The occupational health and safety issues of public school employees in large urban areas are many and complex. Crumbling school infrastructure and crowded classrooms are associated with inadequate indoor air quality, asbestos exposure, noisy environments, and enhanced transmission of communicable and infectious diseases. Poor ventilation in vocational education classrooms, duplicator rooms, kitchens, and science laboratories may also contribute to hazardous exposures. Ergonomic hazards may be responsible for increasing rates of musculoskeletal disorders. Other work-related illnesses and injuries now documented among school employees include asthma, mesothelioma, asbestos-related lung cancer, violent assault, voice disorders, and depression. Such a diverse industry with many potentially hazardous activities and conditions calls for a comprehensive research and intervention agenda.