Objective To investigate the prevalence of occupational stress among ride-hailing drivers in a megacity and analyze its influencing factors.

Methods From June 2024 to November 2024, a cross-sectional study and convenience sampling were conducted to investigate the occupational stress of ride-hailing drivers in a megacity. A total of 2 687 self-administered questionnaires were ultimately included in the statistical analysis. Binary logistic regression was adopted to analyze the factors influencing occupational stress.

Results The overall prevalence of occupational stress remained at 53.96% in the megacity, being higher in males (54.38%) than in females (44.04%) (χ² = 4.51, P = 0.034). The comparison between different age groups showed that the prevalence of occupational stress in the group of 35–44 years old was the highest (59.09%). The factors associated with an increased risk of occupational stress among male participants included age of 35–44 years old (OR = 1.42, 95%CI: 1.06–1.90, P = 0.001), inadequate rest (OR = 1.52, 95%CI: 1.28–1.81, P < 0.001), not consuming fresh vegetables daily (OR=1.38, 95%CI: 1.09–1.75, P = 0.007), daily consumption of sugar-sweetened beverages (OR = 1.22, 95%CI: 1.03–1.45, P = 0.021), and daily consumption of milk or yogurt (OR = 1.31, 95%CI: 1.10–1.56, P = 0.002). The factor associated with a decreased risk of occupational stress among males was consuming ≥ 3 meals per day (OR = 0.61, 95%CI: 0.39–0.95, P = 0.002). The factors associated with an increased risk of occupational stress among female participants were daily tea consumption (OR = 2.29, 95%CI: 1.002–5.23, P = 0.049) and not consuming fresh vegetables daily (OR = 4.56, 95%CI: 1.41–14.72, P = 0.011).

Conclusions The prevalence of occupational stress among ride-hailing drivers is high, and its influencing factor are age of 35–44 years, inadequate rest, and dietary habits. Preventive measures targeting occupational stress in this population should be implemented.