Confronting “Karōshi”: Actions to Prevent Death from Overwork


In response to the highly publicized suicide of a young employee at advertising giant Dentsu, Japan’s Ministry of Health, Labor, and Welfare in December 2016 released emergency guidelines aimed at preventing karōshi, or death by overwork. As the issue attracts greater official attention, Japan must examine the factors that have made excessive overtime so pervasive and consider steps to protect employees from the health risks of overwork.

Defining Karōshi

The term karōshi, or death from overwork, dates to the latter half of the 1970s, when Japanese doctors began using it to describe sudden mortality due to the stress of excessive work. Leading causes of karōshi include strokes, heart disease, severe cases of asthma, and suicide. Awareness of the phenomenon gradually increased and by the late 1980s it was broadly recognized as a serious social issue. Over the last decade the Ministry of Health, Labor, and Welfare has on average recognized 200 deaths from overwork annually. However, many experts argue that these figures represent just the tip of the iceberg, pointing to large numbers of nonfatal cases resulting in debilitating conditions requiring prolonged care.

The dark history of karōshi has its start in the early twentieth century. Numerous female silk mill workers in Nagano Prefecture, exhausted from working 12 to 14 hours each day and desperate to escape their harsh working conditions, committed suicide by jumping into nearby Lake Suwa. The situation was so grave that a newspaper account from 1927 reported that over a six-month period 47 female workers took their lives. Stirred by the tragedy, local scholars formed a volunteer group that posted signs urging potential suicides to rethink their choice and patrolled the banks of the lake.

Following its defeat in World War II, Japan, armed with a newly drafted Constitution, drew up the Labor Standards Act. This established a slew of new occupational regulations, including the adoption of the eight-hour work day. The gold standard of labor practices, however, was never fully embraced by the Japanese corporate world: Long overtime hours became one factor underpinning the nation’s rapid growth and transformation into a global economic superpower.

Work Practices Pose a Threat to Health

Firms in Japan circumvent restrictions on working hours in two main ways. The first is the widespread, unlawful practice of expecting employees to work off the clock, a trick that allows companies to skirt the obligation to pay overtime and maintain the guise of an eight-hour work schedule. The second is a so-called Article 36 agreement, named for the portion of the Labor Standards Act that permits companies to enter an agreement with employees that puts them to work more than eight hours each day. Such arrangements generally place caps on overtime, but in practice employers can demand that workers toil as late as needed.

These two approaches have combined to make 100 or more hours a month of overtime a standard fixture at many Japanese companies. The toll of this work culture, however, began to hit home in the 1980s. As Japan basked in the glory of its economic miracle, having risen from the ashes of war to become a global leader, a karōshi scourge befell its steadfast workforce in the form of strokes, heart attacks, and other afflictions brought on by countless hours on the job. Shocked at the carnage, lawyers, doctors, and other experts came together to establish the aid group Karōshi Hotline in 1988. Shortly after its founding the organization was inundated with consultation requests from family members of people who had died from overwork.

The situation worsened following the bursting of Japan’s economic bubble in the early 1990s and the subsequent prolonged downturn. Companies shifted focus from making profits to merely surviving, and cases of stress-induced depression and suicides rose dramatically among people who found themselves chopped from the labor force. The situation was equally dire for employees who held on to their jobs, as the looming specter of additional layoffs and burden of keeping companies afloat in the shifting economic seas led to greater stress and longer working hours.

In the 1990s karōshi came to be characterized by four main traits. These were a steep uptick in suicides, an increase in people taking their lives due to long working hours or harassment from superiors, a rise in deaths among younger workers in their twenties and thirties, and a growth in incidents involving female employees.

All four of these factors can be seen in the suicide of Takahashi Matsuri, a young employee of the advertising agency Dentsu who took her life in December 2015, an incident that sent shockwaves across Japanese society. The Labor Ministry recognized the case as karōshi in September 2016, leading it to issue a white paper on the risks of death from overwork and preventative guidelines.

The Social Backdrop to the Scourge

There are three main social factors behind the phenomenon of death by overwork.

First, Japan has for the last century and a half fostered a culture that values putting in long hours. Following the Meiji Restoration of 1868, Japanese toiled to raise the nation to the level of the dominant Western powers by boosting the country’s industrial strength. The monumental achievement of transforming from a feudal society to a fully industrialized nation in just a few short decades, however, required vast amounts of labor. Japan accomplished a similar feat in the postwar period, shaking off its World War II defeat to draw level with and even surpass the leading economies of the West. It was during this latter period that excessive overtime became a central facet of Japanese work life. Long hours of work have thus become an integral part of Japan’s economic life over a century and a half; today they are so ingrained that eliminating the practice would require a monumental commitment to reform by companies and the government.

Next, companies function as tight-knit collectives where workers pour their energies into pursuing profits and are expected to put the good of the firm ahead of their personal needs. This has emboldened Japanese corporations to blatantly ignore fundamental principles of human rights guaranteed under the nation’s postwar Constitution. The situation has persisted as unions have proved too weak to push for meaningful labor reform.

Finally, the wide variety of conveniences available to Japanese consumers has placed an incredible burden on the service industry. Take, for example, the many businesses offering 24-hour service. Customers may enjoy the accessibility, but it comes at the expense of employees being forced to work the graveyard shift. A similar situation exists at Japan’s pervasive delivery services. To keep up with rising demand, drivers must be on the streets from morning to night without breaks to ensure they finish their rounds. The price, of course, has been an uptick in karōshi. It has come time to put the health and wellbeing of people in the service industry ahead of our desire for convenience.

How to Stop Karōshi?

Citizen’s groups made up largely of family members of karōshi victims have been instrumental in drawing attention to the issue. The efforts of these organizations led the Japanese Diet in June 2014 to unanimously pass a law addressing death by overwork. The legislation specified the government’s duty in establishing concrete preventive measures; it was as part of this obligation that the Labor Ministry released the first white paper on karōshi in October 2016.

Below I specify three steps necessary for eliminating the culture of overwork and reducing the karōshi toll.

First, managers at Japanese firms must be weaned of the erroneous belief that long hours are a necessary part of doing business. They should look to countries like Germany, France, and Sweden for clues on how to boost productivity while spending less time in the office.

Second, the government has to take more of an interest in and direct greater resources toward addressing the issue, including revising labor laws and bolstering oversight measures.

Lastly, citizens must be involved in changing work culture. This requires standing up for the rights of workers by engaging with corporations and the government, sharing their views, and criticizing antiquated and unfair labor practices. The public also needs to recognize its own culpability and work locally to engender change by fostering consumer habits that do not place an undue burden on workers in the service industry.

Going forward, concrete action to prevent karōshi will require all members of society to come together and address the issue head on.

(Originally published in Japanese on April 7, 2017. Banner photo: The mother of Takahashi Matsuri, an employee at advertising agency Dentsu who committed suicide, and the author, her legal representative, at the Ministry of Health, Labor, and Welfare in Tokyo on January 20, 2017. © Jiji.)

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