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Karōshi (過労死) Dr. Craig Jackson Senior Lecturer in Health Psychology Faculty of Health UCE Birmingham
Country Profile 2 nd largest economy in world Main source of global capital and credit Traditional society – strong social and employment hierarchies >75% live in urban areas – “Rabbit Hutches” exercise implications Sprawling conurbations and coastal plains Neighbour relations still influenced by Pre and WWII actions Atonement for atrocities a sticking point e. g. history books
Country Profile Population: Capital: Area: Major language: Major religions: Life expectancy: Monetary unit: Main exports: 127. 9 million (UN, 2005) Tokyo 377, 864 sq km (145, 894 sq miles) Japanese Shintoism, Buddhism 78 years (men), 85 years (women) (UN) yen ¥ Vehicles, computer parts, chemicals, scientific instruments and watches GNI per capita: US $37, 180 (World Bank, 2005) Internet domain: . jp International dialing code: +81 10% of World Exports from 2% of world population
Karōshi A condition in which psychologically unsound work processes are allowed to continue in a way that disrupt the worker's normal work and life rhythms. This leads to a build up of fatigue and a chronic condition of overwork accompanied by a worsening of pre-existent high blood pressure and a hardening of the arteries and finally resulting in a fatal breakdown. Tetsu Uehata
Karōshi Common by latter part of the 1980 s during the bubble economy However, when several high-ranking business execs still in their prime years suddenly died without any previous sign of illness. Media stories began - “new phenomenon” Quickly labelled karōshi Once symptoms were popularised immediately seen as a new and serious menace for people in the workforce.
Karōshi (過労死) “death from overwork“ Enters OED in 2002! Tetsu Uehata occupational sudden death Major medical causes of Karōshi are heart attack & stroke Japanese culture due to historical traditions of Seppuku (切腹) Ritual suicide by "stomach-cutting" or "belly slicing" Seppuku is better known as hara-kiri (腹切り) First case of Karōshi in 1969 death from a stroke of a 29 -year-old married male worker shipping department of Japan’s largest newspaper company.
Life Expectancy
Suicides Joins UN Financial boom Recession
Suicides Education system notorious for strictness and competitiveness Attend 240 days/year - (40 -60 days more than West) After-school overtime “juku” to prepare for exams Crime low Youth traditionally compliant “If it wasn’t for the nips Being so good at building ships The yards would still be open on the Clyde But it can’t be much fun for them Beneath the rising sun With all their kids committing suicide” Roger Waters
Karōshi 1987 - Jap Ministry of Labour began statistical recording of deaths Japan's rise from the devastation of WWII to economic prominence regarded as “trigger” for this epidemic Employees cannot work for up to twelve hours a day six or seven days a week continuously without suffering physically as well as mentally. Japanese worker has approx two hours overtime a day on average, mostly always unpaid The Ministry of Labour compensates for 20 to 60 deaths each year, but critics suggest the real figure is nearer 10, 000. 143 deaths in 2001 – all time high
Commuter Hell Cause of Karoshi not just working hours Commuting very stressful One-way commute of 1 hour not unusual Housing market means 3 hours round-trip is common 250 workdays/year = 750 hrs/year on trains! Usually 7: 00 pm before earliest leavers get home
A Society under Stress? 1990 Average Japanese worker put in 2, 124 hours a year 500 hours more than Germans or French 2001 Figure had fallen to a more manageable 1, 843 hours - health ministry Well above the global average, but low by Japanese standards Official aim to reduce average working year to 1, 800 hours by 2005 Job losses for first time since WWII Work more hours but fewer weeks than Germans or USA
A Society under Stress? Japanese offices, still largely male-dominated Notorious for their punishing culture Ministry of Labour uses new broader definition of Karoshi: examining the deceased's working conditions in the six months before death. Keen to uncover “hidden Karoshi” those ashamed to reveal their stress Recent large-scale payouts made this more necessary
Cultural Differences Some role of personality – Type A implicated Long-working hours is THE route for company advancement Refusal of overtime or taking paid leave is evaluated negatively Salary gaps and slowing advancement begin Compulsory overtime – some workers have been fired for refusing
Meet the Oyabun • Social ranking and hierarchy • Initial introductions (Aisatsu) • Japanese corporate structure and group decision-making process • Obligation and saving face • Linguistic comparisons between Japanese and English conversation • The company presentation to the potential Japanese client • "The role of the shadow manager" • "Reporting to the home office--no excuses" Understand the cultural and corporate background that motivates a Japanese manager Comprehend and utilize the principles of American/Japanese "blended" corporate management
After a hard day at the office. . . Heavy drinking and smoking expected with colleagues Metropolis – few health clubs near workplaces
A Society under Stress? Increasingly, healthy-looking salarymen drop dead from unexpected heart attacks or strokes Caused by the unrelenting stress of their jobs Phenomenon really found public attention in the boom years of the 1980's Many top executives found themselves “eating desk” 46% of 500 office workers in Tokyo found were concerned about dying on the job (Insurance company survey) Heart attacks and strokes are very common, and it's difficult to determine the number of deaths actually caused by overwork
Work Organization Management & labour meet once a year to negotiate working days, holidays and hours “The Toyota Calendar” Kanban Production System Saturdays and Sundays holidays all other days require production – even public holidays Related companies and contractors must obey this rule Enforced weekend work to use cheaper electricity. Workers had to take weekdays off. Caused mass disruption. Compnay saved 500, 000¥ (£ 2. 4 M)
Solitary Job Transfer - SJT Temporary transfer assignment to another part of country Moves by himself Leaves family behind Family left behind for “exam wars” and fear of harming children’s exam performance Leads to irregular eating habits Less opportunity to relieve stress and tension 50% of calls to Karoshi Hotline cite SJT as a factor in health breakdown Worker died in own car found by children
Would the last person to leave. . .
Suicide Case Study - Karōjisatsu Advertising agency Dentsu was ordered to pay £ 790, 000 compensation Death from overwork-related suicide of junior copy writer Ichiro Oshima in 1991. He killed himself a day after completing an important project. Mr Oshima had worked 17 months without a day off, and with as little as half an hour's sleep a night. "The employee was totally tired and depressed. He was relieved when his project was finished but when he thought of the extremely long hours of work he had to face again the next day he fell into depression. ” - Judge Toshifumi Minami
Karōshi Case Study 1 Female designer (employed at advertising-related editorial company) died from a brain hemorrhage after working up to 150 hours a month overtime before changing jobs After finishing her work at the firm, she took one week off then started a new job, but on April 7, 1998, the second day of her new job, she suffered a brain hemorrhage and died. Acknowledged as having suffered a workplace accident, by Osaka Labor Standards Inspection Office Reportedly the first under a worker's accident standards revision that came into effect 2001 The firm made a 40 million yen settlement with her parents in Feb 2002
Karōshi Case Study 2 Nobuo Miura, 47, died in 1999 after working overtime on successive nights over an extended period Just before he collapsed, he worked from 11 am until 4. 30 am the next day supervising the fitting of a restaurant interior He was preparing to go back to work after a few hours' sleep when he was taken ill. His death a week later was classified as karoshi Junichi Ochiai, 47, the president of a Tokyo interior fitting company, is accused of habitually demanding illegal levels of overtime from employees without paying overtime rates. The company is also accused of failing to conduct annual health checks on workers as required by law. This is the first time criminal charges have been brought.
Karōshi Recent international expansion of Japanese multinationals led to an export of the Karōshi culture to countries such as China and Korea Death-by-overwork lawsuits have been on the rise in Japan, with deceased person's relatives demanding payments Many do not demand payment. Before compensation can be awarded, the labour inspection office must acknowledge that the death was work-related May take many years in detailed and time-consuming judicial hearings Others do not know that payment for Karōshi related death can be demanded from the government.
Karōshi in South Korea (Confucian-Inspired work ethic) Much of the adult populace Both male and female Work a six-day week Long hours Known as “Gwarosa" (과로사)
Karōshi in Indonesia A factory worker producing Reebok shoes in Indonesia died after being forced to do excessive overtime The mother of two had asked for permission to go home after feeling sick AFTER two hours of compulsory overtime at the Spotec factory. The request was denied The victim's husband said she was often forced to work 11 hour shifts. Workers could not refuse overtime work, and were also required to work Sundays. According to one report, a worker at the Pratama Abadi Industrial Factory producing Nike shoes said "the only rest you get is after you collapse at your machine.
Karōshi in Italy In 1991, a 35 -year-old building worker employed in the construction of the football facilities for the 1992 World Cup in Livorno, Italy, suffered a heart attack and died. The provincial occupational health service (USL) asked for a post mortem to be carried out. The investigation showed no adverse signs of disease in his heart or circulatory system. The man, who was a migrant worker from Argentina, had been working days and nights for four weeks before his death. His living quarters were provided on the construction site. The Labour Inspectorate enforced improvements in the facilities, but had no power over his working hours.
Suicide Case Study - Karōjisatsu A teacher who set herself alight had complained about pressure of work, an inquest has been told. Janet Dibb, 28, had complained to her father about overwork. 20 March 2004 A family doctor hanged herself because of stress at work, an inquest has heard. Bury coroners' court was told Dr Dawn Harris, 38, who worked at the Lever Chambers practice in Bolton, became "angry, very distressed and quite hurt" by problems at the busy medical practice. 22 May 2004
Karōshi “Japanese salarymen aren’t hardworking. They are inefficient. The only way to get ahead in Japanese business is to always appear to be at the office, stay later than your boss (who in turn is staying loner than his boss) stay late, go out with your jousi and be part of the company family. This means leaving early is frowned upon. This is nothing to do with working hard. . . What a waste. ” Gman, September 29, 2004. 02; 30 a. m.
A build up of. . . 1. Fatigue from: heavy labour long overtime hours working without days off late night work other obstruction of bio. rhythms 2. Stress from: overly intense responsibilities solitary working undesired assignments job transfers 3. Accompanying factors: disruption of sleep reduced free-time and leisure altered eating excessive drinking & smoking neglect of medical treatment disrupted family life
Karōshi Hotline 1988 Group of lawyers and doctors set up the nation's first karoshi hotline. 135 people phoned in on the first day 1 year later – 309 called on 1 st anniversary Since then, 42 hot lines across the nation, and an international call-in center has been set up 50% of callers were workers wives 20% were workers wanting prevention info
Karōshi Hotline Stats 1988 -1990 Clients workers 16. 8% wives 54. 4% Occupation relatives 17. 2% Directors Symptoms unions 0. 7% Managers Cerebral haem 17. 2% others 10. 9% Sales / office Subarachnoid haem 18. 4% Technical Cerebral thromb 6. 8% Construction MI 9. 8% Manufacture Age Heart failure 18. 7% Drivers 30 -39 9. 6% Others 29. 1% Maintenance 40 -49 24. 5% Govt 50 -59 26. 0% Others 60+ 5. 2% ? 30. 9% 1806 cases reported 3. 8% 10. 9% 15. 4% 5. 6% 7. 8% 9. 1% 6. 7% 1. 2% 4. 7% 34. 8%
Karōshi Physiology Excessive stress Sympathetic nerves & suprarenal glands Increases in BP Hardening arteries Increased coagulation of blood Cerebral haemorrhage Cerebral infarction Heart failure 300, 000 cerebral and heart deaths per year
Working Hours of Karōshi Hours p/w Workers < 50 13 (13. 2%) 50 – 69 22 (22. 4%) 70 – 99 32 (32. 7%) > 100 21 (21. 4%) Indefinite 10 (10. 2%) Total 98
Absence of Symptoms before Karōshi Symptom Persons with symptoms ? ? Cerebral haemorrhage 32 18 (56. 3%) Cerebral infarction 12 4 (33. 3%) Subarachnoidal haemorrhage 44 25 Myocardial infarction (46. 4%) 28 13 (56. 8%) Heart failure 40 23 (57. 5%) Total 156 83 (53. 2%)
Environmental Stressors uninterrupted heavy workload heavy physical work excessive demands from irregular overtime and shift work excessive workloads from emotional stress, such as responsibility, transfers, and conflicts • irregular sleep habits • decreases in rest • decrease social time • alcohol abuse • increased smoking • unhealthy diet • neglecting medical checks • breakdown in family life
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