2024-04-17 Wednesday - Health Effects of Overwork

[image credit: anykeep on pixabay.com]

 

 This blog post is a placeholder for organizing citations of articles and medical research reports on the effects of overwork (e.g., working more than 40+, 50+, 55+ hours per week - on a sustained basis). 

General articles:

1. https://en.wikipedia.org/wiki/Effects_of_overtime
• "Employees who work overtime hours experience numerous mental, physical, and social effects. In a landmark study, the World Health Organization and the International Labour Organization estimated that over 745,000 people died from ischemic heart disease or stroke in 2016 as a result of having worked 55 hours or more per week."
• "... those working long hours (55 hours or more per week) were at 40% higher risk of developing atrial fibrillation compared to those working a standard 35-40 hour-week"
  
2. https://en.wikipedia.org/wiki/Karoshi

 

Professional research: 

1. Long working hours and burnout in health care workers: Non-linear dose-response relationship and the effect mediated by sleeping hours—A cross-sectional study (2021-05-06, Journal of Occupational Health)
• https://onlinelibrary.wiley.com/doi/10.1002/1348-9585.12228
• https://doi.org/10.1002/1348-9585.12228
2. Impact of work schedules of senior resident physicians on patient and resident physician safety: nationwide, prospective cohort study (2002-2007, 2014-2017, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA)
   
• "...exceeding 48 weekly work hours or working shifts of extended duration endangers even experienced (ie, PGY2+) resident physicians and their patients."
• "Working more than 48 hours per week was associated with an increased risk of self-reported medical errors, preventable adverse events, and fatal preventable adverse events as well as near miss crashes, occupational exposures, percutaneous injuries, and attentional failures (all P<0.001)."
• "Working between 60 and 70 hours per week was associated with a more than twice the risk of a medical error (odds ratio 2.36, 95% confidence interval 2.01 to 2.78) and almost three times the risk of preventable adverse events (2.93, 2.04 to 4.23) and fatal preventable adverse events (2.75, 1.23 to 6.12)"
• "Working one or more shifts of extended duration in a month while averaging no more than 80 weekly work hours was associated with an 84% increased risk of medical errors (1.84, 1.66 to 2.03), a 51% increased risk of preventable adverse events (1.51, 1.20 to 1.90), and an 85% increased risk of fatal preventable adverse events (1.85, 1.05 to 3.26). Similarly, working one or more shifts of extended duration in a month while averaging no more than 80 weekly work hours also increased the risk of near miss crashes (1.47, 1.32 to 1.63) and occupational exposures (1.17, 1.02 to 1.33)."
  
• https://bmjmedicine.bmj.com/content/2/1/e000320 
• https://doi.org/10.1136/bmjmed-2022-000320
3. At-Risk Work Hours Among U.S. Physicians and Other U.S. Workers (American Journal of Preventive Medicine, Volume 65, Issue 4, October 2023, Pages 568-578)
• "Systematic reviews by the WHO have shown an increased risk of morbidity and mortality related to ischemic heart disease and stroke among individuals working an average of ≥55 hours/week."
• "The relationship between work hours, well-being, and health outcomes is complex. At least 2 pathways—a physiological stress response pathway (e.g., autonomic nervous system, immune function, hypertension, arrhythmia risk) and a behavioral stress response pathway (e.g., alcohol use, unhealthy diet, tobacco use, physical inactivity, impaired sleep)—may contribute to morbidity and mortality associated with long work hours."
• "risk of burnout increases by approximately 2% for each 1 additional hour worked each week"
• "recent studies have found that working ≥55 hours/week is associated with an increased risk of ischemic heart disease and stroke."
  
• https://www.sciencedirect.com/science/article/pii/S0749379723001666
• https://doi.org/10.1016/j.amepre.2023.03.020

 

Some suggsted additional background reading: 

• https://hbr.org/2015/08/the-research-is-clear-long-hours-backfire-for-people-and-for-companies
• https://academic.oup.com/occmed/article/67/5/377/3859790
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8642716/ 
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8977802/
  
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6617405/
• https://link.springer.com/referenceworkentry/10.1007/978-3-031-30492-7_12 
  
• https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(21)00189-7/fulltext
  
• https://www.who.int/news/item/17-05-2021-long-working-hours-increasing-deaths-from-heart-disease-and-stroke-who-ilo
  
• https://health.clevelandclinic.org/effects-of-working-too-much 
• https://www.healthline.com/health/working-too-much-health-effects
  
• https://news.yahoo.com/heres-happens-brain-body-more-185822070.html