Why does talk of a "school toilets campaign" seem amusing? Perhaps because toilet humour has a centuries-long tradition on these shores, from Chaucer, Shakespeare and Burns, right through to Billy Connolly's The Jobbie Weecha. The only way to prevent bodily functions from repelling us, it seems, is to turn them into a source of jokes.
Even campaigns to improve school toilets have had a punning levity - Bog Standard and Flushed with Success? - but the frivolity hides some stark facts about substandard facilities.
School toilets are the "primary source of infection for pupils", says campaigning group Education and Resources for Improving Childhood Continence (ERIC). They are "ideal breeding grounds" for pathogens - harmful micro-organisms - and their neglect can lead to sore throats, skin infections, blood poisoning, E. coli and MRSA infections.
High-quality school toilets are important for a significant minority of students: 76,000 children in Scotland under the age of 15 - one in 12 - have bladder or bowel problems, according to ERIC.
Yet a recent Ipsos Mori poll of more than 2,000 S1-S6 students in Scotland found that 33 per cent rated their school toilets' cleanliness as "poor" or "very poor", 46 per cent used them only when absolutely necessary and 10 per cent never used them.
Tam Baillie, the Scottish children's commissioner, has launched the Flushed with Success? campaign, backed by Sir Harry Burns, the chief medical officer, to demand that the Scottish government do more to improve school toilets.
The campaign's origins can be traced to 2010, when Mr Baillie's team asked thousands of children what his job should be. He was surprised at how often they bemoaned the state of school toilets. "It came up time and again," Mr Baillie said. "I felt there was something there about a lack of respect towards children and young people - it's not just a health issue."
But the Convention of Scottish Local Authorities (Cosla) is being hard- headed about the issue. "The one thing missing from what is being proposed is cost - and a very significant cost at that. It would take money that councils simply do not have at the moment," a spokesman said.
"If we have Mr Baillie's comments backed up by the chief medical officer for Scotland, then can we presume that the money to address this is also forthcoming? Are they really both saying that children's toilets are a top priority ahead of all other things that councils provide for children?"
But Mr Baillie insisted that many problems could be fixed at little cost, for example by replacing broken locks, keeping soap dispensers topped up and ensuring regular and thorough cleaning. More fundamental problems could be resolved in the design of new schools, as most complaints were made about facilities in older schools.
Popular culture has long tapped into anxiety about school toilets - the bullying in Grange Hill, the serial killer who lurks in a cubicle in Scream - as dank, secluded places where school rules are easily violated.
Mr Baillie had heard horror stories of his own, such as phones being slipped under cubicle doors to take pictures of the occupant. But he was encouraged by some new-build designs, where toilets were well-lit rows of cubicles whose doors ran from floor to ceiling, ensuring privacy. Nevertheless, he saw respect for children - not design - as the most important factor.
"One school won an award for its toilets, not because they were brand- spanking new, but because of the way the school, and the toilets, were managed; the students felt valued and that they had a say in running the school," Mr Baillie explained.
In a 2011 survey on school toilets conducted by the Scottish Parent Teacher Council (SPTC), more than a third of parents said their children held on until they got home before going to the toilet.
"Kids often avoid using the toilets during the school day if they are smelly or unpleasant," said Eileen Prior, SPTC's executive director. "They keep their fluid consumption down during the day - a very bad idea. Some parents have told us of the dreadful health impact; of children who have ended up with a variety of digestive and bowel complaints.
"A second issue is around how schools manage youngsters' access to the loo," she added. "In one school, parents complained that any child who had visited the toilet during class time was made to wear a tabard so they could be identified - equivalent to the dunce's cap, and deeply humiliating.
"Some schools keep toilets locked (at) break and lunch time, and others run a variety of equally restrictive regimes."
Ken Cunningham, general secretary of School Leaders Scotland, said that "restrictive regimes have probably been brought about because of vandalism, truancy, behaviour issues (and are) usually relaxed when things return to normal". Issues could also arise with supply teachers who did not know students and who found it more difficult to manage requests, he added.
TESS has heard some shocking stories, such as one school where secondary students had to use miniature infants' toilets. Perhaps this is because Scottish legislation on school toilets - thought by ERIC to be better than anywhere else in the UK - dates back to 1967. In more recent legislation, from 2007, it became a requirement to "endeavour to ensure that . schools are health-promoting" - yet the legislation makes no mention of toilets, or bowel and urinary health.
When we asked the Scottish government if it had any plans to update existing legislation, perhaps requiring school inspectors to examine toilets - something that they do at present only if asked to by families or staff - there was no indication that it did. Its response was merely to deflect the matter of the cleanliness of school toilets on to local authorities and Education Scotland.
In a letter, the government advised Mr Baillie to direct his concerns to Cosla. The government was contributing to improving school toilets through its pound;1.25 billion Schools for the Future school-building programme, a spokesman said.
That is not enough to appease campaigners. Jenny Perez, director of ERIC, put it simply: "School toilet facilities should be protected by legislation in the same way as workplace toilets. Adults don't have to put up with poor toilet facilities, so why should children?"
- 56 per cent of secondary students in Scotland avoid using school toilets. Of those, 46 per cent use the toilets only when they "really have to" and 10 per cent never use them
- 33 per cent rate cleanliness as poor or very poor
- 24 per cent report supplies of toilet paper being inadequate, while 37 per cent complain of a lack of soap and 30 per cent about a lack of working locks
- 16 per cent seldom or never feel safe in school toilets
- 16 per cent say they are rarely allowed to go to the toilet in class time, and only about 33 per cent are always or usually allowed to go
Source: Ipsos Mori survey of 2,154 S1-S6 students from 59 schools across Scotland in 2012
Joe, 15, from Angus
"I think it's really cruel to make any kid hold on like that for the toilet. The toilets in my school are horrible. There are only two cubicles and every day the toilet seats are covered in urine. We're not allowed out (of the school premises) at lunchtime, so I can't use the public ones down the road. We can't use the toilets during lessons unless we've been given a medical certificate. The toilets are sometimes not cleaned for days. There are no locks on the doors, nothing to dry your hands with and you need to go to the (school) office for loo paper. It's a real shame because it is a newly built school with modern technology in the classrooms, but when it comes to the toilets, everything looks like it's seen better days. What worries me most is if I wet myself one day. I've developed a real fear about it. I avoid drinking and wear lots of clothes to keep very warm, as I've heard the cold makes you need the loo more."
Andrew, 15, from Midlothian
"The toilets at my school are actually very nice but the teachers hardly ever let anyone go during class. It's apparently to stop disruption but sometimes it has the opposite effect. A few weeks ago, I needed to go really badly but the teacher wouldn't let me. Eventually he said I could leave five minutes before the end of class. But I simply couldn't hold on and ended up doing a wee in my trousers. It was the most embarrassing moment of my life, and caused so much more disruption to the whole class than if he had just let me go. I think it's really cruel to make any kid hold on like that and practically force them to wet themselves in front of everyone.Unless it's happened to you, I don't think you really realise how horrible it is to have an accident at school. Everything about it - from having to sit desperately for ages, to telling my parents - was embarrassing beyond belief. I know one other boy in the year below who also had an accident in class. If we can do something to stop it happening to even one other person, it will be worth it."
Abigail, 12, from Aberdeenshire
"The toilets at my academy are awful. My friends and I won't drink at school so that we don't have to go to the toilet. The toilets have been vandalised, they leak and overflow, making them very unpleasant to be anywhere near. By not drinking, we get sore heads and struggle to concentrate in classes, especially after lunch."