• Timothy Yeung, Gerard O'Reilly, Biswadev Mitra, and Alexander Olaussen.
• Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Victoria, Australia.
• Emerg Med Australas. 2021 Apr 1; 33 (2): 250-254.

ObjectiveOccupational violence and aggression (OVA) in the ED is an issue of global concern and increasing incidence. The empirical evidence for the relationship between the lunar cycle and 'lunatics' remains equivocal. The present study aims to examine the association between OVA in ED and the full moon (FM).MethodsData on all presentations were extracted from The Alfred Hospital ED records for consecutive patients over a 3-year period (January 2013-December 2015). The primary outcome of the present study is OVA among patients in the ED. Univariable and multivariable logistic regression were used to determine the association between aspects of the lunar cycle and OVA.ResultsThere were 184 059 ED presentations during the 3 years, 6234 (3.4%) of which occurred on a FM. There were 1853 episodes of OVA, 57 (3.1%) of which occurred on a FM. OVA among patients presenting to ED was not associated with the FM (adjusted odds ratio [OR] 0.92 [95% confidence interval 0.70-1.20]; P = 0.53). However, the first quarter (FQ) (adjusted OR 1.38 [1.11-1.72]; P < 0.01) and third quarter (TQ) (adjusted OR 1.29 [95% confidence interval 1.03-1.62]; P = 0.03) moons of the lunar cycle were independently associated with OVA.ConclusionsContrary to traditional beliefs, the FQ and TQ of the lunar cycle but not the FM were associated with OVA. This highlights a relatively unexplored relationship that has previously been overshadowed by the FM in the literature. Prediction models of violence in the ED could consider incorporating the FQ and TQ of the lunar cycle in their models.© 2020 Australasian College for Emergency Medicine.

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