SHIFT WORK AND OCCUPATIONAL INJURIES AMONG HEALTHCARE WORKERS IN A TERTIARY HEALTHCARE CENTER IN LEBANON: A RETROSPECTIVE STUDY

Abstract

Background: Occupational injuries are a significant concern among healthcare workers (HCWs), particularly in low- and middle-income countries like Lebanon, where health systems face resource limitations and workforce shortages. Although shift work has been associated with elevated injury risk globally, little is known about its effects in low-resource settings. In 2020, a policy shift at a major tertiary hospital in Lebanon transitioned registered nurses from 8-hour to 12-hour shifts, providing a unique opportunity to examine the impact of extended shift work on injury incidence.

Methods: This retrospective cross-sectional study analyzed 2,218 occupational injury reports filed by HCWs at the American University of Beirut Medical Center (AUBMC) between 2019 and 2023. Data on injuries, costs, and absenteeism were drawn from administrative records. Negative binomial regression and a difference-in-differences (DiD) approach were used to examine the associations between shift type, policy change, and injury risk. Logistic and linear regressions assessed injury severity and economic outcomes.

Results: Shift work accounted for 53% of all injuries, with a 12% higher incidence compared to standard shifts (IRR=1.12, p=0.07). Following the 2020 policy change, injury risk during shift work increased significantly (IRR=1.34, p<0.001), with registered nurses experiencing a 69% higher injury rate relative to other HCWs (DiD IRR=1.69, p<0.001). Needle stick injuries and workplace violence were significantly more common during shift work. Each day of absenteeism was associated with a $67.12 monthly increase in injury-related costs (p<0.001).

Conclusion: In our study, shift work and extended 12-hour shifts were associated with increased occupational injury risk among HCWs, especially registered nurses. These findings underscore the importance of re-evaluating work scheduling policies and suggest the need for more elaborate studies.