Psychosocial risk, shift work and burn-out among health workers
Workload, night work, understaffing and emotional demand — and the mental health consequences for doctors and nurses.
Last updated: 3 October 2026
Overview
Psychosocial risks arise from how work is organised: workload, time pressure, shift and night work, low control, poor support and exposure to suffering. WHO classifies burn-out in ICD-11 (code QD85) as an occupational phenomenon resulting from chronic workplace stress that has not been successfully managed, with three dimensions: exhaustion, mental distance from the job, and reduced professional efficacy. During COVID-19, a meta-analysis found pooled prevalence among health workers of 23.2% for anxiety, 22.8% for depression and 38.9% for insomnia (Pappa et al., 2020, cited in Frontiers in Public Health, 2023).
GILS found no published Georgian data on this hazard. This page therefore sets out the international evidence and the standards that apply, and defines what the GILS 2027 survey of health workers with the David Tvildiani Medical University School of Public Health will measure.
Key figures
QD85
WHO ICD-11 code for burn-out, an occupational phenomenon
WHO
23.2% · 22.8% · 38.9%
Anxiety, depression and insomnia among health workers during COVID-19, pooled prevalence
Pappa et al. (2020)
22:00–06:00
Night work as defined in the Labour Code of Georgia; prohibited for minors and pregnant women
Labour Code
None
Specific regulation of psychosocial risks at work in Georgia
ETF–Eurofound (2024)
Standards and what Georgia has
| Instrument | Content | Georgia |
|---|---|---|
| EU Framework Directive 89/391/EEC | Employers must assess and prevent all risks, including psychosocial | Not yet transposed |
| EU Working Time Directive 2003/88/EC | Limits on working hours, rest periods, night work | EU benchmark; Georgian Labour Code sets 40/48-hour weeks and night-work rules |
| ILO Convention No. 149 (1977) | Conditions of work of nursing personnel, including hours and rest | Not ratified |
| WHO and ILO (2022) | Psychosocial risk management as part of facility programmes | Guidance |
| Labour Code of Georgia | Working time, rest, night work; no psychosocial-risk provisions | In force |
What works
- Risk assessment that includes workload and staffing; limits on consecutive night shifts; predictable rosters.
- Peer support and confidential access to mental health services for staff, without career penalty.
- Management training and participation of staff in decisions on work organisation.
- Monitoring: regular staff surveys using validated instruments, with results acted upon.
Public health perspective (WHO)
WHO defines burn-out in ICD-11 (QD85) and issued guidelines on mental health at work in 2022; the WHO/ILO Joint Estimates identify long working hours as the largest single occupational risk factor, with 745,000 deaths from stroke and heart disease in 2016 (WHO and ILO, 2021). For the health sector this is doubly relevant: health workers are exposed, and health services must treat the consequences. Workers' health: the public health perspective.
What the GILS 2027 survey will measure
- Burn-out using a validated short instrument; working hours, night shifts and second jobs.
- Perceived staffing adequacy, support and intention to leave the profession or the country.
- Access to mental health support at work.
Sources
- WHO (2019). Burn-out an "occupational phenomenon": International Classification of Diseases. www.who.int
- Frontiers in Public Health (2023). Violence toward health workers during COVID-19, citing Pappa et al. (2020) meta-analysis. www.frontiersin.org
- ETF–Eurofound (2024). Working life in Georgia. www.etf.europa.eu
- WHO and ILO (2022). Caring for those who care. www.who.int
Figures are from the GILS Evidence Register and the official sources shown. GILS is independent of government, trade unions, employers' organisations and the ILO.
In this section
← OSH hubTwo perspectives: ILO and WHO · National OSH Profile · Normative instruments · International standards · Law and institutions · Accidents and deaths · Occupational diseases · Chemical hazards · Noise, vibration and radiation · Ergonomics and musculoskeletal disorders · Psychosocial risks at work · Construction · Mining · Agriculture · Heat and climate · Health workers · Infection and sharps · Violence · Health workers: burn-out · Women at work · Young and older workers · Workplace action and training
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