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Objectives Recently, overwork‐related disorders have become a major public health concern in Korea. This study investigated the current trends of working hours, causes of death in the working population, and compensation rates. Methods We reviewed the current trends of working hours, cause of death statistics in the working population, industrial accident compensation insurance (IACI) statistics, issues of compensation and prevention of work‐related cerebro‐cardio vascular diseases (CCVDs), mental disorders, and suicide. Results Although weekly working hours and the proportion of long working days have decreased, workers in small companies with fewer than five employees and those in the service sector continue to work long hours. The age standardized mortality due to CCVD and suicide was highest among those with managerial roles. In total, 589 CCVD cases and 104 mental disorder or suicide cases were compensated as occupational diseases in 2017. Between 2016 and 2017, 61% of 59 compensated suicides were related to overwork, specifically: long working hours, increased responsibility, or increased workload. The Korean government has introduced various policies to reduce working hours and to increase compensation approval rate for overwork‐related CCVDs. Stakeholders have called for the introduction of independent laws to prevent overwork‐related disorders, change organizational culture, and address the blind spots of the IACI Act and Labor Standard Act. Conclusions Prevention and compensation policies have improved working conditions in Korea, but there remains much to be done. This review significantly contributes to the understanding of the overall policies and research to prevent overwork‐related disorders in Korea.

Objectives Long working hours are linked to an increased risk of exposure to work safety hazards that threaten the health of workers. To date, only a few cross‐sectional studies regarding the relationship between working characteristics, such as over‐workload and chronic kidney disease (CKD) have been reported. Therefore, in this longitudinal study, we aimed to examine the direct relationship between long working hours and the incidence of CKD. Methods We included 97 856 participants without CKD in the Kangbuk Samsung Health Study. Using a self‐report questionnaire, we evaluated weekly working hours, which were categorized into 35‐40, 41‐52, and >52 hours. CKD was defined as estimated glomerular filtration rate 52 hours compared with working 35‐40 hours were 1.99 (1.22‐3.25). In subgroup analyses, the significant association between working >52 hours and incident CKD was consistently observed in groups of age ≥40 years, men, and obesity with no interaction. Conclusions Our large‐scale cohort study of young‐ to middle‐aged men and women demonstrated a significant association between long working hours and an increased risk of incident CKD.

Objectives Cerebrovascular and cardiovascular diseases (CCVDs) and mental disorders, including suicide, are prevalent among overworked individuals in Japan. The 2014 legislation regarding the prevention of overwork‐related deaths and disorders has accelerated the research in this field and ultimately the implementation of preventive actions. Methods To understand the current problematic situations, the Research Center for Overwork‐Related Disorders of the National Institute of Occupational Safety and Health, Japan, conducted analyses of compensated claims for overwork‐related CCVDs and mental disorders that were recognized from January 2010 to March 2015. Results The majority of CCVD cases were the men in their 50s. Transport and postal activities was the highest risk industry. Cerebrovascular cases were higher than cardiovascular ones. Long working hours was the principal factor for CCVDs. The mental disorder cases comprised approximately 70% men and affected younger age groups (peak in the third decade) with various industries at risk. In men, there was an almost equal number of F3 (Mood [affective] disorders) and F4 (Neurotic, stress‐related, and somatoform disorders) diagnoses according to the 10th revision of the International Classification of Diseases and Related Health Problems. A larger number of women were diagnosed to have F4. The mental disorder cases were associated not only with long working hours, but also with injuries and disasters as well as interpersonal conflict at work. Conclusions Multiple, simultaneous actions need to be made by employees, employers, researchers, and the authorities to achieve the goal of reducing the number of workers suffering from the overwork‐related CCVDs and mental disorders.

Background: The European Union's Working Time Directive stipulates recovery periods as "Eleven consecutive hour daily rest periods (DRPs) between working days." In Japan, adopting this regulation has been discussed. Objective: To examine the association between weekday DRPs and recovery from fatigue by conducting a one-month observational study using a fatigue monitoring application (fatigue app) on a smart tablet. Methods: Fifty-five daytime employees working at an information technology company participated in this study. Visual analogue scales (VAS) regarding fatigue, psychological detachment from work, a psychomotor vigilance task (PVT), and sleep-wake logs were repeatedly measured using a fatigue app that we developed for this study. Sleep was measured by a wrist actigraph. Results: The average and SD of weekday DRPs was 13.1 ± 2.3 h. However, 54.5% of employees experienced less than the minimum 11-hour DRP at least once a month. Sleep duration was significantly changed with weekday DRPs, though no significant difference was found in sleep efficiency. Linear mixed effects models showed that sleep duration increased by approximately 15 minutes for each hour of weekday DRPs (β = 0.24, 95% CI; 0.17, 0.32, p

Objectives Overwork has been recognized as a risk factor for cerebrovascular and cardiovascular disease (CCVD). To our best knowledge, Japan is the first country in the world to implement an independent act (the 2014 Act) for the prevention of overwork‐related disease, which was promoted through application of preventive measures, such as reductions in working hours. We assessed changes in working hours and overwork‐related CCVD before and after introduction of the 2014 Act. Methods We calculated the overwork‐related CCVD incidence rate and average monthly working hours for 10 industry groups in Japan with data from 2012 to 2018. We applied a causal mediation analysis to estimate the total effect of implementing the 2014 Act on the overwork‐related CCVD and the effect mediated by working hours. Results An average of 271 for every 48 million employees developed overwork‐related CCVD per year. After introducing the 2014 Act, the incidence rate ratio of overwork‐related CCVD was 0.881‐fold lower (95% CI 0.780‐0.995) compared with before the policy change. The 2014 Act contributed to a decrease of 26% (78 cases per year; 95% CI 29‐173) of the overwork‐related CCVD incidence per year. Approximately 41% (32 cases per year) of this effect could be explained by reduced working hours. Conclusions Our study highlights the impact of the 2014 Act in Japan on the reduction in working hours, which further contributes to the reduction in overwork‐related CCVD. Policymakers should consider adopting our innovative approach to assess the mediation effect underlying the implementation of new policies.

Objectives Long work hours and overwork may increase the cardiovascular load of workers. But long work hours and overwork are not the same. Cardiovascular overload from working is dependent on the physical demand of the work and the worker's physical fitness, as well as the working hours. This cross-sectional study was designed to identify the association between overwork and cerebrocardiovascular disease, taking into account the physical demand of work, physical fitness, and work hours. Methods Study data were obtained from surveillance of occupational cerebrocardiovascular disease. Questionnaire surveys including general and work-related characteristics were conducted. Maximum acceptable work time was estimated using the physical work demand and physical fitness of the subjects. The overwork index, which was the ratio of maximum acceptable work time and actual work hours of the subjects, was calculated. Results In the workers with a moderate or high physical demand of work, the adjusted odds ratios for overwork indexes of 1.01-1.20, 1.21-1.50, and >1.50 were 2.679 (95% confidence interval (CI) 1.025-6.999), 3.124 (95% CI 1.111-8.783), and 4.331 (95% CI 1.719-10.908), respectively. Conclusions The results indicate that the risk of cerebrocardiovascular disease might be high in the workers with long working hours, high physical demand of work, and poor physical fitness engaged in work with a moderate to high physical work demand. Work hours should be accommodated according to the worker's physical fitness and the physical demand of work, and this could lower the risk of cerebrocardiovascular disease.