As American managers puzzle over how to help employees “thrive” at work, Japan struggles at the other end of the spectrum — how to keep employees from working themselves to death. Karoshi, literally translated as “death from overwork,” is an officially recognized cause-of-death in Japan. In the United States, one of the few countries where employees work more paid hours than Japanese employees, we commonly think of karoshi as someone else’s problem. But is it?

Karoshi is a well known phenomenon in Japan, where victims commonly work 14-hour days, seven-day weeks and die at an early age. Some karoshi victims have been known to work 80 straight days and more than 100 hours of overtime for months at a time. This brutal regimen is rooted in a culture that reveres hard work and self-sacrifice, as well as a 1980′s economic boom that drove demands for productivity, followed by a grueling economic recession that led to deep-seated job insecurity ever since. A 2004 International Labour Organization survey revealed that more than six million Japanese were working an average of more than 60 hours per week.

The first documented case of karoshi occurred in 1969, reportedly when a 29-year-old married man working in the shipping department of Japan’s largest newspaper died suddenly of stroke while at work. The Workers Compensation Bureau of Japan’s Ministry of Labor eventually deemed shift work and overwork as the causes of the death. Five years later, the man’s family received compensation.

In subsequent years, karoshi became an increasingly known phenomenon in Japan, predominantly among white collar workers known as “salary men.” The direct medical causes of karoshi were usually heart attack and stroke. A variation of the phenomenon is karo jisatsu, suicide due to overwork. (Suicide is believed to be underreported due to its stigma in Japanese culture, but in 2009 Japan’s national police agency estimated that 10,000 suicides, of the total 30,000 occurrences in Japan that year, were related to work.)

Tetsunojo Uehata, the medical authority who coined the term, defined karoshi as a “condition in which psychologically unsound work processes are allowed to continue in a way that disrupts the worker’s normal life rhythms, leading to a buildup of fatigue in the body and accompanied by a worsening of preexistent high blood pressure and a hardening of the arteries, finally resulting in a fatal breakdown.” More specifically, karoshi is linked to crushing workloads, relentless hours, absence of work/life balance, and silent suffering with no outlet to express dissatisfaction and no influence over work conditions.

In 1994, the government’s Institute of Economics estimated the number of karoshi deaths at around 1,000 or 5 percent of all deaths from cerebrovascular and cardiovascular disease in the 25 to 59 age group.

Some researchers have drawn a connection between the Japanese prevalence of karoshi and the nation’s commitment to lean production, the efficiency-above-all else approach to manufacturing that ultimately helped spawn the Lean Six Sigma approach that has taken American industry, especially healthcare, by storm.

One of the most notorious cases of karoshi occurred in 2002, when Kenichi Uchino, a 30-year-old manager of quality control at Toyota, collapsed dead at 4am — at work — having perservered more than 80 hours of overtime each month for the previous six months. Toyota and the Japanese government refused to compensate Uchino’s family, arguing that much of the overtime was voluntary and unpaid. Japanese courts didn’t buy it, and the family was compensated by both the government and Toyota. (Compensation for karoshi has been reported to frequently be the equivalent of $20,000 per year and up to $1 million dollars in punitive damages). The case led to systematic reform — new government regulations limiting overtime and promoting work-life balance, and corporate reforms, as well.

According to an insightful article by British journalist Emma Holmqvist

In response to mounting pressure, many Japanese companies are now making an effort to establish a better work-life balance… Toyota has upped its game, and has attempted to limit overtime to 360 hours a year, which amounts to about 30 hours monthly. Meanwhile, some companies run recorded announcements to urge their staff to go home or take a break at certain times, while firms such as Nissan have introduced telecommuting to ease the burden of employees with children. Taking the overtime issue more seriously still, a string of large corporations have begun operating with days strictly prohibiting overtime, requiring staff to leave the office promptly at 5:30pm.

But the extent to which these changes have influenced rates of karoshi is unclear. Widespread reports suggest that Japanese workers continue to work exorbitant overtime hours — off the books (“cloaked overtime” or furoshiki). And cases of overwork leading to non-disabling illness and to neglected health are not tracked. Indeed, the nature of the culture is that even true cases of karoshi, for which victims’ families can be compensated, are not likely to be reported. Some have speculated that the reigning issue has shifted — from prevalent work-related stroke and heart attack to a greater prevalence of work-related suicide.

Does karoshi exist in the United States, one of the few industrialized nations where employees work more reported hours than Japanese employees (though it’s believed that the Japanese tip the scales with cloaked overtime)? Some writers have drawn comparisons, such as Matthew Reiss writing on American Karoshi in the New Internationalist, and a Bostinno.com post called Karoshi: How Chronic Long Hours May Kill, And How Startup Life May Point to the Future.

American culture differs from Japan’s. In the United States, individualism reigns supreme. And the U.S. tradition of organized labor and workplace regulation reflects a different attitude toward the employee/employer relationship. Perhaps the difference in Japanese and American approaches to karoshi can best be illustrated with this observation: Whereas Japan has been criticized for sweeping karoshi under the rug, the U.S. has given karoshi little attention beyond one company’s development and the subsequent popularization of the video game “Karoshi: Suicide Salaryman.”

When it comes to employment and health, are Americans having strokes and heart attacks — or committing suicide — after suffering in silence under crushing workloads?  Or is something else at work? We’ll get to that in an upcoming post.

Related articles

• What’s the point in working yourself to death? (japantimes.co.jp)
• When is an hour at work not a work hour? (japantimes.co.jp)
• Could Japan’s Latest Buzz Word Get You Sued? Lawyer Weighs In (en.rocketnews24.com)