News: May 13, 2009
Disgusting toilets and feeling uncomfortable when using them make children hesitant to go during the school day, but the teachers' rules also matter. This is shown in a thesis at the Sahlgrenska Academy at the University of Gothenburg, Sweden.
Almost 400 children at eight primary and lower secondary schools in Gothenburg, Sweden, responded to a survey on how they feel about their school toilets and on their toilet habits during school hours. Although this was a local study, the geographical spread of reports on the standards and cleanliness of school toilets hints that they may be a concern to children around the world. Many children reported that there may be urine and faeces splattered on the toilet ring and that the floor is often wet and soiled. As if that was not enough, toilet paper, soap and paper towels are often missing.
'The hygiene, standard and security children experience in school toilets are very important for their willingness to visit them', says the author of the thesis paediatric nurse Barbro Lundblad.
Although most children need to go to the restroom at least once during every school day, the study shows that 16% never urinate and 63% never have a bowel movement at school.
'Children's toilet habits are clearly related to their need for security and well-being during school hours. Many children also reported having problems with the door lock and that they are afraid of being "caught" in a compromising situation', says Lundblad.
Cleanliness and security in school restrooms are central to the roughly 20% of school children with bladder and/or intestinal disorders, since these children usually need to perform self-care during school hours. For example, children with bladder problems need to calmly sit down on the toilet and urinate with a certain relaxation technique at least every three hours or as soon there is a need. Most interviewed children hold it as long as they can so as not to have to visit the school toilets more than absolutely necessary.
The teachers' rules for toilet visits during class time may also cause problems for children when they need to go. Opportunities to go to the toilet are often related to what is going on in the classroom.
'Older children feel it is both embarrassing and integrity insulting to raise your hand and have to inform the teacher in front of all the other pupils about the urge to go to the toilet. Not letting children go when they need to may affect children's health and well-being during the school day', says Lundblad.
For more information, please contact:
Barbro Lundblad, registered nurse, telephone +46-31-786 60 54, email
Professor Anna-Lena Hellström, telephone +46-31-342 10 00, email
Associate Professor Marie Berg, telephone +46-31-786 60 84, e-mail
Doctoral thesis for the degree of Doctor of Philosophy at the Sahlgrenska Academy at University of Gothenburg, the Institute of Health and Care Sciences.
Title of the thesis: Should I go, or is it better to wait? - Conditions for children to go to the toilet at school.
The thesis defence will be held on Thursday June 11th at 9 am, lecture room (hörsal) 2118, the Institute of health and Care Sciences.
The thesis consists of the following papers:
I Lundblad B, Hellström A-L. Perceptions of school toilets as a cause for irregular toilet habits among schoolchildren aged 6 to 16 years. J Sch Health. 2003;75(4):125-8
II Lundblad B, Berg M, Hellström A-L. Experiences of children treating functional bladder disturbances on schooldays. J Pediatr Urol. 2007;3:189-93.
III Lundblad B, Hellström A-L, Berg M. Children`s experiences of attitudes and rules for going to the toilet in school. In press in Scandinavian Journal of Caring Sciences.
IV Lundblad B, Berg M, Hellström A-L. Teacher´s attitudes and strategies when schoolchildren need to go the toilet. Submitted.