Frank Pega1, Bálint Náfrádi2, Natalie C Momen3, Yuka Ujita2, Kai N Streicher3, Annette M Prüss-Üstün3, Alexis Descatha4, Tim Driscoll5, Frida M Fischer6, Lode Godderis7, Hannah M Kiiver8, Jian Li9, Linda L Magnusson Hanson10, Reiner Rugulies11, Kathrine Sørensen12, Tracey J Woodruff13. 1. Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland. Electronic address: pegaf@who.int. 2. Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland. 3. Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland. 4. UNIV Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Angers, France; AP-HP (Paris Hospital), Occupational Health Unit, Poincaré University Hospital, Garches, France; Versailles St-Quentin Univ-Paris Saclay Univ (UVSQ), UMS 011, UMR-S 1168, France; Inserm, U1168 UMS 011, Villejuif, France. 5. Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia. 6. Department of Environmental Health, School of Public Health, University of Sao Paulo, Sao Paulo, SP, Brazil. 7. Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium. 8. Eurostat, European Commission, Luxembourg, Luxembourg. 9. Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California Los Angeles, Los Angeles, CA, USA. 10. Stress Research Institute at Department of Psychology, Stockholm University, Stockholm, Sweden. 11. National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark. 12. National Research Centre for the Working Environment, Copenhagen, Denmark. 13. Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, CA, USA.
Abstract
BACKGROUND: World Health Organization (WHO) and International Labour Organization (ILO) systematic reviews reported sufficient evidence for higher risks of ischemic heart disease and stroke amongst people working long hours (≥55 hours/week), compared with people working standard hours (35-40 hours/week). This article presents WHO/ILO Joint Estimates of global, regional, and national exposure to long working hours, for 194 countries, and the attributable burdens of ischemic heart disease and stroke, for 183 countries, by sex and age, for 2000, 2010, and 2016. METHODS AND FINDINGS: We calculated population-attributable fractions from estimates of the population exposed to long working hours and relative risks of exposure on the diseases from the systematic reviews. The exposed population was modelled using data from 2324 cross-sectional surveys and 1742 quarterly survey datasets. Attributable disease burdens were estimated by applying the population-attributable fractions to WHO's Global Health Estimates of total disease burdens. RESULTS: In 2016, 488 million people (95% uncertainty range: 472-503 million), or 8.9% (8.6-9.1) of the global population, were exposed to working long hours (≥55 hours/week). An estimated 745,194 deaths (705,786-784,601) and 23.3 million disability-adjusted life years (22.2-24.4) from ischemic heart disease and stroke combined were attributable to this exposure. The population-attributable fractions for deaths were 3.7% (3.4-4.0) for ischemic heart disease and 6.9% for stroke (6.4-7.5); for disability-adjusted life years they were 5.3% (4.9-5.6) for ischemic heart disease and 9.3% (8.7-9.9) for stroke. CONCLUSIONS: WHO and ILO estimate exposure to long working hours (≥55 hours/week) is common and causes large attributable burdens of ischemic heart disease and stroke. Protecting and promoting occupational and workers' safety and health requires interventions to reduce hazardous long working hours.
BACKGROUND: World Health Organization (WHO) and International Labour Organization (ILO) systematic reviews reported sufficient evidence for higher risks of ischemic heart disease and stroke amongst people working long hours (≥55 hours/week), compared with people working standard hours (35-40 hours/week). This article presents WHO/ILO Joint Estimates of global, regional, and national exposure to long working hours, for 194 countries, and the attributable burdens of ischemic heart disease and stroke, for 183 countries, by sex and age, for 2000, 2010, and 2016. METHODS AND FINDINGS: We calculated population-attributable fractions from estimates of the population exposed to long working hours and relative risks of exposure on the diseases from the systematic reviews. The exposed population was modelled using data from 2324 cross-sectional surveys and 1742 quarterly survey datasets. Attributable disease burdens were estimated by applying the population-attributable fractions to WHO's Global Health Estimates of total disease burdens. RESULTS: In 2016, 488 million people (95% uncertainty range: 472-503 million), or 8.9% (8.6-9.1) of the global population, were exposed to working long hours (≥55 hours/week). An estimated 745,194 deaths (705,786-784,601) and 23.3 million disability-adjusted life years (22.2-24.4) from ischemic heart disease and stroke combined were attributable to this exposure. The population-attributable fractions for deaths were 3.7% (3.4-4.0) for ischemic heart disease and 6.9% for stroke (6.4-7.5); for disability-adjusted life years they were 5.3% (4.9-5.6) for ischemic heart disease and 9.3% (8.7-9.9) for stroke. CONCLUSIONS: WHO and ILO estimate exposure to long working hours (≥55 hours/week) is common and causes large attributable burdens of ischemic heart disease and stroke. Protecting and promoting occupational and workers' safety and health requires interventions to reduce hazardous long working hours.
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