The World Health Organization and the International Labour Organization (WHO/ILO) jointly reported in May 2021 that long working hours (≥ 55 hours/week) attributed globally in 2016 to 745,194 deaths and 23.3 million disability-adjusted years from ischemic heart disease and stroke.1 Long working hours are now considered by the WHO/ILO to be the occupational risk factor with the largest attributable disease burden. WHO/ILO advise, “Protecting and promoting occupational and workers’ safety and health requires interventions to reduce hazardous long working hours.”

Response to new information

If no one at your organization will ever work more than ≥ 55 hours/week, then maintaining a general awareness of this health risk is all that you may need to do. If, however, some workers work, or may work, these long hours then some action on your part is necessary. The first necessary action is to verify the validity of the information.

Review scientific reports

Reference 1 provides a link to the scientific report that justifies the WHO/ILO estimates of work-related disease burden from long hours of work. A thorough reading of the report’s Introduction and Conclusion sections, followed by a brief scan of the Methods, Findings, and Results sections, is the tendency of most people to satisfy their initial curiosity. If you follow this tendency, then there will be little doubt that the WHO/ILO report has the scientific vigor to support its validity. If you assume the report is valid, then is promotion of a policy within your organization to prohibit work ≥ 55 hours/week for health reasons a good action on your part?

Timely tools and support

The WHO/ILO is not the only organizations that suggest caution now for the health and safety risks for long hours of work. Consider, for example:

NIOSH Publication No. 2021-110, NIOSH Well Being Questionnaire (WellBQ), was published May 2021.2 NIOSH WellBQ is intended to “help researchers, employers, workers, practitioners, and policymakers understand the well-being of workers and target interventions to improve worker well-being, among other applications.” The WellBQ includes questions on “Sleep Hours” and “Daytime Sleepiness.” And;

ISO 45003 Occupational health and safety management – Psychological health and safety at work: managing psychosocial risks – Guidelines, was published as a final standard June 2021. Working hours and schedule, that includes “long or unsociable hours” is an identified hazard that warrants an assessment of risk and opportunity.

WHO/ILO, NIOSH and ISO, among others, such as OSHA, are highly reputable sources that offer support for employers to consider assessment of risk for long hours of work. Armed with this timely information and tools, is promotion of a policy within your organization to prohibit work ≥ 55 hours/week for health reasons a good action on your part?

Big picture – initial history

Restricting long working hours for health reasons is the oldest regulated occupational health risk in the United States. In 1867, Wisconsin became the first U.S. state to pass a law that restricted the hours women, but not men, could work in mechanical or manufacturing establishments for health and safety reasons. By 1900, 20 U.S. states, promoting the same health and safety logic as Wisconsin, limited the hours women could work in various occupations.

In 1903, Oregon passed a law that limited women to a maximum 10 hours per day of work in factories and laundries. Muller owned a laundry in Oregon and was fined when he violated the law. Muller appealed his violation of the law all the way to the U.S. Supreme Court. The court’s decision would determine if state laws that limit hours of work for health and safety reasons would be repealed or enhanced.

Louis Brandeis represented the state in the U.S. Supreme Court case of Muller v Oregon. Brandeis’s defense of Oregon’s law relied almost entirely on expert testimony and evidence, rather than legal precedent, to establish the law’s rationale. Brandis’s argument was persuasive. In 1908, the U.S. Supreme Court unanimously agreed with Brandis that Oregon’s law limiting the hours worked by women for health, safety and public welfare reasons was valid.  The “Brandis Brief” demonstrating the dangers of long work hours, and the first meta-analysis of scientific evidence presented before U.S. courts, should be read in its entirety (see ref. 3) for its historical significance.

On October 29, 1919, the ILO “convened at Washington by the Government of the United States” to establish International Convention No. 1, Hours of Work (Industry), with the principle of “8-hours day or 48-hours week.” See ref. 4 for further information.

Big picture — current history

Women are no longer singled out for limiting their work hours for health reasons. Restricting working hours for safety reasons does occur for some U.S. jobs today. For example, hours-of-service regulations restrict DOT commercial vehicle drivers and FAA commercial pilots to generally 60 hours in a 7-day period, with daily limits up to 14 hours depending upon circumstances. Other industries, such as maritime, also restrict daily and weekly working hours. The rationale for these time restrictions is to prevent drowsiness that may lead to accidents that may endanger the public. The intent of these regulations is that the worker should rest, or more appropriately, sleep, when they are not working.

Shared responsibility

Limiting work hours for health and safety reasons today is complex because of shared responsibility between employer and worker.

Working ≥ 55 hours/week alone does not cause an increase and ischemic heart disease and stroke. Not getting enough sleep when not performing paid long work hours increases the health risk.

The challenge: How does an employer require and enforce their workers to get adequate sleep when not performing paid work? Brandis demonstrated that women had household chores and other womanly duties to perform when not working for pay. Limiting women’s industrial work to 10 hours a day facilitated, but did not guarantee, that adequate hours of sleep would be certain.

A policy within your organization to prohibit work ≥ 55 hours/week for health reasons sounds good but is a weak solution to this complex problem. How does an employer enforce their workers to get a healthy 8 hours of sleep each day?