Stress and Karoshi: It's Time for a Shortened Work Week

Leanna M.W. Lui, HBSc

Disclosures

July 21, 2021

The COVID-19 pandemic has pressed the importance of having work-life balance. However, the motif of remote working has been "burnout" or even, to some extent, karoshi.

Karoshi is a Japanese term for "death by overwork." Japan has a culture of long working hours, which has led to occupational-related mortality. This phenomenon has been observed in other regions as well (eg, Western Pacific). In fact, a study by the World Health Organization (WHO) and the International Labour Organization from 2000 to 2016 reported that overwork (> 55 hours/week) is a leading risk factor for occupational disease — more specifically, ischemic heart disease and stroke.

"With the COVID-19 pandemic we have seen an increase in work from home, which has blurred work-life balance among many individuals, leading to disrupted sleep patterns and exercise; this has in turn increased the risk for cardiovascular disease and stroke," says Sevith Rao, a physician and founder of the Indian Heart Association.

While employment rates have taken a plunge, for many, the pandemic has also caused a shift or even an increase in work responsibilities. Frank Pega, a WHO technical officer and lead author on the aforementioned study, states, "The reality seems to be that the people who are still working have to work more to compensate for the job losses" ... "We have some evidence that shows that when countries go into national lockdown, the number of hours worked increase by about 10%."

In short, longer working hours portend poor health outcomes:

  • Physiologic response to stress

  • Poor health habits and behaviors (eg, unhealthy diet, decreased sleep and exercise)

While "burnout" has long been in our vocabulary, are we finally ready for a shortened work week?

Results from recent trials in Iceland found that a shortened work week (a transition from 40 hours to 35-36 hours a week) led to significant improvements in well-being. Workers reported decreases in stress and burnout, and improvements in work-life balance and overall health. Additionally, productivity either remained the same or improved.

Icelandic trade unions are now advocating for shorter weeks. There's even a push toward further reduction in working hours (a true 4-day work week of 32 hours). It was suggested that these reduced hours helped motivate employees because it allowed them to have more control over their lives and more freedom.

Perpetual Guardian transitioned to a 4-day work week. According to its founder, Andrew Barnes, the shortened work week is "not just having a day off a week – it's about delivering productivity, and meeting customer service standards, meeting personal and team business goals and objectives."

Unilever New Zealand is running a 12-month trial of a 4-day work week. Nick Bangs, the managing director of Unilever New Zealand, states, "We don't want our team to have really long days, but to bring material change in the way they work."

These sentiments have been echoed by Jacinda Ardern, the prime minister of New Zealand. A shortened work week could have positive implications for productivity and tourism.

Iceland and New Zealand are not the only ones paving the way forward for shortened work weeks. Spain will also embark on a 4-day work week (32 hours) for a 3-year term. In fact, in 2019, Microsoft Japan also tried a 4-day work week called the "Work-Life Choice Challenge" where employees worked 4-day weeks in August. Productivity increased almost 40% during this time in comparison to the same period the previous year, measured by sales per employee.

However, shorter work weeks may also come with disadvantages. A trial in 2014 with Filimundus (Sweden) found that a 6-hour work day resulted in an increase in overall positivity but also led to mixed productivity. Another trial in Sweden found that the 6-hour work day led to decreased stress among workers but also significantly increased costs which made the policy unsustainable. Perhaps the next step is to conduct quality-of-life and cost-effectiveness studies across multiple fields to determine whether shorter work weeks are viable and productive solutions.

Ultimately, everyone has a different view on work. Some people live to work and some work to live. But working longer doesn't always equate to working smarter. There's no need to glorify overworking, nor do more work hours always mean greater productivity. Working oneself to the brink shouldn't be "trendy."

If anything, COVID-19 has helped us understand what we each truly value in life. There needs to be a shift in attitude toward greater working flexibility offered by employers. It's time we invest in people.

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About Leanna Lui
Leanna M.W. Lui, HBSc, completed an HBSc global health specialist degree at the University of Toronto, where she is now an MSc candidate. Her interests include mood disorders, health economics, public health, and applications of artificial intelligence. In her spare time, she is a fencer with the University of Toronto Varsity Fencing team and the Canadian Fencing Federation.

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