With an increased number of media reports indicating pathogenic contamination of books, there is a need to investigate the potential for library environments as a source for vectors that transmit infectious disease. Review of current literature indicates the presence of bacterial and fungal pathogens in library air, books, and surfaces. Many of the pathogens found have been associated with severe respiratory illness and skin infections. Although the presence of pathogenic microorganisms has been confirmed by many studies, there is currently no regulation in place for the inspection of library environments. Further studies exploring the health of workers and library users, coupled with guidelines and legislation, can contribute greatly to the health of the public and occupational health of public libraries worldwide.