Few studies have simultaneously addressed the role of occupational factors, individual characteristics and living conditions in occupational injuries, and to the best of our knowledge none on railway workers. This survey assessed the roles of these factors in various types of injuries and for various jobs in French railway workers. This case-control study was conducted on 1,305 male workers with an occupational injury during a one-year period and 1,305 male controls. A standardized questionnaire was administrated by an occupational physician. Data were analyzed by the logistic regression method. The significant factors found for all the injuries combined were: young age (<30 yr) (adjusted odds ratio 1.47, 95% CI 1.01-2.14), 5 yr or less in present job (1.43, 1.15-1.78), sleep disorders (1.30, 1.08-1.57), current smoker (1.27, 1.08-1.50), and no do-it-yourself or gardening activity (1.23, 1.02-1.48). Young age, sleep disorders, and smoking were common for several types of injuries. The role of these factors differed between various job categories. Among injured workers sick leaves of eight days or over were more frequent in current smokers and overweight subjects. In conclusion, young age, lack of experience, job dissatisfaction, sleep disorders, smoking, and lack of physical activity increase the risk of occupational injuries. The risks induced were related with jobs. Preventive measures concerning work conditions and these factors could be conducted in railway workers generally, and especially in workers most at risk. The occupational physician could make workers more sensitive to these risks and help them to improve their living conditions during medical examinations.