Introduction Overwork-related cardiovascular and cerebrovascular disease (CVD) is an emerging occupational and public health issue in East Asian societies with a substantial impact on workers’ rights and labor standards. To eliminate exposure to work-related risk factors and prevent overwork-related CVD, establishing national policy is a key step. We investigated the development and impact of policies and research regarding overwork-related CVD in recent years in Taiwan.

Methods We collected information regarding government policies that aimed to prevent and recognize overwork-related CVD. Among the risk factors, long working hours have been widely adopted as a quantitative measure to recognize CVD as overwork-related or not. We also collected data on the number of overwork-related CVD cases and average working hours for each industry from 2006 to 2017.

Results In Taiwan, overwork-related CVD 79% of all deaths due to occupational diseases in 2017, although it accounted for 13% of all cases of occupational diseases. Taiwanese workers have long working hours compared to those in other countries, but Taiwan did not have official criteria for recognizing overwork-related diseases until 1991, and it did not recognize its first case until 2006 after several onsets of CVD reported on the news. Our estimation showed an under-recognition problem in less severe outcomes (i.e., illness). We also found variations in CVD risks across industries, with the higher risk in transportation and information.

Conclusions National policy changes for preventing overwork were pushed by insightful scholars, labor unions, nongovernmental organizations, and legislators. Clear criteria for recognizing overwork-related CVD can help occupational physicians and industrial hygienists to assess the workers’ working characteristics more objectively. Although Taiwanese government has adopted the criteria for recognizing overwork-related CVD from Japan, the underreporting of less severe outcomes and industry disparities warrants further research to explore causal mechanisms and policies to narrow the gaps.