Has Japan achieved industrial success at the expense of its workers' health? Is such ill-health "contagious"?
Virginia Tech management professor Richard Wokutch reports that "karoshi," or "death due to overwork," is one of the most controversial health issue in Japan. And there is an indication that Japanese companies may be exporting stressful work conditions to their overseas operations.
Wokutch's findings that there are indeed more incidences of death due to overwork than would be indicated by the number of claims filed are a result of studying government documents and official statistics and "talking to a lot of people," he says. For example, he interviewed safety and health officials with industry and the government, on the one hand, and critics such as journalists and members of the National Defense Counsel for Victims of Karoshi, on the other hand. "I tried to find as many people as I could on all sides of the story," he explains.
"The problem with karoshi is it's ambiguous and it's political," says Wokutch. "Karoshi refers to a wide range of medical conditions believed to be work-related, that result in death, serious injury, or illness, and there have been several lawsuits by family members claiming someone has died from unusual stress at work. But there's a gray area. Was the person going to have the heart attack anyway? Or was death a result of overwork?
"People have used the term to refer to suicides, ulcers, insomnia, back pain, writer's cramp ... even impotence," he says. They believe that karoshi results not only from work conditions such as a fast work pace or long hours, but also from other, indirect factors, such as long commutes, cramped living spaces, and inadequate sleep and exercise.
"Given the imprecise definition of karoshi and the controversy over whether individual cases are work related, estimates of the number of karoshi cases vary greatly," Wokutch says. On the high end, the National Defense Counsel for Victims of Karoshi estimates that excessive work contributes to the deaths of more than 10,000 Japanese workers each year. Official government figures are much lower (though there is no actual category for karoshi cases); the lowest estimates are based on the average of 620 karoshi claims for death or disability submitted each year since 1987.
In trying to make a judgment between the claim of 10,000 deaths and fewer than 700 claims filed per year, "you have to look at the statistics for death and injury from a variety of causes to determine which are most likely to be work-related, based on similar studies done in previous years in other countries," the researcher explains. "Because the Japanese are not a litigious people, we know that 700 is probably too low."
Wokutch also conducted research at Japanese auto plants in Japan and the United States -- not only to determine the extent of karoshi, but to look at whether stressful work practices are being exported to the U.S. He says similar maladies undoubtedly occur in other countries, but he did not know of any other country that classified such problems under a single rubric. "In the United States, the standards for determining whether a karoshi-like illness or fatality should be recognized as being work related would depend on the standards of the workers' compensation program in the state where the incident occurred."
Wokutch has found a high rate of cumulative trauma disorders, such as carpal tunnel syndrome, among workers in Japanese auto plants in the U.S. These injuries can be a result of the fast pace and repetitive tasks of the assembly line.
"Cumulative trauma disorders are not as much of a problem in Japan," he says. One theory is that in Japan, the assembly line can be built to 'fit' the typical Japanese worker's size and strength. However, in the U.S., men and women of diverse size and strength make up the workforce. Another theory as to why there are fewer complaints of cumulative trauma disorders in Japan is "the Japanese may be more accustomed to working with pain," Wokutch suggests. "There is a sense that it is dishonorable to complain."
The Japanese have taken various steps to alleviate karoshi. The government has sponsored efforts to reduce the work week, encourage more leisure activities, and promote worker health. Still, Wokutch says, many of these measures are seen as mere "window dressing." At the same time, statements made by Japanese business and government leaders criticizing the work ethic in the United States and other Western countries have sent conflicting signals about the need to reduce work stress in Japan.
(Richard Wokutch wrote an article about karoshi for the 1994 Medical and Health Annual of the Encyclopedia Brittanica and wrote a book on occupational safety and health in the Japanese auto industry, Worker Protection, Japanese Style, published by ILR Press of Cornell University in 1992.)
— Written by Sookhan Ho