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The following lecture has been approved for
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Karōshi (過労死)
Dr. Craig Jackson
Senior Lecturer in Health Psychology
Faculty of Health
UCE Birmingham
Country Profile
2nd 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 1980s 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
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.
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 7:00pm 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 500,000,000¥ (£2.4M)
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
compensation
Dentsu
was
ordered
to
pay
£790,000
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 11am until 4.30am 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
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 Case Study 3 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 Case Study 4 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 1st 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%
relatives 17.2%
unions 0.7%
others 10.9%
Age
30-39
40-49
50-59
60+
?
9.6%
24.5%
26.0%
5.2%
30.9%
Symptoms
Cerebral haem
Subarachnoid haem
Cerebral thromb
MI
Heart failure
Others
1806 cases reported
17.2%
18.4%
6.8%
9.8%
18.7%
29.1%
Occupation
Directors
Managers
Sales / office
Technical
Construction
Manufacture
Drivers
Maintenance
Govt
Others
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
Persons with symptoms
????
Cerebral haemorrhage
32
18 (56.3%)
Cerebral infarction
12
4 (33.3%)
Subarachnoidal haemorrhage
44
25 (56.8%)
Myocardial infarction
28
13 (46.4%)
Heart failure
40
23 (57.5%)
156
83 (53.2%)
Total
But what symptoms? General iIl-health? The above are sudden deaths
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