LAST_UPDATEWed, 20 Jun 2018 8pm

‘Working To Death’: Recent Study Shows More Malaysians Getting Stress-Related Illnesses

Ever heard of the term 'karoshi? The term means ‘death caused by overwork’ in Japanese, referring to extreme stress caused by working more than 60 hours per week. Do people literally work themselves to death?

Earlier this year, a British expat working in Tokyo filmed a video diary documenting a typical 80-hour week faced by employees working in the financial services. The video posted to Youtube titled ‘A week in the life of a Tokyo salary man’ took a humorous look at a more serious underlying issue in Japan famous for its 13-hour days for six days a week, where employees leave the office after 11pm every night, with barely time to squeeze in dinner.

While our developing nation work culture has not reached such a boiling point, we should ask the question now whether we are headed in that direction.

According to global workplace provider Regus's latest online survey released early this year, 70 percent of Malaysian workers are reporting more stress-related illnesses due to challenging global economic conditions.

The report which covered the opinions of 20,000 senior executives and business owners across 95 countries, revealed that 48 per cent of the Malaysian respondents felt their stress levels had risen and over 42 per cent reported sleeping less due to work worries.

33 percent of respondents also shared their worries about losing their job while another 32 percent feel less confident about the sector they work in and 53 percent of respondents report that their family and friends have noticed they are stressed by work with another 47 percent say that stress is damaging their personal relationships.

"It's not surprising that work-related worries and the sleepless nights they cause are taking their toll on employees' personal lives," Regus APAC regional director John Henderson commented on the study results.

A young Goldman Sachs analyst from India, Sav Gupta, once told his father that his job is too much work and too little time. After months of working close to 100-hour weeks, the young banker fell to his death at his apartment parking lot at the tender age of just 22.

In China, 26-year-old Tian Fulei was found dead in a dormitory he shared with other workers at a factory making Apple iPhones. The young man had endured 12-hour shifts for seven days a week, which amounts to 84 hours of intense physical labour per week which his family alleged had played a part in his death in February this year.

As Regus's Henderson pointed out, the more important implication is that employees health are at stake as stress is a known catalyst for a number of serious illnesses. Are Malaysians more exposed to workplace stress today?

What Malaysian Workers Say

“I used to be envious of some people who boast about working non-stop and wear it as if it’s a badge of honour. Before I entered the working world, I had wished that I’d be one of these people too. But something happened and it forever changed my outlook,” says Carina Lim who used to work full-time at a boutique ad agency as a graphic designer.

She rarely went back home before 8pm, and working long hours is the norm. On some busy days (especially when she had the ‘luck’ of getting insufferable clients), she’d stay back at the office till midnight. “I’m still lucky though, at least I get to go home. I heard some of my friends who work in the industry had to sleep in the office just to finish a project,” says the quirky designer who is now in her 30s and working as a freelancer.

“Several months prior to my first heart attack, there were some signs but I ignored it; thinking it was impossible for someone as young as I am to have a serious health condition. Then it happened and I had to miss work for a while.

"Coincidentally, I had read a news story about an Indonesian girl who works as a copywriter; who had been working for 3 days straight before she suffered from heart failure and slipped into a coma. I thought it was a sign from God to take a break and appreciate my youth. It was an eye-opener for me,” Carina concludes.

“Normally, I’m stressed out because of the constant chasing of customers, and that I have to do legal work at the same time,” says Nureliza Najib, a clerk in her 30s working in the recovery department at a bank. Her job involves reminding borrowers of their upcoming payment to avoid them having to incur penalty charges, aside from several legal-related tasks. Though her unit is currently on the regular business hour shift, there’ll be overtime at the end of the month.

“The overtime is not compulsory but if the work isn’t done, then you’d have to do it. For overtime, it’s required that we work until 7 or 8pm. But then we’d also have to come in to work on Saturday from 10am to 4pm,” she says.

Not everyone works according to the regular business hours in this particular industry, like financial sales specialists. Usually, customers will meet with a financial sales specialist on weekends or after office hours. The specialists would sometimes have to man a booth during the weekend as well.

For Dr. Arif Husaini Abdul Rahim, a Medical Officer (MO) at Sarawak General Hospital, working too much with little rest is all part of the job, something to be expected. “No one told us it was going to be easy in the first place anyway,” he said.

Being a doctor is no easy fit indeed, Throw on calls into the mix and you’ll guarantee a sleepless ‘zombie’ would emerge. The word ‘on call’ is used when a doctor is required to work overtime (after 5pm). During the working days (Monday-Friday), on call starts at 5pm until 8am the next day (runs for 15 hours), which means that a doctor is working for 24 hours straight during that period!

When the on call is over, the doctor needs to work again at 8am until 5pm. This amounts to 33 hours of non-stop working for doctors who are on call. During the weekends, an on call starts at 8am until 8am the next day (which is 24-hour shift). The frequency of on call depends on how many Medical Officers (MO) and specialist doctors are involved with on calls.

With all that said, don’t be alarmed yet, as people can’t die just by overworking, according to Dr. Arif. “Unless your job involves a lot of risks, then usually nobody dies by working too hard or too long by itself.”

Is 'Working To Death' Just An Urban Myth?

For the Japanese, the definition of 'karoshi' refers to fatalities or associated work disability due to cardiovascular attacks (such as strokes, myocardial infarction or acute cardiac failure) which could occur when hypertensive arteriosclerotic diseases are aggravated by a heavy workload.

When asked whether overworking can lead to death, the doctor firmly replies, “It's like saying you died by holding your breath for too long. You will naturally stop holding your breath and breathe in. It is survival instincts. The same goes to working.

“No matter how much you try, if your body can't take it, it will shut down by itself, usually in the form of sleep. No matter how much coffee you take or all the steps you do to try to stay awake, if your body needs rest you will rest.

“However, in cases of extreme exhaustion, other things can happen that can lead to death. Dehydration can cause kidney damage, leading to increase toxin levels in the blood.

“Severe constant stress can cause the rhythm of the heart to be affected and, in people who are at risk of heart disease, can precipitate a heart attack. Usually there has to be something else involved that caused the death, not just the work,” says the doctor, who is yet to see a case where someone dies due to overworking.

He further explains that people who are prone to work-related health problems are those who have some underlying problem in the first place. “Heart conditions due to an innate problem or a long history of hypertension/high cholesterol, kidney problems due to an innate problem or long history of diabetes, unhealthy lifestyles with minimal exercise, poor social support to overcome the stress; all these things will make you unhealthy as a person, and overworking will cause you to suddenly have a heart attack or a stroke or kidney injury or change of behaviour which are all dangerous.”

When inquired about the best treatment or medication to deal with such issues, he replies, “The best medication is still rest. There's no magical drug that instantly gets your energy back. Some can mask the effects of course.

“Caffeine can temporarily boost your energies but it's like using your spare gas tank. In the end you need more fuel to fill up your normal tank and your spare tank. And how you rest depends on what you consider resting.

“Some people sleep. Some read. Some go for walks, watch movies, draw. There are some medications (not available in government hospitals or need specialists signatures) that help ease anxiety and stress. But they're not something you can buy from pharmacies and you need proper specialist assessment before being prescribed them.

“All in all, overworking is not a valid cause of death. I have not seen a case of death by overwork in my whole career so far. Those who have a lot of health problems are at risk of dying regardless whether they are overworked or not. So I guess in a way not everyone dies easily from overworking. It wouldn't happen to an otherwise healthy individual,” says Dr. Arif.

Striving Towards Work-Life Balance

“I don't think we have a choice (for some). But we're humans too and get tired as well; we just try to manage time properly. The key is for quality rest in compact periods. Take the shorter route, arrange your schedule so you get the most done at one go without retracing your steps, arrange your outings appropriately, know your limits, and plan many days ahead...things like that,” concludes the young doctor.

According to the Organisation for Economic Co-operation and Development (OECD), an important aspect of work-life balance is the actual amount of time a person spends at work. Looking at data from the OECD and the International Labour Organization (ILO) we can see some broad and interesting trends.

"Asian countries tend to work the longest [hours], they also have the highest proportion of workers that are working excessively long hours of more than 48 hours a week," says Jon Messenger, an ILO expert on working hours as reported by the BBC.

"Korea sticks out because it's a developed country that's working long hours," he says. "Normally it's developing countries like Bangladesh, Malaysia, Thailand, Sri Lanka - countries like this that are working long hours."

As expected, Malaysia's statistics follow the pattern of the rest of the Asian nations. According to an Expedia's 2012 Vacation Deprivation Survey, Malaysia ranks in 4th place after India, Brazil and Italy, in terms of employee dedication as many just can't seem to “let go” of their work during vacations.

Conducted based on 8,000 employed adults from 22 countries throughout the globe, the survey also revealed that Malaysians spent about 40 hours a week at work and went on an average of 14 days of annual leave, among the lowest in the world.

While Malaysians might not be at risk of dying of overwork, it is undeniable that the steep rise in non-communicable diseases attributable to workplace stress can jeopardize the nation's push towards developed nation status, especially if it affects productivity.

If you feel you're struggling with work-life balance, the Mental Health Foundation has some important advice:

  • Take personal responsibility for your work-life balance: take action when work demands overwhelm
  • Try to work smart, not long: set time limit for tasks
  • Take proper breaks at work: set aside time for lunch, some physical activity
  • Draw a line between work and leisure: try to limit work you bring home
  • Understand that work-related stress and mental health are linked: do exercise and pick up hobbies to relax
  • Keep track of your working hours over a period of weeks or months, rather than days


- Malaysian Digest