Karoshi

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Original synthesis to sit alongside the encyclopedia article below. Not part of Wikipedia; verify facts on Wikipedia when precision matters.

Karoshi, derived from the Japanese term "过労死" (meaning "death from overwork"), refers to sudden death caused by prolonged excessive work hours, chronic stress, and disrupted work-life balance. Originating in Japan during its post-war economic boom in the 1970s-80s, it gained international recognition as a critical occupational health issue, linked to fatal conditions like heart attacks and strokes. Recognized by global health bodies such as the WHO, karoshi highlights the severe physical and mental toll of overwork on individuals worldwide.

Key moments

  • 1969First publicized karoshi case in Japan: a 29-year-old newspaper worker died from a stroke after excessive overtime
  • 1982Japanese doctors formalized the term "karoshi" in their book documenting overwork-related deaths
  • 2002"Karoshi" was officially added to the Oxford English Dictionary
  • 2021WHO and ILO joint report estimated 745,000 global annual deaths from overwork-related diseases

Cultural and Systemic Drivers in Japan

Karoshi emerged amid Japan's rapid economic growth, fueled by a corporate culture that emphasized loyalty, long working hours, and societal pressure to prioritize work over personal health. This culture created environments where employees often felt compelled to work overtime without proper rest, contributing to the rise of overwork-related deaths. While policy reforms have attempted to address this, deep-rooted cultural norms continue to pose challenges to reducing karoshi cases.

Global Prevalence and Underreporting Challenges

Beyond Japan, karoshi-like phenomena are increasingly recognized globally, particularly in industries with high workload demands such as technology, manufacturing, and healthcare. However, underreporting remains a significant issue due to the lack of standardized diagnostic criteria in many countries, making it difficult to accurately track the true scale of overwork-related fatalities and implement effective interventions.

Public Health and Policy Implications

The WHO's 2021 report underscored karoshi as a major public health crisis, prompting some governments to introduce regulations limiting working hours and promoting workplace wellness programs. Yet, enforcement of these policies varies widely, and addressing karoshi requires a multi-faceted approach that combines legal protections, corporate accountability, and cultural shifts to value work-life balance and employee well-being.

Karoshi (過労死), which can be translated into 'overwork death', is a Japanese term relating to occupation-related sudden death.[1]

The most common medical causes of karoshi deaths are heart attacks and strokes due to stress and malnourishment or fasting. Mental stress from the workplace can also cause workers to commit suicide in a phenomenon known as karōjisatsu (過労自殺).[1]

Karoshi is also widespread in other parts of Asia. Generally, deaths from overwork are a worldwide occurrence. For example, over 770 wage labourers die of overwork annually in Sweden, a country with robust labour regulations.[2][3][4][5]

History

The first case of karoshi was reported in 1969 with the stroke-related death of a 29-year-old male worker in the shipping department of Japan's largest newspaper company.[6][7]

In 1988, the Labor Force Survey reported that almost one fourth of the male working employees worked over 60 hours per week (equivalent of two-and-a-half days), which is 50% longer than a typical 40-hour (equivalent of over one-day-and-a-half) weekly working schedule. Realizing the seriousness and widespread nature of this emerging problem, a group of lawyers and doctors set up "karoshi hotlines" that are nationally available, dedicated to helping those who seek consultation on karoshi-related issues.[8]

Japan's rise from the devastation of World War II to economic prominence and the huge war reparations they have paid in the post-war decades have been regarded as the trigger for what has been called a new epidemic. It was recognized that employees cannot work for 12 or more hours a day, 6–7 days a week, year after year, without suffering physically as well as mentally.[9][10] Also labor unions doing strikes for better working conditions (which happens in many other parts of the world) are extremely taboo in Japan.[10]

In an April 2013 International Labour Organization (ILO) article about karoshi,[11] the following four typical cases of karoshi were mentioned:

As well as physical pressure, mental stress from the workplace can cause karoshi.[12][13] People who die by suicide due to mental stress are called karōjisatsu (過労自殺).[12] The ILO also lists some causes of overwork or occupational stress that include the following:

  • 1) Mr. A worked at a major snack food processing company for as long as 110 hours a week (equivalent of four and a half days) and died from a heart attack at the age of 34. His death was recognized as work-related by the Labour Standards Office.
  • 2) Mr. B, a bus driver, whose death was also recognized as work-related, worked 3,000 hours a year (equivalent of four months). He did not have a day off in the 15 days before he had a stroke at the age of 37.
  • 3) Mr. C worked in a large printing company in Tokyo for 4,320 hours a year including night work (equivalent of nearly six months, thus half a year) and died from a stroke at the age of 58. His widow received workers' compensation 14 years after her husband's death.
  • 4) Ms. D, a 22-year-old nurse, died from a heart attack after 34 hours of continuous duty five times a month.
  • 1) All-night, late-night or holiday work, both long and excessive hours. During the long-term economic recession after the collapse of the bubble economy in the 1980s and 1990s, many companies reduced the number of employees. The total amount of work, however, did not decrease, forcing each employee to work harder.
  • 2) Stress accumulated due to frustration at not being able to achieve the goals set by the company. Even in economic recession, companies tended to demand excessive sales efforts from their employees and require them to achieve better results. This increased the psychological burden placed on the employees at work.
  • 3) Forced resignation, dismissal, and bullying. For example, employees who worked for a company for many years and saw themselves as loyal to the company were suddenly asked to resign because of the need for staff cutbacks.
  • 4) Suffering of middle management. They were often in a position to lay off workers and torn between implementing a corporate restructuring policy and protecting their staff.

Karoshi Hotline

In a 1988 report published by the Karoshi Hotline Network, the majority of the clients who consulted were not workers, but the wives of the workers who had either died because of karoshi or were at high risk of doing so.[14] This indicated that those who were stressed out by work either did not realize the cause was overwork or were under social pressure to not express it explicitly or to seek help.

The Karoshi Hotline received the highest number of calls when it was first established in 1988. From 1988 to 1990, there were a total number of 1806 calls received. From 1990 to 2007, the number of calls received per year was lower, but has not shown a clear trend of further decrease.[15]

Effects on society

Suicide can be induced by overwork-related stress or when people are dismissed. The deceased person's families demand damages when such deaths occur. Life insurance companies started putting one-year exemption clauses in their contracts. They did this so that the person must wait one year to commit suicide in order for the family to receive the money.[16]

There is a new movement of Japanese workers, formed as a result of karoshi. Compared to older Japanese people who often work overtime, young Japanese people are preferring part-time work. This is a new style of career choice for the young Japanese people who want to try out different jobs in order to figure out their own potential. These individuals work for "hourly wages rather than regular salaries," and are called "freeters." The number of freeters has increased throughout the years, from 200,000 in the 1980s to about 400,000 in 1997.[17]

Freeters undergo a special kind of employment, defined by Atsuko Kanai as those who are currently employed and referred to as "part-time workers or arbeit (temporary workers), who are currently employed but wish to be employed as part time workers, or who are currently not in the labor force and neither doing housework nor attending school but wish to be employed only as part-time workers."[18]

Government policies

To provide a strategic plan to decrease the rate of karoshi, the National Institute of Health proposed the establishment of a comprehensive industrial health service program to reduce karoshi and other diseases caused by work-related stress in its 2005 annual report. The program requires communal efforts from the following groups:

As a formal response to this proposal, the Industry Safety and Health Act was revised in 2006. The Act established various terms that focus on work-related health issues, including mandatory health checks and consultations with professional medical personnel for employees who work long hours and have a higher probability of having work related illnesses.[20]

  • 1) The government, as the policy maker, should promote shorter working hours, make health services readily accessible, encourage voluntary health examination and enhance the effectiveness of medical care.
  • 2) As the group that is more closely involved with the everyday health of employees, labor unions and employers should strive to implement and comply with government policies that focus on reducing work overtime and creating a better work environment.
  • 3) The employees themselves should recognize the need to take rests regularly and take preventive measures as needed.[19]

Corporate response

Many companies have been making an effort to find a better work–life balance for their employees. Toyota generally limits overtime to 360 hours a year (an average of 30 hours monthly), and, at some offices, issues public address announcements every hour after 7 p.m. pointing out the importance of rest and urging workers to go home. Nissan allows for remote work to make it easier to care for children or elderly parents.[10] Dozens of large corporations have also implemented "no overtime days", which require employees to leave the office promptly at 5:30 p.m. In 2007, Mitsubishi UFJ Trust & Banking, a division of Japan's largest banking group, started to allow employees to go home up to 3 hours early to care for children or elderly relatives. As of January 5, 2009, just 34 of the company's 7,000 employees had signed up for the plan.[10]

In February 2017, the Japanese government launched a campaign called "Premium Friday" asking companies to allow their workers to leave at 3pm on the last Friday of the month. The initiative is part of an attempt to address the punishingly long hours many Japanese are expected to work, prompted by the suicide of a 24-year-old employee at the advertising firm Dentsu who was doing more than 100 hours' overtime in the months before her death. While some major companies, such as Honda, the drink maker Suntory and the confectioner Morinaga & Company, have adopted the optional scheme, others are less enthusiastic about the prospect of a mid-afternoon staff exodus. A survey of 155 big companies by the Nikkei business newspaper showed that 45% had no immediate plans to implement the scheme, with 37% saying they had either decided to enter into the spirit of Premium Friday or had plans to do so.[21]

Media attention

The French-German TV channel Arte showed a documentary titled Alt in Japan (literal translation: "Old in Japan") on 6 November 2006 dealing with older workers in Japan. In 2008, karoshi again made headlines: a death back in 2006 of a key Toyota engineer who averaged over 80 hours overtime each month was ruled the result of overwork. His family was awarded benefits after his case was reviewed.[22]

Taiwanese media have reported a case of karoshi.[23] An engineer had worked for Nanya Technology for 3 years from 2006 to 2009. It was found that he died in front of his computer surrounded by company documents. The prosecution found that the engineer had died of cardiogenic shock. The engineer's parents said that he worked for 16–19 hours a day. CNN shows another reported case of karoshi in Taiwan.[24] This short clip called "The Dangers of Overwork" shows a man who suffered a stroke and was left for three hours before being taken to the hospital.[24] It was made known that physicians are starting to make people more aware of these health deficits due to overwork. More people have been visiting their doctor, recognizing signs and symptoms of overwork.[24]

In other countries

The phenomenon of death by overwork is also widespread in other parts of Asia. 745,194 deaths worldwide were attributable to long working hours in 2016, based on WHO/ILO data.[25]

China

In China, the analogous "death by overwork" concept is guolaosi, which in 2014 was reported to be a problem in the country.[26] In Eastern Asian countries, like China, many businessmen work long hours and then feel the pressures of expanding and pleasing their networks. Making these connections is called building guanxi. Connections are a big part of the Chinese business world, and throughout different parts of China, businessmen would meet up in teahouses to take their job outside of the work atmosphere. It was important for businessmen to broaden their guanxi relationships, especially with powerful officials or bosses.[27]

There is a lot of pressure to go to these nightclubs almost every night to drink heavily to move up in the business world.[28] It has been shown that this kind of work could lead to health related problems down the line. For example, a businessman named Mr. Pan discussed with John Osburg, an anthropologist who wrote "Anxious Wealth: Money and Morality Among China's New Rich," about his health and the need to continue working. Mr. Pan, the 'biggest boss in Chengdu,' was in the hospital for 'excessive drinking.' This has happened to him before. Mr. Pan said, "I can't stop or slow down. I have many people whose livelihoods depend on me (literally 'depend on me to eat'). I've got about fifty employees and even more brothers. Their livelihoods depend on my success. I have to keep going."[29]

A 2012 report by Legal Daily found the leading cause of line of duty deaths among police officers was exhaustion related heart attacks, followed by traffic accidents.[30]

India

Indian labour law has, in theory, offered protection to labour rights. However, the average office worker, women and the IT sector are unofficially forced to work overtime without overtime pay. In 2023, Narayana Murthy, co-founder and former CEO of Infosys, stated, "Somehow our youth have the habit of taking not-so-desirable habits from the West. My request is that our youngsters must say – 'This is my country. I want to work 70 hours a week'. This is exactly what the Germans and Japanese did after the Second World War".[31][32] This sparked a national debate with many male CEOs strongly supporting 70-hour workweeks to boost productivity and cover losses due to the COVID-19 pandemic.[33] A 70-hour workweek translates to working approximately 12 hours a day, for six days a week, a phenomenon unofficially occurring in the IT industry.[34]

South Korea

In South Korea, the term gwarosa (alternatively romanised as kwarosa) is also used to refer to death by overworking. South Korea has some of the longest working hours in the world, even more so than Japan with the average being 42.[35] This has caused many workers to feel the pressure of their jobs which has taken a toll on both their physical and mental health. Many have died from being overworked and the issue has only begun to gain more national attention due to many government workers having died from gwarosa.[36] In 2018, the South Korean government enacted a law cutting working hours from 68 to 52.[37]

Sweden

In Sweden the deaths due to excessive stress at work is expected to increase from the current level in the future.[2][3] A study conducted with researchers in cooperation with The Swedish work environment authority in 2019 concluded that 720 workers in Sweden already die every year due to stress from engaging in wage labour.[2] This study sparked an increased amount of public debate.[4][5][3]

See also

Japan:

General:

  • Japanese management culture
  • Japanese work environment
  • Black company (Japan)
  • Suicide in Japan
  • Japanese labour law

References

  1. Case Study: Karoshi: Death from overwork 2013-04-23^
  2. Jonna Söderqvist. Över 770 svenskar dör av stress varje år Arbetarskydd, May 28, 2019^
  3. Anna Sjöström. Allt fler dör till följd av arbetsrelaterad stress Byggvärlden, May 30, 2019^
  4. Johan Apel Röstlund. 500 arbetare dör av jobbstress varje år Arbetaren, May 29, 2019^
  5. Karin Persson. Lek med döden – jobbstressen kan leda till fler dödsfall Akademikern, October 23, 2019^
  6. Karoshi-Death from overwork: Occupational health consequences of the Japanese production management International Journal of Health Services, February 4, 1997, retrieved June 9, 2009^
  7. Jeffrey Pfeffer. Dying for a Paycheck HarperCollins, 20 March 2018^
  8. Koji Marioka. Work Till You Drop New Labor Forum, 2004^
  9. Japanese salarymen fight back The New York Times - Wednesday, June 11, 2008^
  10. Recession Puts More Pressure on Japan's Workers Bloomberg News, January 5, 2009^
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  12. Karoshi - Institutet för språk och folkminnen 2021-04-13, retrieved 2022-03-22^
  13. Alexandra Ma. Japan's toxic culture of overwork drove a 31-year-old woman to death — and it looks like there's no end in sight Insider, retrieved 2022-03-23^
  14. Tetsuro Kato. The Political Economy of Japanese 'Karoshi' (Death from Overwork) Hitotsubashi Journal of Social Studies, 1994^
  15. 過労死110番 karoshi.jp, retrieved 2023-01-18^
  16. Jake Adelstein. Killing Yourself To Make A Living: In Japan Financial Incentives Reward "Suicide" retrieved 18 November 2016^
  17. Romit Dasgupta. Salarymen doing straight: Heterosexual men and the dynamics of gender conformity Routledge, 2005^
  18. Kanai. Karoshi (Work to Death) in Japan 2008^
  19. Shunichi Araki, Kenji Iwasaki. Death Due to Overwork (Karoshi): Causation, health service, and life expectancy of Japanese males Japan Medical Association Journal, 2005, retrieved 19 January 2018^
  20. Industrial Safety and Health Act (Act No. 57 of 1972) retrieved 22 January 2018^
  21. Justin McCurry. Premium Fridays: Japan gives its workers a break – to go shopping The Guardian, February 24, 2017^
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  28. John Osburg. Anxious Wealth: Money and Morality Among China's New Rich Stanford University Press, 2013^
  29. John Osburg. Anxious Wealth: Money and Morality Among China's New Rich Stanford University Press, 2013^
  30. 法制日报:暴力袭警成民警因公负伤主因 Ministry of Public Security, Legal Daily, 2013-04-03^
  31. Payal Chawla. What male CEOs like Narayana Murthy don't get about working women and the youth The Indian Express, November 22, 2023^
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  34. Average to poor work life balance: Indian IT sector employees forced to work 50 hours a week The Times of India, 2023-11-21, retrieved 2025-05-28^
  35. E-나라지표 지표조회상세^
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  37. Benjamin Haas. South Korea cuts 'inhumanely long' 68-hour working week The Guardian, 1 March 2018^