自營作業者的社會安全與職業安全健康風險：在COVID-19疫情期間的攤販業者經歷

Abstract

背景：COVID-19大流行造成許多人工作模式或就業狀況改變。勞動條件較弱勢的自營作業者，例如攤販，面臨較大的市場競爭與景氣變動壓力，因此可能在經濟危機期間更容易受到不利的健康影響。針對疫情對就業與工作者身心健康的衝擊，國內外文獻已有一些研究，但大多僅針對受僱者；目前仍少有針對自營攤販業者職業安全健康面向之研究。 目的：本研究旨在瞭解自營作業者健康與職災風險之相關因素並與受僱者作比較，且進一步針對自營攤販業者探討其社會安全與職業安全健康風險，以及受COVID-19疫情影響的情形。 方法：研究分為兩部分。第一部分利用勞動部勞動與職業安全衛生研究所於2016年進行的勞動環境安全衛生認知調查資料進行次級資料分析，以瞭解自營作業者的社會人口特質、工作狀況、職場社會心理特質、職災經歷、健康狀態與參與社會保險的情形，並依據分析變項與結果來設計訪談大綱。第二部份以半結構訪談大綱進行深度訪談，訪談對象為至少有3年的攤販工作經驗且主要工作為小吃攤販的自營作業者，以瞭解他們的工作與健康狀況以及在疫情期間的經驗。 結果：第一部份量性分析結果顯示，相對於受僱者，自營作業者較為年長、教育程度較低、工時較長、收入較低，然其工作心理負荷較低且工作控制較高；在健康與職災風險方面，自營作業者的自評健康較差、職災盛行率較高，但個人疲勞及心理健康狀況則較受僱者佳。多變項迴歸分析表明，在控制社會人口特質、工作狀況和職場社會心理特質變項後，自營作業者的健康與職災風險並無顯著高於受僱者，表示自營作業從業身分本身並未提高其健康與職災風險。第二部分質性訪談分析結果則顯示，自營小吃攤販擁有工作自主性，但工作時間長，並容易於工作場所中面臨多重職業危害，包括災害事故風險、物理性危害、人因性危害和社會心理性危害；他們也較容易為了賺取更多收入而忽視職業安全健康風險，且勞動相關社會保險的涵蓋率與使用率相對低落。在COVID-19疫情期間，部分攤販被迫暫停營業而陷入經濟困頓，選擇繼續營業的攤販則擔憂染疫的風險，進而影響心理健康。 結論：相較於受僱者，自營作業者擁有較高的工作自主性，然而整體而言，仍屬勞動條件與健康較為弱勢的族群，且較少受到勞動與社會安全制度的保障。針對自營攤販業者，收入不安全是主要心理壓力來源，尤其在面臨重大疫情之時，社經狀況越弱勢者，所受到的衝擊程度也就越高。建議政府應重視自營作業者的職業安全健康狀況，並強化其職業傷病發生之後的經濟安全及社會保護制度。

Background: The COVID-19 pandemic has substantially affected many people’s work patterns or employment status. Own-account workers, such as street vendors, are more likely to be exposed to market competition and economic fluctuations and thus may be more susceptible to adverse health effects in times of crisis. Studies that have been carried out to examine the impacts of the pandemic on workers’ employment and health have mostly been conducted in employees. Few studies have investigated the work and occupational safety and health among own-account vendors’. Purpose: This study aimed to compare health and occupational injury risks between own-account workers and employees, and to investigate the social security and occupational safety and health risks of own-account vendors, and the situation affected by the COVID-19 pandemic. Methods: The research was divided into two parts. The first part utilized the statistical data of the 2016 Labor Environment Safety and Health Cognition Survey to understand the sociodemographic characteristics, working conditions, psychosocial work characteristics, experiences of occupational injuries, health status and participation in social insurance among own-account workers. Consequently, the interview outline was designed for the second part of this study, in which in-depth interviews were conducted with own-account workers who have at least 3 years of work experience as street food vendors. All interviews were fully transcribed, and qualitative textual analysis was performed. Results: The results of the quantitative analysis showed that, compared with the employees, own-account workers were older, had lower educational attainment, longer working hours and lower income, but their work demands were lower and work control was higher. In terms of health and occupational injury risks, own-account workers had poorer self-rated health and higher prevalence of occupational injuries, but their personal burnout levels and mental health status were better than the employees. Multivariate regression analysis showed that after controlling for sociodemographic characteristics, working conditions and psychosocial characteristics, the health status and the risk of occupational injury of own-account workers were similar to that of employees, indicating that own-account work status itself did not increase their health and occupational injury risks. The qualitative interview showed that own-account street food vendors had higher work control but long working hours, and they had higher occupational safety and health risks. However, they tended to neglect their health condition in order to earn more income. Street food vendors who had closed their business due to the COVID-19 pandemic were in financial difficulties while those who chose to continue operating were worried about the risk of infection, resulting in poor mental health. Conclusion: Own-account workers are relatively vulnerable in terms of working conditions and health, but they are less likely to be protected by the labor and social security systems. For own-account street vendors, income insecurity is the main source of psychological stress. In the face of the COVID-19 pandemic, the lower the socioeconomic status, the more adverse impact they have. Governments should pay attention to the occupational safety and health of this group, and improve the economic safety and social protection after occupational injuries.