title: School toilets: facilitating hand hygiene? A review of primary school hygiene facilities in a developed country.
abstract: BACKGROUND
  Clean hands play an important role in preventing infectious disease transmission. The physical quality of any toilet and handwashing facilities is an important determinant of whether and how it is used, especially for school children.
  
  
  METHODS
  This study assessed the physical quality of toilet and handwashing facilities used by 9 year olds at 68 primary schools in three cities in the South Island of New Zealand. The facilities were assessed for availability, functionality and provision of hand basins, hygiene products and drying facilities.
  
  
  RESULTS
  Nineteen schools (28%) followed the New Zealand Ministry of Education Code of Practice for toilet and bathroom facilities in schools, by providing warm water, liquid soap at every basin and functioning hand drying facilities. A further 25 schools (37%) would have met the standards except they provided only cold water (21 schools) or the cloth roller towels were unusable (4 schools). The other 24 schools' toilet facilities were deficient in some way, including one with no soap and six that provided no drying facilities. School socioeconomic position and toilet facility quality were not related.
  
  
  CONCLUSIONS
  These results suggest that a significant number of New Zealand children do not currently have access to high quality hygiene facilities at school.
authors.affiliation: Department of Preventive and Social Medicine,  University of Otago, PO Box 913, Dunedin 9054,  New Zealand.
authors.forename: L M
authors.initials: LM
authors.lastname: Reeves
authors.forename: P C
authors.initials: PC
authors.lastname: Priest
authors.forename: M R
authors.initials: MR
authors.lastname: Poore
mesh_terms: D002648:Child; D003625:Data Collection; D004782:Environmental Health / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D063373:Hand Hygiene / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009520:New Zealand; D012574:Schools / Q000592:standards / Q000706:statistics & numerical data; D013334:Students; D014038:Toilet Facilities / Q000592:standards* / Q000706:statistics & numerical data