Objectives This study investigated the associations between shift work characteristics and self-reported work-related accidents as well as incidents of dozing off at work and during the work commute.

Methods Data from a Norwegian hospital’s working-time register encompassed information on quick returns (<11 hours between shifts), day-, evening-, night-, and long (≥12 hours) shifts worked during 2020, and were linked to questionnaire data from 1195 healthcare workers collected in January 2021. The questionnaire assessed work-related accidents causing harm to oneself, patients/others, and/or equipment the last year, as well as dozing off at work the last month and/or during commute the last year. Data were analyzed using negative binomial regressions, adjusting for age, sex, children, marital status, shift work experience, monthly working hours, circadian type, and night shifts.

Results Number of quick returns the last year was positively associated with causing harm to oneself [incidence rate ratio (IRR) 1.021, 95% confidence interval (CI) 1.009–1.034]. Number of day shifts and evening shifts were negatively associated with causing harm to patients/others (IRR 0.987, 95% CI 0.981–0.992; IRR 0.989, 95% CI 0.982–0.996, respectively). Number of night shifts was positively associated with dozing off at work (IRR 1.005, 95% CI 1.002–1.008) and during commute (IRR 1.007, 95% CI 1.003–1.010), but was not associated with work-related accidents. Number of long shifts was positively associated with healthcare workers causing harm to oneself (IRR 1.198, 95% CI 1.111–1.291), patients/others (IRR 1.209, 95% CI 1.122–1.304), and equipment (IRR 1.174, 95% CI 1.080–1.275).

Conclusion Limiting quick returns and long shifts may be relevant considerations for improving employee and patient safety.

Key terms accident; adverse event; commute; dozing off; healthcare worker; injury; late-early; long shift; night shift; register data; retrospective survey; safety; shift schedule; shift work; short rest period