中國平台外送工作者的職災風險與災後處境：結合問卷調查與訪談之解釋性序列研究

Abstract

研究背景：隨著數位平台經濟的快速發展，外送工作已成為中國城市中重要的非典型就業形式之一。外送平台透過合作關係取代傳統僱傭關係，並結合演算法管理與即時評價機制，形塑出高工作強度與高度不穩定的工作環境，可能對外送工作者的身心健康與職業安全造成不利影響。既有研究雖已關注平台外送工作者的工作條件、心理健康或職業災害風險，但多半僅聚焦單一結果，較少整合工作條件、心理健康與實際職災發生之間的關係，亦缺乏對職災發生後外送工作者災後處境的進行系統性分析。在中國推動新型職業傷害保障試點政策的背景下，亟需結合量化與質性資料，全面探討平台外送工作者的工作條件、健康風險與災後處境，以補充現有研究並為相關制度與政策提供實證基礎。 研究目的：本研究的目的如下：（一）探討平台外送工作者之工作條件與其主觀心理健康指標（包括工作倦怠、憂鬱情緒及工作滿意度）之相關；（二）探討平台外送工作者之工作條件與其職業災害發生風險之相關；（三）探討過去1年內曾發生職業災害之平台外送工作者的災後處境與應對經驗，包括醫療、勞動保障、經濟與工作安排等面向。 研究方法：本研究於2024年1月至2025年2月進行，採解釋性序列研究設計，結合問卷調查與深度訪談，分析平台外送工作者的工作條件、心理健康、職業災害風險及其災後處境。量化研究透過問卷蒐集外送工作者之社會人口學特徵、工作條件與心理健康狀況，並分析工作條件與心理健康指標及職業災害發生風險之關聯。質性研究則針對過去一年內曾發生職業災害之外送工作者進行深度訪談，深入瞭解其職災發生經驗、醫療與補償歷程、工作狀況變化，以及災後對心理健康與生活的影響。 研究結果：問卷調查結果顯示，平台外送工作者以年輕男性為主，整體外送年資偏短。本研究中，於平台外送工作年資超過一年之外送員中，有9.09%曾因外送工作而發生受傷或生病情形。多變量迴歸分析結果顯示，工作負荷與職場暴力經歷為影響外送員心理健康與職業傷害的重要因素。相較於低工作負荷者，高工作負荷之外送員呈現較高倦怠、憂鬱水平，亦具有較高的職業災害風險。 質性訪談結果進一步顯示，外送員發生職業傷害的直接原因多與惡劣天氣與複雜交通路況有關，而平台演算法管理所帶來的時間壓力與經濟壓力，則構成間接且重要的風險背景。此外，多數受訪外送員指出，現行職業傷害補償與保障制度不足，面臨職災醫療費用先行墊付與收入中斷風險，導致顯著的經濟脆弱性。部分外送員於發生較嚴重職業災害後，因缺乏制度支持而被迫退出外送工作。 結論：本研究顯示，平台外送工作高工作負荷與人際衝突並存，健康風險呈現累積性與結構性特徵。本研究亦指出，職業災害並非僅為個別事故事件，其後續影響深刻，持續牽動外送員的工作持續性、經濟穩定性與健康復原歷程。改善平台外送員健康與職業安全，不能僅依賴個人防護或風險教育，而應從工作組織與制度層次著手。建立合理的工作管理機制、以及提供完善且可實際使用的職業傷害保障制度，將有助於減緩平台外送工作所伴隨的健康不平等，並促進平台經濟的永續發展。

Background: With the rapid development of the digital platform economy, food delivery has become a significant atypical form of employment in major cities in China. Food delivery platforms, through partnerships that replace traditional employment relationships and combine algorithmic management with real-time evaluation mechanisms, create high-intensity, highly unstable working environments, potentially adversely affecting the physical and mental health and occupational safety of delivery workers. While existing research has addressed the working conditions, mental health, and occupational injury risks of platform delivery workers, most studies focus on single outcomes, rarely integrating the relationships between working conditions and workers’ mental health and occupational injuries. Moreover, the post-injury situations of delivery workers were lacking. Against the backdrop of China's pilot policy for new occupational injury protection, there is an urgent need to comprehensively explore the working conditions, health risks, and post-injury situation of platform delivery workers by combining quantitative and qualitative data, to supplement existing research and provide an empirical basis for relevant systems and policies. Objective: This study aimed to: (i) explore the correlation between working conditions and subjective mental health indicators (including burnout, depression, and job satisfaction) of platform delivery workers; (ii) explore the correlation between working conditions and occupational injury risk of platform delivery workers; and (iii) explore the post-injury situation and coping experiences of platform delivery workers who had experienced occupational injuries within the past year prior to the interview, including aspects such as medical care, labor protection, economic situation, and work arrangements. Methods: This study employed an interpretative sequential research design, combining questionnaire surveys and in-depth interviews to analyze the working conditions, mental health, occupational injury risk, and post-injury situation of platform delivery workers. Quantitative research used questionnaires to collect sociodemographic characteristics, working conditions, and mental health status of delivery workers, and analyzed the correlation between working conditions, mental health indicators, and occupational injury risk. Qualitative research involved in-depth interviews with delivery workers who had experienced occupational injuries within the past year to gain a deeper understanding of their experiences with occupational injuries, medical and compensation processes, changes in work conditions, and the post-injury impact on their mental health and life. Results: The questionnaire results indicated that platform delivery workers were predominantly young men with relatively short overall service tenure. In this study, among delivery workers with more than one year of experience on the platform, 9.09% reported experiencing an injury or illness related to their work. Multivariate regression analysis showed that workload and experience of workplace violence were significant factors influencing delivery workers' mental health and occupational injuries. Compared to those with low workloads, delivery workers with high workloads exhibited higher levels of burnout and depression, and also had a higher risk of occupational accidents. Qualitative interviews further revealed that the direct causes of occupational injuries among delivery workers were mostly related to inclement weather and complex traffic conditions, while the time and economic pressures imposed by the platform's algorithmic management constituted an indirect but significant background risk. In addition, most of the interviewed delivery workers pointed out that the current occupational injury compensation and protection system was inadequate, leaving them at risk of having to pay occupational injury medical expenses in advance and of income interruption, leading to significant economic vulnerability. Some delivery workers were forced to quit delivery work due to a lack of institutional support after experiencing serious occupational accidents. Conclusion: This study demonstrates that platform delivery work entails both a high workload and interpersonal conflict, with health risks exhibiting cumulative and structural characteristics. The study also highlights that occupational accidents are not merely isolated incidents; their subsequent impacts are profound, continuously affecting delivery workers' job continuity, economic stability, and recovery. Improving the health and occupational safety of platform delivery workers cannot rely solely on personal protective equipment or risk education; it should begin at the organizational and institutional levels. Establishing a reasonable work management mechanism and providing a comprehensive and practical occupational injury protection system will help mitigate health inequalities associated with platform delivery work and promote the sustainable development of the platform economy.