Especially if combined with high demand, low control, and poor social support

The death of a junior doctor in Britain last year, after working excessive hours and sleeping little, brought new relevance to the question, can overwork kill? It seems reasonable to suggest that excessive workload could be harmful. In Japan, there is even a recognised syndrome of “death from overwork”; the family of a Japanese man who killed himself after working for 17 months without a day off has recently won compensation from his employer.1 But the British government disagrees with the European Union that a proposal to limit the working week to 48 hours should be regarded as a health and safety issue. Indeed, there is surprisingly little hard evidence about whether mortality can be increased by physical or psychological overwork. A recent review noted a lack of research on the health effects of the interaction of physical and psychosocial factors at work.2

The empirical research that exists suggests that higher workloads do increase disease and death rates. A Danish study, which followed up 2465 bus drivers over seven years, found that objective workload, as measured by the intensity …