Occupational Fatigue and Multidimensional Traffic Risk Outcomes Among Motorcycle-Based Food Delivery Workers: Cross-Sectional Study

Abstract

Abstract Background Although motorcycle-based food delivery workers face a significant risk of accidents, previous research has primarily focused on traffic accidents, neglecting the multidimensional nature of safety, which includes perceived accident risk, near-miss experiences, and accident-related anxiety. Objective This study addresses this gap by investigating how occupational fatigue and health behaviors are associated with the Traffic Accident Risk Index (TARI) and its subdomains (near-miss experiences, self-rated accident anxiety, and other-rated accident anxiety). Methods A cross-sectional study was conducted. Data were collected from South Korean delivery workers via an online survey and analyzed using multiple linear regression. Results In total, 336 workers were included in the analysis. Occupational fatigue was positively associated with the overall risk index (=0.017, 95% CI 0.012 to 0.021;<.001) and all subdomains, including near-miss experiences (=0.016, 95% CI 0.011 to 0.021;<.001), other-rated accident anxiety (=0.019, 95% CI 0.013 to 0.024;<.001), and self-rated accident anxiety (=0.016, 95% CI 0.011 to 0.021;<.001). Inconsistent helmet use was associated with a higher TARI (=0.413, 95% CI 0.030 to 0.796;=.04), other-rated accident anxiety (=0.495, 95% CI 0.025 to 0.966;=.04), and self-rated accident anxiety (=0.493, 95% CI 0.036 to 0.949;=.04). Insufficient physical activity was associated with a higher TARI (=0.368, 95% CI 0.016 to 0.719;=.04) and self-rated accident anxiety (=0.586, 95% CI 0.168 to 1.005;=.006). Current smoking was associated with near-miss experiences (=0.298, 95% CI 0.041 to 0.555;=.02). Conversely, shorter break times were associated with lower accident risk (30 min to 1 h:=−0.329, 95% CI −0.650 to −0.007;=.045) and near-miss experiences (<30 min:=−0.474, 95% CI −0.936 to −0.011;=.045; 30 min to 1 h:=−0.470, 95% CI −0.846 to −0.095;=.01) than breaks exceeding 2 hours. Conclusions Occupational fatigue was associated with a higher overall perceived accident risk, more near-miss experiences, and greater accident-related anxiety. Modifiable health behaviors showed additional domain-specific associations. Prevention efforts may benefit from combining fatigue management with strategies to improve helmet use, increase physical activity, and support smoking cessation. Future research should refine the measurement of break time and establish evidence-based rest guidance for motorcycle-based delivery workers.