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Compensation for disease-caused sudden death at work in China 2006–2012
  1. Jian Li1,
  2. Zichu Yang2,
  3. Adrian Loerbroks1,
  4. Peter Angerer1
  1. 1Institute of Occupational and Social Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
  2. 2Department of Thoracic and Cardiovascular Surgery, Second Affiliated Hospital, Kunming Medical University, Kunming, China
  1. Correspondence to Dr Jian Li, Institute of Occupational and Social Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstrasse 1, Düsseldorf 40225, Germany; lijian1974{at}hotmail.com

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Currently cardiovascular diseases due to overwork are only officially recognised by workers’ compensation systems in Japan, South Korea and Taiwan.1 ,2 The fatal cases are known in Asia as ‘karoshi’. The biomedical mechanism might be perturbations of the hypothalamic-pituitary-adrenal axis and the autonomic nervous system caused by excessively long working hours (eg, 90 or more overtime hours during the month prior to the event) and associated work stress. These pathways may contribute to accelerated progression of atherosclerosis and increase the risk of cardiovascular events, majorly subarachnoid haemorrhage, intracerebral haemorrhage, intracerebral infarction, myocardial infarction, heart failure, etc.13 In mainland China, karoshi has …

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