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Why it's Important - Survey results

On this page see the results of the survey we did on school toilets. You can also see a summary of several other surveys and reports on the issues of school toilets. To see these, scroll down the page to the end of the results of our national survey.

Results of the National Survey of Schools

In 2003, the Community Practitioners' and Health Visitors' Association (CPHVA, which represents over half of school nurses in the UK) carried out a randon survey of schools across the UK. The CPHVA is one of the partners in the Bog Standard campaign.

This page contains a lot of information. We wanted to include the background to the survey, and analysis, rather than just supply statistics. Each section also says why a particular element is important.
If you don't have time to read all of it, you can read the summary, or click on a link below to jump down the page. Or you can open a printable version of this page and read it later.


Summary

  • 43% of school toilets were described as smelly
  • 84% were only cleaned once daily or less
  • 1 in 3 schools restricted access to toilets during breaks
  • Half the schools had toilet door/partitions that were too low and over two-thirds of schools had too large a gap at floor level. 89% did not have partitioned urinals.
  • 1 in 4 schools did not have sufficient locks on doors
  • One in 3 secondary schools had no or insufficient toilet paper
  • 23% did not have hot or warm water and 14% did not have cold water
  • One in 3 secondary schools had no or insufficient toilet paper
  • 23% did not have hot or warm water and 14% did not have cold water
  • 31% of secondary school toilets had no soap (with a further 27% not having enough)
  • 14% of secondary schools did not have any toilet seats at all and a further 21% had missing seats
  • Almost 6 in 10 schools did not have any disabled toilets
  • Toilets in 5% of primary schools and 55% of secondary schools showed signs of vandalism
  • 40% of secondary schools showed evidence of smoking in the toilets
  • 84% had drinking water facilities in the toilet area

Survey designs

The questionnaires were sent out to CPHVA nurses and consisted of three sections, which included a face-to-face interview with the headteacher and a visual inspection of the toilets by the school nurse.

The interview was also designed as an opportunity for school nurses to raise awareness of drinking water and toilets directly with their schools. Several nurses reported that their headteachers accompanied them on the visual inspection and were surprised to learn of long-standing deficiencies, such as no toilet seats or soap in washrooms.

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Limitations of the survey

School nurses sent a letter to heads of schools in their area to obtain permission to carry out a visual survey and to book an appointment with the headteacher. It is therefore possible that some toilets will have received special cleaning before a visit.

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Analysis

Not every question was answered for each school and several questions had poor response rates. Missing responses were excluded individually for each question in the results of the survey i.e. each answer is calculated individually based on only those that answered that question.

Analysis was carried out by Newcastle University.

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Reports from school nurses

Some nurses reported that some headteachers appeared unwilling to admit to poor practices, such as restricting access to toilets and/or that the school did not have a policy over access.

Other nurses commented on the enthusiasm of some headteachers to accompany them on their inspection of the toilets and to the commitment of some schools to provide their pupils with decent toilets.

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Response rate

928 valid questionnaires were returned from 70 LEAs.
School nurses completed 778 (84%) of the surveys.
150 (16%) were completed by another person, usually the school Head Teacher.
31% of schools were undergoing Healthy Schools registration.
13% had already achieved Healthy Schools status.

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Demographics

34% came from a rural school.
51% were from a suburban area.
15% were from inner city schools.
The majority of responses were from mainstream schools (96%) rather than special schools (4%).
82% of schools were primary and 17% were secondary.

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A note about the results

150 questionnaires (16%) were filled in directly by headteachers with no school nurse involved and this may have affected the results. This effect can be seen in the satisfaction rating of the school toilets and the reluctance of headteachers to answer questions, perhaps because of a natural concern that poor results might reflect badly on their school.

Of nurses who completed the survey, 18% were not happy with the state of the toilets, whilst only 3% of headteachers said they were unhappy with the state of the toilet. Headteachers were also much more likely not to even answer the question (65%) compared to nurses (12%).

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Access to toilets during lessons

  • 119 schools (13%) did not answer the question whether pupils were allowed out of lessons to use the toilets.
  • Of those that did answer the question, 9 in 10 schools (89%) reported that pupils were allowed out of lessons with this figure dropping to 4 in 10 (42%) at secondary school age
  • Nearly 1 in 10 schools (10%), of those that did allow pupils out of lessons, restricted permission to certain pupils or certain situations only and at secondary level these restrictions applied in almost a third of schools (30%).

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Access to toilets during breaks

  • 1 in 10 secondary schools (10%) restricted access to toilets during breaks and in primary schools this rose to nearly a quarter of the schools (24%)
  • Seven of the schools that did not give access during lessons only had two breaks throughout the entire school day when pupils were able to go (morning and lunch)
  • 44 of the schools that only gave access if desperate similarly only had two breaks

Not being able to go to the toilet when the need arises is a potential source of a number of health problems.

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State of the toilets

  • 4 in 10 (38%) primary school toilets and nearly half the secondary school toilets (47%) were described as smelly.
  • 8 in 10 secondary schools (78%) were not cleaned adequately and admitted to only cleaning the toilets once a day, while at primary level this figure rose to 9 in 10 (89%), with 2 schools admitting to less than daily cleaning.

The throughput in some schools is very high. When cleaning is only done once daily, it is inevitable that the toilets become unsanitary and are avoided by some children.

A high proportion of toilets were described as smelly, confirming frequent complaints by children.

The smell is often worse in older schools where it may be due to a combination of factors including insufficient cleaning over a number of years resulting in absorption of bodily waste (particularly urine), older and more porous building materials and surfaces and inadequate ventilation.

Some schools have a problem with toilets that are always smelly even after they have been cleaned.

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Anti-social behaviour in toilets

  • 5% (34) of primary schools and just over half (55%) of secondary schools showed signs of vandalism.
  • 4 in 10 (40%) secondary schools showed signs of smoking.

It is likely that when toilets are in a poor state and in need of refurbishment and more frequent cleaning that the toilets will attract poor behaviour, often by a disaffected minority.

Toilets at secondary level are often an adult-free zone and may become appropriated by groups of anti-social young people.

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Number of toilets and urinals

Because of the ways schools calculated the number of toilets/urinals it was impossible to calculate the ratio of toilets to pupils

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Height/depth of doors/partitions

  • Almost half of the schools (43%) had toilet door/partitions that were too low (allowed other pupils to peer over easily).
  • Over two thirds of schools (72%) had too large a gap at floor level (allowed other pupils to peer under).

The high rates of negative responses to this question is interesting and suggests that schools and school nurses may not feel responsible for the design of the facilities and were therefore more willing to admit deficiencies in this area.

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Urinals

Only 1 in 10 schools (11%) had urinals individually partitioned for privacy.
Few questionnaires reported the number of urinals and it was not possible to judge whether schools were relying too heavily on urinals rather than providing sufficient individual cubicles for boys.

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Locks on cubicles doors

1 in 4 schools did not have sufficient locks on doors; 53 (7%) had no locks, 131 (17%) had some locks.
Locks are essential for privacy and, if missing, will contribute to toilet avoidance and resultant health problems.

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Toilet seats

In secondary schools, 14% did not have any toilet seats at all, while another 21% had missing seats. Of those with toilet seats, 35% included broken seats and 27% were not firmly secured. 57 schools (7%) had dirty toilet seats at the time of inspection.

Toilet seats are essential for children to go to the toilet fully and, if missing or broken, will contribute to toilet avoidance and resultant health problems.

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Toilet paper

In 40 schools (5%) pupils had to ask for toilet paper before they went to the toilet, as school policy is to have no toilet paper in the toilets.

In 113 schools (15%) inspection revealed no or insufficient toilet paper and in secondary schools this figure rose to over a third (37%). In 135 schools (18%) toilet paper was not on holders.

Toilet paper is a basic toilet requirement for health and well being. The type of toilet paper was not asked.

Soft toilet paper, however, is preferred to hard, non-absorbent paper. Hard paper is unpopular with users, is a contributing factor to toilet avoidance, increases the risk of infection, skin-breakdown and cross-contamination.

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Female sanitary products and disposal

4 in 10 primary schools (40%) did not provide any sanitary disposal bins at all for girls aged 9+. 19 (4%) schools show what can be achieved: sanitary bins were provided inside each girls’ toilet cubicles to allow private disposal.

1 in 8 girls start their periods while at primary school. Girls may be shy or embarrassed about being among the first to start their periods and need help to manage their periods comfortably and in sanitary conditions.

At secondary level, 1 in 10 schools failed to stock sanitary protection products even for emergencies and, of those that did, in 7 out of 10 schools (71%) girls had to ask an adult.

Just 15% had sanitary facilities in the girls’ toilets where they could get supplies without having to ask a member of staff. 2 schools failed to provide any disposal bins while half the schools (50%) did provide sanitary bins inside each girls' toilet cubicle.

Girls need to feel comfortable about obtaining and disposing of sanitary products without drawing attention to themselves and possibly running the risk of bullying. Lack of disposal facilities creates embarrassment and encourages unsanitary practice.

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Disposal of incontinence materials/products

48% of schools did not have a clinical waste system.

The lack of a suitable disposal unit adds to the already considerable embarrassment of pupils with continence problems, encouraging unsanitary practices and encouraging smells that add to feelings of isolation and raising the risk of teasing and bullying.

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Hand washing facilities:

  • Nearly a quarter (23%) did not have hot or warm water.
  • 14% did not have cold water.
  • Nearly a third (30%) did not have any or sufficient soap. At secondary level, 27% lacked sufficient soap while 31% of schools had no soap at all.

Thorough hand washing with warm water and soap will remove germs. Hand hygiene is important to prevent the risk of infection and disease and their spread through the school and into the wider community.

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Hand drying facilities

  • Were not provided at all in 36 (5%) of schools.
  • Where pull roller or hot air dryers were used, 15% were not working.
  • Of the schools that used paper towels (50%), nearly 1 in 10 (9%) did not provide bins for their disposal.
  • 11 schools used a single loop of towel

Hands that have been washed can be recontaminated by not being dried or by incorrect drying (such as dirty roller towels or failing to thoroughly dry hands under warm air dryers).

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Disabled toilets

Almost 6 in 10 schools (57%) did not have any disabled toilets.

This discriminates against a group that is being encouraged to participate in mainstream education and is contrary to the requirements of the Education (School Premises) Regulations 1999.

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Drinking facilities in toilet areas

Over 8 in 10 schools (84%) had water facilities (fountains, taps and even water coolers) in toilet areas.

The toilet is an inappropriate, unappealing and unhygienic location for drinking facilities and will discourage pupils from drinking.

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A summary of other surveys

Other surveys reveal equal widespread dissatisfaction with school toilets.

UK Youth Parliament survey

Members of the UK Youth Parliament in July 2004 surveyed pupils and teachers from 11 secondary schools in Medway (Kent) and presented their findings at the launch of the Bog Standard campaign at the House of Commons in September 2004.

Pupils

  • 50% of the pupils regularly avoided going to the toilet and waited until they got home.
  • 25% of pupils had health problems from not using the toilet when they needed to.
  • More than 1 in 10 stayed at home at times to avoid the school toilets.
  • 50% of pupils said that the toilets were locked during lessons.
  • 96% of girls and 70% of boys said that teachers regularly stopped them from going to the toilet.
  • 40% feared behaviour of other pupils in the toilets.

Teachers

  • 87% never heard of pupils waiting until they got home to go
  • 88% never heard of pupils’ health problems caused by hanging on
  • 76% never heard of pupils’ absenteeism due to problems around school toilets
  • No teacher realised pupils feared the behaviour of others in the toilets

Armitage Shanks survey on age and condition of toilets

In 2005 Armitage Shanks carried out a postal survey of primary and secondary schools in the UK and received 822 replies from staff. The survey found that seven out of ten schools had toilet blocks installed over twenty years ago. Over half of schools rated the condition of their toilets as poor.

An unpublished survey of toilet problems encountered by pupils in Sheffield schools

Research (by Consultant Paediatrician, Dr K Price) from Sheffield Children’s Hospital of children attending paediatric outpatient clinics (a quarter had problems relating to constipation) over a four-week period showed that over half of all the pupils avoided school toilets, with around a quarter prepared to use them only if desperate.

The 105 participants were aged 5-16. The main problems identified were the smell, dirt, lack of privacy and problems with doors and locks, as well as rules and problems encountered using school toilets:

Toileting habits relating to school toilet use:

Urine:

  • Only 44% will pass urine at school
  • 26% will only pass urine if desperate.

Bowels:

  • 30% will open their bowels at school only if desperate
  • 43% will never use school toilets to defecate
  • 42% will hang on until they get home

Rules and problems encountered using school toilets:

  • 34% are refused use of the toilet during lessons
  • 8% are not allowed to use the toilets even at break times
  • 4% allowed use of toilets at break time only after receiving a letter from a parent
  • 11% report being allowed less than three minutes in the toilets

Lifting the lid on the nation’s school toilets published by the Children’s Commissioner for Wales, 2004

The Children’s Commissioner for Wales visited many schools during his first year in office.

One of the recurring issues was the state of the school toilets which children said was not being addressed, despite their having informed relevant adults.

The Commissioner’s team gathered data and views from 708 children and young people throughout Wales.

It is apparent that children and young people encounter major difficulties in trying to undertake a natural, essential, physical function.

  • 61.7% were unhappy with the state of the toilets in their schools
  • 51.7% of the toilets were smelly
  • 34% of the toilets were dirty with only 20% saying theirs were clean
  • 43% of the doors did not close and lock properly
  • 36% of pupils reported that it was hard to get permission to go to the toilet during lesson time
  • 3% reported the toilets were locked so they could never go
  • 15% reported no toilet paper and 16% hardly ever had toilet paper
  • 21% reported that bullying was a problem in their toilets

The report recommends that the Welsh Assembly Government ensure that future design and plans for major improvements of schools give a prominent profile to school toilets and the importance of design and location of these facilities.

This should include developing guidance and a clear set of standards for the improvement and monitoring of school toilets.

"One of the most important findings is that the state of the nation's toilets is not all bad. The very fact that some are adequate – or even fantastic – proves the point that there is really no excuse for the nasty school loos I so regularly hear about. It's just a question of taking responsibility, making it a priority and involving children and young people.”
Peter Clarke, Children’s Commissioner for Wales

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CBBC Short Change

The BBC children’s programme in 2004 found through their online survey, 71% of pupils were unhappy with their toilets, 22% thought that they were alright but could be better and only 7% were happy.

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An infection control programme in primary schools and the wider public health impact
by V Cleary, K Slaughter, R Heathcock
British Journal of Infection Control, 2003. 4; 11-15

A baseline sanitation survey was undertaken in 72 primary schools in Lambeth, London, with the scores used to prioritise schools for infection control audits. High priority schools were audited.

Medium and low priority schools conducted self-assessments and were subsequently validated.

Among the key findings were the lack of adequate facilities for handwashing such as soap, paper towels and hot water, and ineffective cleaning practices and working practices.

  • 11% of the schools did not have intact toilet fixtures and fittings or clean toilet seats
  • 12% did not have toilet paper
  • 6% of the toilets were difficult to flush
  • Soap was not available in 25% of the schools
  • 23% did not have towels
  • 59% did not have hot water.
  • Only 42% of schools had some sort of bin
  • Female sanitary bins were available in only 27% of schools.
  • Ventilation was poor in 42% of schools
  • 21% had water fountains in the toilets

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Children’s experiences of school toilets present a risk to their physical and psychological health
S Vernon, B Lundblad, A L Hellstrom
Child: Care, Health and Development 2003; 29, 47-53

This study looked at the physical and psychological consequences of children’s poor experiences of school toilets of nearly 400 children in 10 primary schools England (Newcastle) and 157 children in 7 primary schools in Sweden (Goteborg).

In England more than half of the boys (62%) and one third of the girls (35%) avoided using the toilets throughout the school day to defecate, blaming dirty toilets, inadequate privacy and fear of intimidation and bullying.

None of the schools in Newcastle had locks on all the cubicle doors. The boys' toilets were predominantly urinals with few toilet cubicles and boys wanted more individual toilets, to provide necessary privacy and to avoid bullies.

In Sweden fewer children avoided using the school toilets (28%) and single toilets attached to classrooms and fewer and smaller communal toilet blocks may help to explain this – grouped toilets were sited adjacent to dining halls and junior common rooms.

All the schools fulfilled the national requirements of numbers of toilets per pupil (in Sweden this was 1 toilet for 15 pupils over 5 years of age compared to just 1 toilet per 20 pupils in England).

The authors state that it is important for pupils to use the toilet regularly throughout the school day and that failure to do so results in many physical and psychological health problems.

Current legislation is limited in both countries to numbers of toilets per pupil; this needs extending to include acceptable standards of hygiene and maintenance, and privacy.

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A survey of drinking and toilet facilities in local state schools
E C Croghan
British Journal of Community Nursing 2002; 7, 76-79

This survey used school nurses to assess drinking water and toilet facilities and access in 136 Midland schools. Overcrowding was found, with 22% of the schools failing regulatory standards to provide enough toilets for the numbers of pupils in the school.

11% of the toilets were described as smelly and nurses reported potentially unsanitary conditions such as once daily cleaning only (78.4%), no toilet paper in any of the toilets (5%), only 60% of toilets had soap available for each washbasin, and around 10% had missing toilet seats.

Access to toilets was restricted during class times in 7% of schools and 13% were locked, usually during class times.

The sole source of drinking water in 34% of schools was in the toilet area, an unsanitary and unwelcoming site for drinking.

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Standards in school toilets – a questionnaire survey
PM Barnes, A Maddocks
Journal of Public Health Medicine 2002; 24, 85-87

An interviewer-administered questionnaire was given to children attending community audiology clinics and their parents to assess the perception children have of their toilet facilities and whether or not this influences their use of them.

The study found that due to restricted access to toilets (which were also poorly maintained), restricted access to toilet paper, and the lack of locks on cubicle doors (52%) 40% children never opened their bowels at school and 32% would do so if desperate. 25% would only pass urine at school when desperate (trying to hold on until they got home) and 4% avoided going at all at school. 22% of the pupils reported problems of bullying while using the school toilets.

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Sanitary towel provision and disposal in primary schools
R Jones, F Finlay
Child: Care, Health and Development 2001; 27; 85-92

This study focused uniquely on female sanitary provision and disposal and sent a questionnaire to 344 randomly selected primary schools throughout the UK.

Sanitary products could be obtained in 90% of schools, but they were generally only available from an adult. Only 1% of schools had a machine in the girls’ toilets where sanitary products could be obtained unobtrusively.

Crisis in our schools: survey of sanitation facilities in Bloomsbury health district
R K Jewkes, B H O’Connor
British Medical Journal 1990; 301; 1085-1087

This study surveyed sanitation facilities in Bloomsbury schools, London and was carried out by school nurses from a postal questionnaire.

37 questionnaires were returned and showed that most of the schools had serious deficiencies in their sanitary facilities and essential toilet items, including insufficient soap, toilet paper, clean towels sanitary disposal units and insufficient cleaning of the toilets. Sanitary disposal facilities were available in only 43% of girls' toilets.

The doctors called for national guidelines to ensure primary schools provide sanitary facilities to help girls manage their periods.

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