Evidence suggests that school factors influence the prevalence of allergic diseases in students. However, little is known about how such factors affect the health of teachers.

We sought to compare the prevalence of allergic and respiratory conditions among teachers from urban, suburban, and rural schools.

Electronic survey data were collected from a random sample of prekindergarten through grade 12 teachers in Massachusetts. Comparisons were made between teacher demographics and allergic respiratory symptoms.

Of the 398 respondents, median (SD) age was 45 (12.32) years; 71.8% of teachers taught in suburban schools, 76.6% were female, and 87.1% were White, similar to teacher demographics collected by the Massachusetts Department of Higher Education. Although there were more female teachers, male teachers more frequently reported adverse breathing symptoms, such as wheezing (P = .007). Over half of rural teachers (54.54%) experienced respiratory symptoms such as disrupted sleep due to coughing compared to 34.61% of suburban schoolteachers (P = .03). Almost half (48.26%) of public schoolteachers experienced exercise-induced chest pain compared to 37.03% of private schoolteachers (P = .05). A higher proportion of urban schoolteachers with asthma commonly missed school as a result of food allergy compared to suburban and rural schoolteachers with asthma (P = .02). In teachers undiagnosed with asthma, associations existed between school absences and nighttime awakening due to trouble breathing (P < .0001), persistent cough (P = .002), and sore throat (P < .0001)

Rural and public teachers reported proportionately more respiratory symptoms compared to suburban and private teachers, suggesting disparities. Future studies addressing evidence-based solutions are needed.