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New occupational threats to Japanese physicians: karoshi (death due to overwork) and karojisatsu (suicide due to overwork)
  1. T Hiyama,
  2. M Yoshihara
  1. Health Service Center, Hiroshima University, Higashihiroshima, Japan
  1. Dr Toru Hiyama, Health Service Center, Hiroshima University, 1-7-1 Kagamiyama, Higashihiroshima 739-8521, Japan; tohiyama{at}

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It has been said that the Japanese have a “worker bee” attitude toward matters of employment. According to the International Labour Organization (ILO) report (2004), 28.1 of Japanese employees worked 50 hours or more per week in 2001.1 This percentage is much higher than in European countries such as the Netherlands (1.4), Sweden (1.9), Finland (4.5) and Germany (5.3). Physicians are no exception; in fact, they may work more than other types of workers. Japanese physicians worked 66.4 hours per week on average in 2005, according to a report by the Ministry of Health, Labour and Welfare (MHLW) of Japan.2

This working style may cause physical health problems, such as ischaemic heart disease and cerebral haemorrhage.3 “Karoshi”, which is sudden death due to overwork, is reported to be the most serious consequence.4 Overwork can kill if combined with high demand, low …

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  • Competing interests: None declared.

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