London School of Hygiene & Tropical Medicine

School toilets in the UK must be improved, or we could see a rise in the number of children missing school because of illness, hygiene experts will warn today.

Tomorrow is Global Handwashing Day 2010; an annual, global initiative which seeks to promote handwashing with soap, the most effective and cheap way of preventing diarrhoeal and acute respiratory infections. These two, in combination, cause the majority of child deaths, killing millions in developing countries each year.

While efforts are made to improve handwashing facilities, and to encourage handwashing behaviour in schools in the developing world, little is known about the state of handwashing, or handwashing facilities in the UK. Yet the simple act of handwashing with soap is known to reduce the risk of contracting diarrhoea by half, and research has shown that improving rates of handwashing with soap, and making sure good handwashing facilities are available are known to reduce rates of absenteeism in schools.

The London School of Hygiene & Tropical Medicine ran a survey of UK schoolchildren to try and find out just what goes on in school toilets across Britain. The aim was to determine the state of handwashing facilities in UK schools, and to find out about the handwashing behaviour of schoolchildren in the UK, and whether this differed depending on the age and gender of the pupils. The survey was sponsored by Teal, producers of mobile and portable hot water handwash units since 1959.

A total of 457 participants completed the survey, 172 boys (with a mean age of 11.9) and 285 girls (mean age 12.2). For comparison, respondents were split into primary age (4-10 years, 152 children) and secondary school (11-18 years, 305 children).

Significantly more girls than boys reported always washing their hands after going to the toilet at school (86.9% compared to 71.8% of boys). Primary school children were found to be significantly more likely to always use soap when they wash their hands compared to those of secondary school age (63.8% compared to just 39%). 27% of secondary school boys reported never using soap at school, placing them at significant risk of contracting a diarrhoeal disease. However, primary school children also said they received more reminders from teachers about washing their hands.

More than a third secondary school children (36%) said their toilets were never clean, with 42% saying there was sometimes soap available, and almost a fifth (19%) saying there was never any soap. There is also evidence that secondary school children are more likely than younger kids to avoid using the toilets at school. 38% of secondary school girls reported holding it in so they didn't have to go to the toilet, while 24% of all secondary school children said the toilets were so disgusting they avoided them if possible. 16% of secondary school boys reported bad things happening in the toilets, making them wary of going in there.

Dr Val Curtis of the London School of Hygiene & Tropical Medicine's Hygiene Centre comments: "Our survey has found handwashing in Britain's schools to be less than ideal. It would be easy to blame laziness on the part of the kids for this state of affairs, but clearly the problem lies with inadequate and dirty facilities, particularly in secondary schools".

She continues: "There's a strong economic case for investing in good handwashing facilities in our schools. Britain's twelve million cases of norovirus, gastroenteritis, MRSA, e-coli and now swine flu infections are mainly down to dirty hands. Our children deserve better than to be exposed to avoidable illnesses because we are not doing enough to provide safe, clean toilets in our schools.. A bit of effort and investment now will reap huge rewards now - in terms of children taking fewer days off school - and in the future, because adults with good hand hygiene habits lose fewer working days to illness, and will be less likely to use health services if they are not being laid low by avoidable illness".

For more information on the 100 Schools Survey, visit http://www.globalhandwashingday.org.uk/survey.html