Background The development of railways has a long history, but there is limited research on the health of railway workers at home and abroad. China's high-speed railway development has attracted worldwide attention in recent years, and it is of great significance to study how to promote the health of this occupational population to ensure the safety of railway transportation.

Objective To identify development trends and hotspots in the field of railway workers' health at home and abroad.

Methods The research literature related to the health of railroad workers dated from January 1, 1973 to December 31, 2022 was searched using the China Knowledge Network Infrastructure (CNKI) and Web of Science Core Collection (WoS) databases. After screening and cleaning, the included literature was subjected to bibliometric analysis by applying CiteSpace 6.1R6 software to visualize and analyze literature co-citation, keyword emergence, and keyword timeline graphs, and by VOSviewer 1.6.19 to visualize and analyze country/region collaboration, keyword co-occurrence, and keyword clustering.

Results During the period from 1973 until 2022, a total of 273 Chinese literature and 165 English literature were found to report studies related to the health of railway workers. The Chinese literature began to grow rapidly in 2009 and peaked in 2015, and the number of English literature published in a relatively flat state over the studied period. The country with the most papers indexed by Science Citation Index (SCI) was the United States (58 papers), which also presented the richest international collaborations. The document with the highest domestic citation frequency was published in the Chinese Journal of Mental Health in 1994, and the document with the highest SCI citation frequency was published in the American Journal of Epidemiology in 1994. The keyword co-occurrence analysis showed that the included Chinese literature mainly focused on health checkups, health management, hypertension, mental health, and chronic diseases and their prevalence; the included English literature focused on mortality, lung cancer, epidemiology, and diesel engine exhaust and its exposure. The analysis of emergent words showed that health management, frontline workers, and occupational stress were the topics of interest in Chinese literature in the last five years, while occupational stress, diesel exhaust emissions, and noise exposure were the topics of interest in English literature in the last ten years. The results of the timeline graph analysis suggested that the recent research directions in Chinese literature were health intervention, humanistic care, staff canteens, etc. There were few English-language articles related to this area after 2010.

Conclusion The research hotspots of railroad practitioners' health will keep changing with the development of high-speed railways in countries around the world. The outstanding rise of Chinese literature issued in the last decade has been in striking contrast to the slow progress and decreasing of English literature. The Chinese literature has gradually expanded the hotspots from chronic diseases to health management, occupational stress, and sleep disorders.