How far apart should toilets be spaced on American roads?

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You also have to remember that stomach issues were more serious back in the steam era as well. As recently as the 1920's-30's it wasn't that uncommon for people to straight up die from Food Poisoning. Influenza (Flu) wasn't just an inconvenience, it was cause to pick your Coffin just in case, depending on age and circumstances. It was alot rarer for people to place themselves in situations where sudden need of a restroom was a nessicity. As Older employees worked through the food chain of promotions, they'd be very likely to gain that vaunted desk job if they needed that kind of access to Facilities.

After that, out here in the West at least, Crew Stop/Change points would be my guess for likely spots to find facilities. After that I think someone already mentioned the Shovel and Firebox, or even the Door to the Cab in Dire emergencies.....