Howdy, Like many others I have been a silent reader of this excellent list for two months. I have really enjoyed the many posts and in general look forward to logging on to see what's there (except after short vacations when there's over 100 items!). In following the string on office space I thought this article from our local AAP Chapter's Green Mountain Pediatrician would be of interest for anyone building a new office or redesigning an old one. The Web site is http://www.vtmednet.org/gmped if anyone is interested in what's going on up here in Vermont. Most Often Overlooked Accessibility Barriers Many offices and public buildings have made an effort to eliminate barriers for people with limited mobility. Unless they have made a careful study of the regulations and standards it is likely that there are still subtle but significant barriers to full accessibility. After doors are increased to 36" wide and have lever handles, after level changes are provided with ramps and after grab bars are provided for toilets there is still more to do. Check to see if there are any changes in floor level that are greater than 1/2", those changes must be beveled with a slope no greater than 1 in 2. This most often occurs at entry doors and at thresholds at doors (3/4" is allowed at sliding exterior doors). It can also happen when floor finish materials change, such as between carpet over a pad (it is best to avoid carpet pads where accessibility is a concern) and a hardwood floor. These minor level changes must be handled with a wedge ramp which has a slope of no more than 1" in 8" for a maximum of rise 3", a slope of no more than 1:10 for a maximum rise of 6" and 1:12 for any rise greater than 6". Doors require space next to the latch edge to be accessible when they open toward the individual. A minimum of 18" next to the latch is required but the space may have to be as much as 42" in some situations. Closers for doors are required in many locations by fire codes. However, to meet handicapped access requirements a door must require no more than five pounds of pull force to be opened and the speed that the door closes must be regulated to take at least three seconds to travel from 70 degrees open to a point three inches from the latch. Generally this can be accomplished by adjusting the door's closer, but it is not automatically done upon installation. The speed of closure varies with air temperature so exterior doors should be adjusted seasonally. Turning area in front of doors and at ramp landings is required to be 60" in diameter. Ramps themselves do not guarantee accessibility. It is not uncommon to find ramp slopes steeper than the 1" in 12" which is the maximum allowable. Regulations are quite specific about the locations and arrangements for handrails and edge guards on ramps but these details are frequently not followed unless specific directions are given. While grab bars are understood to be required next to toilets, they are often not installed in required lengths and exact positions. There is also a minimum clear height depth required under sinks which is easily overlooked. Kitchenettes and other staff facilities, such as a shower or copier, must be accessible. In the effort to make public spaces and circulation routes barrier-free, staff areas are easily forgotten. Countertops, sinks, cook tops, microwave ovens and refrigerators must all be considered along with the storage cabinets. Signage is subject to very detailed regulations. The size and color of lettering and its background, the use of Braille, where signs are to be located at doorways and what doors are to have signs are all specified and are frequently overlooked. Conforming to these details and many others is not just required as a matter of law. To the extent that a facility meets or ignores these standards a message is sent to a portion of the public about the management's sensitivity to the comfort and safety of all who use it. Remember, particularly in this season of ski injuries, that people who are temporarily "mobility impaired" greatly outnumber those with permanent limitations. Some may be members of your staff. Hope this post was informative without being too verbose. Jonathan Gilbert, MD Mousetrap Pediatrics St. Albans, VT