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An Epidemic of Overtime?

Working long hours is related to a host of health problems, from heart disease to depression

By Elaine Meyer

Published October 9, 2012

In the United States, overtime, skipped lunches, double shifts, and late nights—even overnights—are not just the exception but the rule for workers across all classes. In fact, 86 percent of males and 67 percent of females in America work over 40 hours a week, according to the most recent data from the United Nations, and the U.S. is the only developed nation not to mandate paid vacation time.

“Americans work longer hours than workers in most other developed countries, including Japan, where there is a word, karoshi, for ‘death by overwork,” says a 2010 article by Joan C. Williams and Dr. Heather Boushey at the Center for American Progress.

Many employers seem to believe that the more time they can wring out of their employees, the better it is for a company’s earnings and productivity.

However, epidemiologic research shows that longer work hours are associated with a variety of health conditions. Since poor health decreases worker productivity, demanding more hours from employees may actually backfire.

“Job stress is estimated to cost U.S. industry more than $300 billion a year in absenteeism, turnover, diminished productivity and medical, legal and insurance costs,” according to an oft-cited 2001 statistic by Dr. Paul J. Rosch, chairman and founder of the American Institute of Stress.

Like type 2 diabetes or smoking, working long hours is a risk factor associated with coronary heart disease, according to Dr. Marianna Virtanen, an epidemiologist at the Finnish Institute of Occupational Health.

She is lead author of a systematic review and meta-analysis published this month in the American Journal of Epidemiology which found that employees who work overtime or long hours (10-plus hours a day or over 40 to 65 hours per week) are at a 40 percent increased risk of coronary heart disease.

The risk is associated with other health conditions as well. In just the past year alone, a number of population studies have found such associations, including:

  • A Finnish Institute study which found in analyzing data from Whitehall II, a longitudinal study of British civil servants, that those who worked 11 or more hours per day were 2.4-times more likely to have a major depressive episode compared to those who worked seven to eight hours per day
  • A study of over 400 police officers in Buffalo, NY, which found that males working midnight shifts had significantly larger waistlines—a risk factor for cardiovascular disease—and higher body mass indexes, compared to those who worked fewer hours on daytime shifts
  • In Japan, where researchers found “severe” and “disabling” headaches were significantly higher for those who worked over 55 hours a week and performed little physical activity, compared to those who worked fewer hours and exercised more
  • Another study out of Japan which found that working 10 hours or more per day is a risk for metabolic syndrome in male workers
  • That working over 35 hours per week was associated with more weight gain, according to a study of Australian women

Since all except the Whitehall II study, are cross-sectional, these studies do not show that long work hours cause health problems, only that the two are associated.

“We should confirm with intervention studies whether coronary heart disease can be prevented by shortening working hours,” says Dr. Virtanen. “However, I usually say that if anyone has symptoms such as tiredness, irritation, pain and aches, poor sleep etc. and attributes those symptoms to be at least in part due to excess workload, it would be wise to stop and think what should be done with the situation. In many cases shortening hours can improve well-being.”

This is not always an option. While European Union states must provide at least four weeks of paid annual leave and to limit weekly work hours to 48, and many other nations have comparable requirements, U.S. policymakers, especially Republicans, have looked skeptically upon laws that set maximum work hours or mandatory leave.

In 2009, former U.S. Representative Alan Grayson, a Florida Democrat, tried to pass a resolution that would have required one week time-off for workers in companies of 50 or more and two weeks in companies with over 100 people. However, the bill, failing to find enough support, never even made it to the floor of Congress. Lawmakers said it was not the right time and would “kill jobs.”

As John de Graaf and David A. Bakter, authors of the book What’s the Economy For, Anyway? Why It’s Time to Stop Chasing Growth and Start Pursuing Happiness say: “Almost anywhere else in the world, such legislation would be laughably inadequate.”

Edited by Abdul El-Sayed and Dana March.

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The views and opinions expressed on this website are solely those of the authors and do not represent those of the Department of Epidemiology, the Mailman School of Public Health, or Columbia University.