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Kirsten Samuel


Managing Director

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How the UK can resist the threat of ‘karoshi’ culture


The health of around a fifth of all employees in Japan is estimated to be at risk from going to work. Not accidents or mental health issues, but death. It’s known as ‘karoshi’, a sudden heart attack or stroke as a result of overworking and the pressure of workplace conditions.

Despite growing awareness, the problems are escalating. In 2015 the claims for compensation in Japan rose to their highest-ever level of 1,456 in a single year. Over the recent Christmas period the Managing Director at one of Japan’s top advertising agencies had to resign after an overworked employee committed suicide.

The work culture of Asia in general is coming under more scrutiny, with ‘death by overwork’ problems reported in China, India, South Korea and Taiwan. The question is whether we, here in the West, can assume it’s an issue that doesn’t affect us. The work culture’s too different. Or is it?

The impact of stress on health

It’s long been suspected that there’s a relationship between high levels of stress over a long period and heart problems. Research by Harvard Medical School published in January 2017 has provided solid evidence to back up the idea: when there are higher levels of activity in the amygdala, the part of the brain that processes all the kinds of emotions related to stress, the body produces more white blood cells. This causes inflammation of the arteries and leads to heart attacks, angina and strokes.

The researchers argue that long-term stress, like that associated with high-pressure careers, should be treated the same as smoking and high blood pressure when it comes to assessing health risks.

Whatever Brexit terms are agreed, it’s generally accepted that UK plc will be exposed to more scrutiny and competitive pressures. More opportunities, but also more attention to levels of productivity, innovation and ability to be flexible. In other words, more employees are going to be expected to match-up with those in competitor organisations in countries affected by the karoshi phenomenon.

More employees are going to be expected to match-up with those in competitor organisations

In this context, employee health and wellbeing matters more than ever. And it’s not just a case of monitoring workloads and potential cases of overworking and stress – it’s more fundamental than that. Karoshi isn’t caused by long hours as such according to a study published in The Lancet last year.

The Japanese don’t work the longest hours, that’s the Americans and the Mexicans. The problem might be confinement, the way in which employees feel unable to leave their desk, spend too much time sitting in one spot, not eating or sleeping properly.

Embedding wellbeing

So health and wellbeing initiatives need to be embedded as part of a culture of daily activity – and, as far as possible, during working hours. It’s worth considering some of the following kinds of activities:

  • introducing standing desks and standing meetings (or even walking meetings);
  • ‘deskercise’, the use of simple tips to exercise and stretch while employees are at their desks;
  • providing access to step counters (through smartphone apps) and offer guide targets or challenges to add a sense of competition;
  • lunchtime walking or running clubs;
  • explicit policies on break times and provision of specific spaces to encourage breaks (backed up by work with line managers to raise awareness of the issues and involve them in supporting and encouraging their teams in taking breaks;
  • skipping meals and not eating properly is also a factor in karoshi – and the demise of the canteen doesn’t help. Providing healthy eating options in the workplace, especially snacks, is one option. If there is onsite catering, it’s important to work with the caterers on a menu that’s not only delicious but has good nutritional content, and provide advice to employees on how they can eat better in the workplace: healthy food swaps, healthy recipes, and eating on a budget.

In the coming years, British employers are going to have to measure up to highly productive, high-performance operations overseas. How they do it and how they reconcile the changes with employee wellbeing is going to be a major HR challenge, because there’s a healthy version of hardworking and a very unhealthy one.

One Response

  1. Thanks for this really
    Thanks for this really interesting article! Great to read. I also think it’s important to note it’s not just about health promotion-type activities, but also about job design and really importantly, the way in which people are managed.

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Kirsten Samuel

Managing Director

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