Occupational Fatigue and Multidimensional Traffic Risk Outcomes among Motorcycle-Based Food Delivery Workers (Preprint)

BACKGROUND Although motorcycle-based food delivery workers face significant risks of accidents, the focus on general traffic accidents has left the multidimensional nature of safety understudied. OBJECTIVE This study addressed this gap by investigating how occupational fatigue and health behaviors predict the Traffic Accident Risk Index and its subdomains (near-miss experiences, self-rated accident anxiety, and other-rated accident anxiety). METHODS Data were collected from 336 South Korean delivery workers via an online survey and analyzed using multiple linear regression. RESULTS Occupational fatigue was positively associated with the overall risk index and all subdomains. Non-use of helmet and insufficient physical activity were associated with higher Traffic Accident Risk Index and self-rated accident anxiety. Current smoking was associated with near-miss experiences. Conversely, shorter break times were associated with lower accident risk and near-misses than breaks exceeding 2 h. CONCLUSIONS Occupational fatigue was associated with higher overall accident risk, more near-misses, 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.