Train drivers run a risk of on-the-track accidents, the outcome of which they can seldom influence. In a postal questionnaire study addressed to all Norwegian train drivers, present health status was assessed by GHQ-12 and three health indices calculated from a psychosomatic symptom list. Train drivers who had experienced distressing on-the-track incidents were asked to report peak intensity of psychological reactions to their most distressing experience, by the Impact of Event Scale (IES). Of 830 respondents, 395 reported distressing on-the-track incidents. Present health status was significantly lower in drivers reporting a former distressing experience compared to others. The higher the recalled IES-scores, the more pronounced health problems were reported. This relationship was most marked for musculoskeletal and psychological symptoms related to the IES Intrusion subscore. A possible causal relationship between traumatic on-the-track experiences and long-term health problems in train drivers is postulated.