[Overwork and its health effects--current status and future approach regarding Karoshi].
[Overwork and its health effects--current status and future approach regarding Karoshi].
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DOI：
10.1539/sangyoeisei.45.187
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发表时间：
2003-09-01
影响因子：
--
通讯作者：
Hoshuyama, Tsutomu
中科院分区：
文献类型：
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作者：
Hoshuyama, Tsutomu
过劳死一词，即因工作过度而死亡，并不是为医疗诊断而定义的，但在日本，它是指因致命的职业病，特别是缺血性心脏病和脑血管病而获得赔偿的案件，这些疾病被认为是由繁重的工作造成的。目前的研究表明：1）几乎可以肯定地说，有证据表明过度劳累与心血管疾病之间存在关联，并发现了危险因素; 2）尽管存在这种可能性，但没有发表过关于过度劳累与致命影响之间存在因果关系的报告; 3）对健康的不利影响会因劳动者的性别、年龄、压力应对和感知等特征而异。最近，赔偿案件占索赔的比例从1988财政年度的3.1%增加到2001财政年度的20.7%。这可能与放宽补偿标准有关。2001年制定的最新标准将受害者过度劳累的确定期限延长至最多六个月，而1987年制定的标准仅为一周。根据社会学的分析，日本的长时间劳动不仅与劳动时间制度的结构有关，而且与劳动的社会文化背景有关。2002年，日本政府为所有雇员提供了防止过劳死的第一个对策，规定他们每月加班时间不应超过45小时，如果每月加班时间超过100小时，政府应以行政指导的形式对雇员及其雇主进行干预。这是一项平等地针对所有工人的人口战略，而不仅仅是一项只针对那些有某些风险因素的人的高风险战略，预计它将提供更富有成效的灵活成果，即有区别地加强对老年工人和在高度紧张条件下工作的工人的管理，同时协调工作场所的生产周期。职业健康专业人员，如职业健康医生和护士，将在解决与过劳死有关的各种问题方面发挥关键作用，从而可能导致进一步的调查，为政策制定提供科学依据。
The word karoshi, i.e. death due to overwork, is not defined for medical diagnosis, but in Japan it means cases of compensation awarded by reason of fatal occupational diseases, particularly ischemic heart diseases and cerebrovascular diseases which are recognized as caused by a heavy workload. Current studies have shown that 1) almost definitely there is evidence of an association between overwork and cardiovascular diseases and the risk factors were found, 2) no reports have been published on evidence of a causal relationship between overwork and fatal effects even though the possibility remains, and 3) the adverse health effects can vary according to workers' characteristics such as gender, age, stress coping and perception. Recently there has been an increase in the proportion of compensated cases versus claims from 3.1% in the 1988 fiscal year to 20.7% in the 2001 fiscal year. This may be related to the deregulation of criteria for compensation, or nintei-kijun. The period of determination of overwork for victims has been extended to a maximum of six months in the newest criteria set in 2001, up from only one week in the criteria set in 1987. According to sociological analysis, long working hours in Japan are related not only to the structure of the working-time system but also the sociocultural background of labor. In 2002, the Japanese government provided the first countermeasures for the prevention of karoshi for all employees stating that they should not work more than 45 h overtime per month and that government intervention in the form of administrative guidance to employees and their employers should be conducted if overtime exceeds 100 h per month. It is a population strategy targeting all workers equally, not just a high-risk strategy targeting only those with some risk factors, and is expected to provide more fruitful results with flexibility, i.e. differentially reinforced management for older workers and those working under highly stressful conditions with harmonization of the production cycle in the workplace. Occupational health professionals such as occupational health physicians and nurses will play a key role in making break-throughs to solve various problems related to karoshi, which may then result in further investigations to provide scientific evidence for policy making.