Major injuries and associated factors in traffic accidents among motorcycle food delivery riders during the COVID-19 pandemic in Thailand.

Motorcycle food delivery riders (MFDRs) are at a higher risk of traffic accidents compared to regular motorcyclists. Their safety is a significant issue in many developing countries, particularly in Thailand, which has the highest rate of motorcyclist fatalities globally. This study aimed to determine the prevalence of traffic accidents and explore the association between risky riding behaviors, concerns for working conditions, and accidents among MFDRs. This cross-sectional study was conducted in Chiang Mai, Thailand. Data were collected from a total of 709 MFDRs through an online platform. Collected data included working conditions, risky riding behaviors, concerns about their work conditions, and experience with traffic accidents. In the past six months, the incidence of traffic accidents among MFDRs was 18.9 %., with 2.4 % experiencing hospitalized major injuries, 11.4 % having non-hospitalized major injuries, and 5.1 % having minor injuries. A total of 84.3 % of MFDRs exhibited at least one risky riding behavior, while 5.8 % engaged in ten or more such behaviors. Multivariable logistic regression analysis with adjustments for sex, age, and body mass index indicates that red-light running (adjusted odds ratio, aOR 2.78, 95 % CI 1.07 to 7.21) and being concerned for customer behaviors (aOR 2.66, 95 % CI 1.26 to 5.62) were significantly associated with major injuries. Additionally, factors such as sleeping less than 6 h per day (aOR 1.68, 95 % CI 1.10 to 2.56), riding the wrong way (aOR 2.49, 95 % CI 1.12 to 5.52), and having concern for customer behaviors (aOR 1.91, 95 % CI 1.03 to 3.55) were associated with total number of accidents. Red-light running and concerns for customer behavior in MFDRs are associated with a higher risk of traffic accidents with major injuries. Effective strategies and interventions should focus on strengthening the enforcement of traffic risk behaviors and encouraging food delivery companies to establish regulations relating to the workers' concerns.