Although federal and state regulations require employers to provide toilets, government agencies, incredibly, do not require employers to permit workers to use them. Marc Linder, a labor lawyer and political economist, and Ingrid Nygaard, a physician specializing in urogynecology, place this regulatory breakdown in the wider context of the history of labor-management struggles over rest periods.

They emphasize the physiological consequences that workers suffer when they are not allowed to interrupt work to rest or urinate. Linder and Nygaard explain how protective rest period legislation has shrunk over time. Ironically, because most statutes singled out women for rest breaks, they were invalidated by Title VII's ban on sex discrimination. The authors explain other countries' regulations and conclude with a recommendation for legislation to mandate rest and bathroom breaks for all workers.