Compensation for Work-Related Cerebrocardiovascular Diseases

Abstract

The purpose of this study was to discuss the history of, and concerns regarding, the newly amended criteria of occupational cerebrovascular or cardiovascular diseases (CCVDs). Since the early 1990s, CCVDs have been the second most common occupational disease, despite fluctuations in their criteria. The first issue was the deletion of cerebral hemorrhage on duty as a recognized occupational disease in 2008. The second issue was the obscurity regarding definitions of an acute stressful event (within 24 hr before disease occurrence), short-term overwork (within 1 week), and chronic overwork (for 3 or more months). In this amendment, chronic overwork was defined as work exceeding 60 hr per week. If the average number of weekly working hours does not exceed 60 hr, night work, physical or psychological workload, or other risk factors should be considered for the recognition of occupational CCVDs. However, these newly amended criteria still have a few limitations, considering that there is research evidence for the occurrence of disease in those working fewer than 60 hr per week, and other risk factors, particularly night work, are underestimated in these criteria. Thus, we suggest that these concerns be actively considered during future amendment and approval processes.Graphical Abstract

Sociomedical problems of overwork-related deaths and disorders in Japan

“…Overall, the number of compensated cases for cerebrovascular diseases was found to be 1.6 times higher than that for the cardiovascular diseases. This tendency is consistent with the dataset of compensated cases for overwork‐related CCVDs in South Korean workers . The observed patterns of diagnosis, for example, intracerebral hemorrhage as the top of the cerebrovascular diseases and myocardial infarction as the most frequently compensated cardiovascular disease, respectively, may inform us of the pathophysiology and management of the CCVDs associated with overwork.…”

“…We have been struggling with how to address these tragedies for 30 years or more in Japan . Similar circumstances have also been reported in its neighboring countries including South Korea, Taiwan, and China . Furthermore, long working hours and other stress factors at work have been targeted as critical hazards to workers’ health and well‐being in the European countries and the United States …”

“…This tendency is consistent with the dataset of compensated cases for overwork-related CCVDs in South Korean workers. 2 The observed patterns of diagnosis, for example, intracerebral hemorrhage as the top of the cerebrovascular diseases and myocardial infarction as the most frequently compensated cardiovascular disease, respectively, may inform us of the pathophysiology and management of the CCVDs associated with overwork. Recent findings for prospective studies with large sample sizes support the hypothesis that stroke is more closely related to long working hours.…”

Nonlinear associations between working hours and overwork-related cerebrovascular and cardiovascular diseases (CCVD)

“…The Ministry of Health, Labour and Welfare of Japan, in 2001, was the first to add overtime hours worked to their existing criteria as a risk factor for work-related CCVD. Similar criteria were established in Taiwan in 2004 and in South Korea in 2013 1 , 4 , 15 , 16 . According to these criteria, overtime refers to the hours worked in excess of the standard maximum monthly working hours 4 .…”

Policy changes for preventing and recognizing overwork-related cardiovascular diseases in Taiwan: An overview

“…For night shift work between 10:00 PM and 6:00 AM , the Korean guidelines have added 30% to the daily working hours to calculate long‐term workload. A process for evaluating the combination of working hours and other risk factors is also clearly stated, particularly for those who do not comply with the limits on long‐term overtime hours . The change in Korea's guidelines resulted from a social consensus between physicians, labor unions, an employers' federation, and the government, and it provides valuable insight on how Taiwan can modify its guidelines to make the evaluation process for recognizing overwork‐related CVD cases more justified and uniform.…”