Abstract:Background: As the demand for long-term care in Taiwan increases, the government enacted the “Long-Term Care Services Act” in 2015 to ensure the quality and accessibility of care services. However, the occupational safety and health as well as general labor protections of frontline care workers have received relatively little attention. Methods: This study conducted a literature review to examine major occupational safety and health issues and analyze structural-level social determinants, including the decision-making process of working hours arrangements, salary and benefit provisions, employment stability, and access to social security benefits. Results: Care workers in Taiwan were found to have prolonged exposure to high physical demands, a lack of personal protection equipment, and were at risk for musculoskeletal injuries. They were also prone to infectious diseases, workplace violence, and workplace harassment. They need to commute and work alone further increasing the risks for traffic-related injuries and psychological stress. Most home-based care workers were paid on piece-rate or revenue-sharing schemes, and their work schedules and work assignments were determined mainly by managers. The complexities involved and a lack of transparency in work and pay arrangements might contribute to income insecurity, further restricting workers’ job autonomy and job security. Some care workers bore the full cost of mandatory social insurance premiums. Additionally, they were unfamiliar with the workers’ compensation system and did not have institutional support, further hindering the realization of their entitlements. Conclusion: Existing literature indicates that care workers in Taiwan lack proper labor protections, making them vulnerable to occupational safety and health risks. However, much of the empirical research has focused on the experiences of individual workers, overlooking the influences of institutional arrangements and labor governance from an integrated perspective. Based on the review, the author identified some directions that warrant in-depth research.
Keywords: Global Health Workforce, Long-term care workers, Occupational safety, Health protections, Literature review, Exploration of future research directions
