Poor standards of school toilets -- including smelly facilities, lack of toilet paper and missing locks in stalls -- can lead to chronic constipation and cause or exacerbate incontinence and urinary infections in children, according to a new survey of school toilets in the United Kingdom.

Conducted by the Bog Standard campaign, the results show children are reluctant to use toilets (or bogs, as they're referred to in Britain) that are in poor condition, so many will try to hold it in all day until they get home, according to the Nursing Times.

This repeated avoidance is what can lead to constipation and continence problems, and 79 percent of schools and all of the Nursing Times readers agree that poor facilities can lead to children developing toilet-related issues.

"School toilet issues continue to cause children and parents concerns in nursery, primary and secondary school settings. Broken toilet seats, no hand soap, no toilet paper, no lighting, broken locks on doors, no sanitary bins, locked toilets and bullying away from adult supervision are all an issue," says one Nursing Times reader.

The lack of sanitary toilets also may lead children to resist drinking water during the school day, according to experts from Education and Resources for Improving Childhood Continence (ERIC), a British national charity that runs the Bog Standard and Water is Cool in School campaigns. This can lead to dehydration, which contributes to a number of short- and long-term health problems, according to AOL Health.

Strikingly, 84 percent of schools surveyed reported poor toilet standards could have a negative effect on a child's learning.

"Our research and contact with families shows that children with continence issues may experience more emotional problems and have lower self-esteem than children without continence problems," Jenny Perez, director of ERIC, tells the Nursing Times. "A lot of these problems could be avoided or eradicated with improved school toilet facilities, encouraging drinking water during the day and easy accessibility to the toilet. This is not only a health and well-being issue for those with continence issues; it affects all children and young people at school and may also affect their academic attainment and attendance levels."

Nearly half of all continence experts and nurses asked said improving school toilets would help the majority of children with toilet-related health issues and help them regain continence, the Nursing Times reports.

All of the surveyed schools agreed there should be a minimum standard for schools toilets. Yet, while improvement of toilet facilities seems to be a higher priority for schools -- with 73 percent having renovated their toilets in the past five years -- one in four schools reported they still receive complaints from students, according to the survey.

The article concludes that there is still much work to be done to achieve acceptable standards in all schools, and urges parents to inspect the toilets at their child's school.

Although the survey was based in the United Kingdom, restroom standards are no less of an issue in the United States. U.S. studies report similar results; organizations such as the American Restroom Association and initiatives including Project CLEAN advocate for restroom safety, cleanliness and hygiene. The National Institute of Building Sciences provides recommendations for proper restroom design and the World Toilet Organization fights to improve toilets and sanitation globally on World Toilet Day and beyond.

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