Lisa Choi ignored the first symptoms. After all, the 53-year-old business analyst was a very active, fit vegetarian, who cycled frequently and avoided high-fat foods. She was far from the typical victim of a heart attack.
However, the Seattle-based Choi was working 60-hour workweeks, including evenings and weekends. She was facing tight deadlines and managing complex digital projects. This workload was utterly normal to her. “I have a really high-stress job… I’m usually on overdrive,” she says.
It wasn’t until several months ago, when she suddenly started feeling an anvil-like pressure on her chest, that she began to take her symptoms more seriously. In the hospital, it turned out that she had a tear in her artery. This is a hallmark of a spontaneous coronary artery dissection (SCAD), a relatively rare heart condition that particularly affects women and people younger than 50. Told that she would need an angioplasty to open up her artery, Choi thought, “I don’t have time for this. I’m scheduled for migrations at work, and I’m doing all this stuff.”
Like Choi, many are also finding themselves in ill health due to intense work schedules. New, sobering research – said to be the first-ever study to quantify the global burden of disease from working long hours – has shown how bleak the situation is.
In a paper published 17 May, authors from institutions including the World Health Organization (WHO) and the International Labour Organization (ILO) suggest that, each year, three-quarters of a million people are dying from ischaemic heart disease and stroke, due to working long hours. (Ischaemic heart disease, also known as coronary heart disease, involves narrowed arteries. Choi’s SCAD is different from conventional ischaemic heart disease, but stress and high blood pressure are major factors in both.)
In other words, more people are dying from overwork than from malaria. This is a global health crisis, demanding attention from individuals, companies and governments alike. And, if we don’t solve it, the problem may not only continue – it could get worse.
How overwork affects health
In the paper, published in the journal Environment International, researchers systematically reviewed data on long working hours, defined as 55 hours or more per week; health impacts; and mortality rates from most of the world’s countries, from 2000 to 2016. The authors controlled for factors like gender and socioeconomic status, in order to tease out the pure effects of overwork on health.
The study establishes that overwork is the single largest risk factor for occupational disease, accounting for roughly one-third of the burden of disease related to work. “For me personally, as an epidemiologist, I was extremely surprised when we crunched these numbers,” says Frank Pega, a WHO technical officer and the lead author of the paper. “I was extremely surprised by the size of the burden.” He describes the findings as moderate, but clinically significant.