we assembled a group of tradeswomen in what is called a Research Circle. Elizabeth Skidmore is a member of the Research Circle. This group has met for the past two years. The Research Circle members have reviewed the national report and compiled extensive data on its relevance to women in construction in the Boston area. The first year findings are published in the Year One Summary Report and the final report will be available soon.

The key finding that we would like to raise with you today is the lack of sanitary and handwashing facilities on construction sites.

How does the accepted industry practice of inadequate sanitary facilities and no place to wash your hands affect tradeswomen?

How many people in the audience today have actually done construction work, worked with the tools? If you have actually been a construction worker working 8-hour shifts digging, building or demolishing our highways, homes, skyscrapers or other commercial buildings, raise your hand.

That’s about 10% of us.

For the rest of the audience who have not had the benefit of that experience, and perhaps to refresh the memory of those who haven’t been out there in a while, picture this:

You are outside for 8, or more hours, every working day. For several months every year, you wear heavy winter clothing. Construction work is not generally aerobic. It is anaerobic like weightlifting. To stay warm, you wear the best in construction cold weather fashion. Bundled up in helmet liner, gloves, boots and quilted overalls,

You top off your outfit in a winter-weight "Carhart." You are ready to work. Now picture this: You have your period.

Or how about this scenario:

You are floating in a raft inside a drainage pipe building concrete forms overhead. Occasionally a tool is dropped and has to be fished out of the water. Brown foam regularly floats by. It’s 12 noon, time for lunch. You and your co-workers pull yourselves out of the pipe and grab your coolers. There are no facilities to wash up.

If you’re saying now, "That’s not a women’s issue," you are right, of course. This true story happens to be Liz Skidmore’s. But it could have been from her union brother, Al Peciaro.

Al is now a council representative with the New England Regional Council of Carpenters, but he was a steward on the site where workers first brought this issue to the attention of COHP researchers. He wrote an eloquent statement to management on this issue in which he said:

"We are amazed that in 1997, [construction workers] are forced to use the same so-called sanitary facilities that have been around for hundreds of years. In this day of infectious diseases and flesh-eating viruses, the idea that we do not have flushing toilets and hot and cold running water to wash with is uncomprehendable."

Workers, who have mostly been male, have repeatedly told us that their number one health problem is the lack of adequate sanitary facilities and their inability to wash their hands at work.

Workers also see this as an issue of respect and dignity. Blue-collar workers deserve the same conditions and respect that white-collar workers receive. Construction workers constantly compare their facilities to those of management. They see it is a form of class segregation to have decent facilities for one set of employees and second-rate facilities for others.

This is a growing issue for workers in many sectors of our economy. A 1997 article in the magazine WorkingUSA reported on factory workers, farmworkers, telephone workers and school teachers who suffer from urinary tract infections, bladder disorders and other medical consequences of being denied access to toilets.

We believe that the reason this issue coming up now in Boston is the experience of thousands of construction workers on Deer Island.

The MWRA (Massachusetts Water Resources Authority) supplies trailers with running water. Workers and contractor representatives speak frequently of the high quality sanitary facilities on the island. The island has shown the industry that it can be done.

This is not only a construction industry issue. It is an important public health issue that enters all of our lives when construction workers leave work. The CDC has concluded, "handwashing is the single most important means of preventing the spread of infection." In 1997, the Mass. Department of Public Health estimated that poor handwashing resulted in 60,000 hospitalizations a year in Massachusetts and cost $400 million in 1996.

But many of the tradesmen who have seen the changes at Deer Island seem willing to quietly return to the old way. We know that they are dissatisfied with these conditions, but as one tradeswoman said,

"I think the guys have problems also, but they take it for granted. They accept the conditions as part of this rough world that they function in. And also, many times if there is no near bathroom, they’ll just pee...."

It is women, through the OSHA HASWIC report and the Boston-area HASWIC Research Circle who have been willing to take a public stand and say that these conditions need to be changed. And we are hoping that the women of NAWIC will also see this as an important issue.

So why are there not adequate and clean sanitary handwashing and sanitary facilities on most construction sites? The reasons given usually come down to these three:

  1. It’s not possible
  2. It’s too expensive
  3. OSHA doesn’t require it.

Let’s look more closely at what our research seen and the HASWIC reports have said on these issues.

First, it’s not possible.

One worker pointed out, "tradespeople build a variety of temporary facilities, including complicated structures such as bridges. Building temporary toilets should be relatively simple." Workers are generally incredulous at this response. They built this city. They believe they can build semi-permanent toilet facilities.

The next excuse is usually something like, "But we don’t have water." Workers point out that it is never a problem to get water to clean equipment, wash trucks or mix mortar. "The bricklayers always have water," they have said. The HASWIC Research Circle has developed seven specific solutions to the problem of getting hot running water for handwashing on construction sites. My favorite is battery-heated running water, like in RVs. I always think of my parents and a convoy of senior citizens in their Winnebagos traveling all over New England. Believe me, my mother always had access to hot water. Another example of how technology has been used to address temporary needs for handwashing is outdoor festivals. In discussing this issue with Mark Erlich, senior assistant administrator of the N.E. Regional Council of Carpenters, I used the example of King Richard’s Faire, held annually for several weeks down in the Carver woods.

Mark’s answer was "That’s medieval. You’re talking construction. We’re in the Stone Age."

The second objection is that it costs too much money to provide adequate facilities. However, indirect costs are often overlooked. Workers point out that, besides the costs of making workers sick in unsanitary conditions, lack of adequate facilities reduces productivity on the spot if they have to travel half an hour or leave early to find a bathroom. One worker stated, "Even if we can’t leave and just have to hold it, our productivity suffers because we can’t think clearly."

But what of the up-front costs? One contractor said to us, "We just don’t think about it…but the stewards brought up the issue. It’s hot. It stinks. We won’t use [the port-a-johns], the guys in the office. We bought it." What this contractor bought is a $35,000 portable restroom with flush toilets and hot water. It’s a job trailer that can move from site to site. But we all know that only the cutting edge contractors will spend money over and above that required to complete the job unless forced to by external forces.

There are several routes to providing this external motivation to change in the construction industry.

The building trades unions can take up sanitary and handwashing facilities as a health and safety issue in contract negotiations. The workers tell us that "among the construction trades, only the tunnelworkers and boilermakers have sanitary facilities in their contracts. Other trades normally have unsatisfactory sanitary facilities." Union members are concerned about this issue and if more Collective Bargaining Agreements in Massachusetts addressed it, the standards would change across the industry.

Besides the unions, the owners of the projects need to take leadership on this issue. A route to change is bid specifications that call for adequate facilities. This would level the playing field for contractors and make them accountable to the owner for the conditions on site.

This takes us to the excuse most often given for these conditions: OSHA doesn’t require it.

Well, do they or don’t they? The applicable standard, 29 CFR 1926.51, is confusing and contradictory. In a letters of interpretation, OSHA has said that workers must be able to wash their hands if they are exposed to any harmful or toxic substances, but that the requirements for lavatories do not cover construction because construction sites are not "permanent places of employment." An OSHA representative told me three years ago that he believed that the standard did require most construction employers to provide workers with handwashing but that this legal requirement is ignored through an informal agreement that he termed "acceptable area practice." This was the clearest explanation of OSHA policy on this issue that I have heard. Unfortunately, my source has passed away and no one from the agency has been so forthcoming since. A group advising OSHA is addressing this confusion and lack of direction. They will soon recommend that the standard be strengthened to require handwashing "where practical" and to give OSHA the ability to enforce the standard.

Will the industry respond to this needed change in the standard by resisting its promulgation and implementation? Or will contractors support a stronger standard as a means of improving working conditions while averaging the costs across the industry? Will industry leaders, such as the women in this room, support an important improvement in the industry?

We hope that you will support this change because this is a public health issue. Tradeswomen are alerting us that "inadequate handwashing facilities is a major problem at their work sites.… The inability to wash one’s hands leads to sicknesses spreading among all members of a crew, especially in the winter." These illnesses cannot be confined to construction sites. They go home with the workers, to their families and friends, to restaurants, schools and all the other places in our communities where germs are exchanged. We all have an interest in sanitary working conditions.

We hope that you will support this change because this is an important health and safety issue for the workers in your industry and all workers should have the right to these accommodations at the workplace.

What can NAWIC members do to support the improvement of sanitary and handwashing facilities on Massachusetts construction sites?

  1. Read the OSHA HASWIC Report and the reports of the Boston area HASWIC Research Circle. Give them to friends and colleagues in the construction industry who are interested in these issues.
  2. Within your organizations, support and promote the recommendations of the national and local HASWIC group.
  3. From the OSHA HASWIC Report: "OSHA should amend CFR Section 1926.51 (toilets at construction jobsites) to specify that gender-separate, external and internal locking sanitary facilities be provided on construction worksites, that employees be allowed to use such facilities as needed, be provided keys for gender appropriate facilities, that the toilet facilities be maintained in a sanitary condition and in good repair (e.g., that locks work), that clean toilet paper be provided within reach of the toilet, and that handwashing facilities be located within close proximity to toilet facilities."
  4. From the Boston area HASWIC Research Circle: "At the first meeting of the HASWIC Research Circle, in January, 1998, members listed improved sanitary facilities, including trailers with bathrooms, as goals they would like to achieve within the next five years."

Within your organizations, support and promote the concept of including adequate and clean sanitary and handwashing facilities:

  • in bid specifications
  • in Collective Bargaining Agreements

Within your organizations, support and promote the strengthening and enforcement of the OSHA standard, 29 CFR 1926.51 to improve sanitary and handwashing on construction sites.

For copies of the HASWIC Reports and more information on how you can support and promote improved sanitary and handwashing facilities in the construction industry, call the COHP at 978-934-3258.

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