Children's experiences of school toilets present a risk to their physical and psychological health.

OBJECTIVE To ascertain why children and parents frequently describe problems with school toilets. SETTING Two contrasting cities in Northern England (Newcastle upon Tyne 394 pupils) and Southern Sweden (Goteborg/Mölndal 157 pupils) METHODS Self-administered questionnaires were given to children aged 9-11 years in England and Sweden. Researchers administered questionnaires to Head teachers and recorded their observations of facilities according to predetermined basic standards. RESULTS Children from both countries said they found school toilets unpleasant, dirty, smelly, and frightening and that bullying occurred there. Many children avoided using the school toilets (62% of boys and 35% of girls (in the UK site) and 28% boys and girls in Swedish site avoided using the school toilets to defaecate). Results were similar in both centres. CONCLUSION European standards are needed for school toilets in order to prevent children developing problems such as constipation, urinary tract infections and incontinence.