Parental perspectives concerning gluten-free food insecurity in households with children with coeliac disease: take away messages for policy makers.

The rapid expansion of the digital platform economy has given rise to novel employment arrangements and reshaped global labor markets (). At the heart of this transformation sits algorithmic management, which relies on big data and machine learning to handle resource allocation, task assignment, and performance evaluation in real time (). The approach has been widely adopted in sectors such as ride-hailing and online food delivery (OFD), and has markedly improved operational efficiency (). The OFD industry itself has grown into a major global sector. Tens of millions of workers are now engaged in this industry, and the sector generates a market value of more than 130 billion dollars (). This growth reflects both the modernization of the catering sector and the evolution of urban service systems, and now forms a central part of the broader platform economy (). Algorithmic management has produced substantial economic gains as the platform economy continues to expand. However, the efficiency gains that drive platform growth also create systemic occupational health challenges for platform-dependent workers. OFD riders are particularly affected because their labor processes and income structures depend heavily on platform algorithms (). Although algorithmic management has reduced transaction costs and offered more flexible earning opportunities (), the deepening of algorithmic control has turned worker health protection into an urgent public health issue (). The resulting health burden spans multiple dimensions and does not stay within a single domain. Consider first the physical toll. OFD riders often work extended hours under intense time pressure, and this pattern raises the risk of physical fatigue and musculoskeletal strain (, ). To meet these tight delivery deadlines, riders routinely run red lights and speed during deliveries (). These behaviors raise the risk of traffic-related injuries and pose direct threats to physical safety (, ). The psychological toll runs in parallel. Income instability and occupational stigmatization contribute to persistent distress and produce anxiety and burnout (). Underlying both sits a structural protection gap. The absence of adequate social insurance compounds these burdens and leaves riders without timely access to medical care or occupational injury compensation (, , ). From a public health perspective, these challenges go far beyond ordinary labor disputes. Seen together, they form a cluster of occupational health burdens that now affect millions of workers in the expanding platform economy (). The World Health Organization and the International Labour Organization have estimated that long working hours and occupational injuries cause hundreds of thousands of deaths each year (). Exposure to long working hours alone accounts for approximately 745,000 deaths annually from ischemic heart disease and stroke, and represents the single largest occupational risk factor in the global burden of disease (). OFD riders operate under algorithmic regimes that systematically compress rest time and transfer risk to individual workers. This makes them a particularly vulnerable occupational group, and the health outcomes of this group carry implications far beyond the workplace, reaching individual well-being, urban traffic safety, public healthcare expenditure, and social equity.