Prevalence of and risk factors for burnout and occupational stress among couriers: A systematic review

Objective To estimate the prevalence of burnout and occupational stress (OS) among couriers and to identify the main risk factors. Method We followed PRISMA guidelines to search studies published in English and Chinese databases before February 2022. Results The search yielded 15 (7 English and 8 Chinese) papers, 12 of which studied Chinese couriers, and three studied French, Israeli and Malaysian couriers. Twelve studies reported OS using various validated measurement tools, and six reported burnout using adapted versions of Maslach Burnout Inventory. Only four included studies suggested cut-off points to define the condition, hence we used the midpoint of the scales to estimate the prevalence (the proportion of the cases that were above the midpoint). The estimated prevalence of burnout (or a dimension of burnout) among couriers ranged from 20% to 73% (median=33%). The prevalence of OS (or a dimension of OS) ranged from 7% to 90% (median=40%). Twelve studies reported risk factors for burnout or OS; the main ones were physical demands, customer behaviour and a range of working and employment conditions, such as employment precarity and financial insecurity. Job resources (i.e. social support and decision latitude) and organizational support had mitigating effects. Conclusions Burnout and OS are relatively high among couriers. Interventions to prevent or reduce burnout in this occupation are currently limited. The use of platform technology to shift risks, intensify work and tighten managerial controls could be a potential work-related stressor for app-based couriers but remains a knowledge gap. ### Competing Interest Statement PW is a director and shareholder of CareLoop Health Ltd, a for-profit company that develops and markets digital therapeutics for mental health conditions; and a director of Prism Life Ltd, a small research and consultancy company. ### Funding Statement The project is funded by the MRC Public Health Intervention Development Scheme (PHIND). Grant Ref: MR/T027215/1. CA is supported by NIHR Manchester Biomedical Research Centre and the NIHR Greater Manchester Patient Safety Translational Research Centre. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors