Long working hours associated with increased stroke risk

Executive Summary

Long working hours (LWH) are said to cause various health problems. Stroke and heart disease are prominent among them. Various studies have linked stroke to LWH, which are 10 hours or more a day, for at least 50 days a year.

Now, a very large study of French participants has shown that LWH for 10 years or more increase the risk of stroke by 29%. In people younger than 50 years, this increase is by 128%.

People in professions, where one has more decision–making latitude, have lesser increase in stroke chances.

Read the full article below for more details on types of stroke, various studies linking working conditions to stroke, and suggestions from experts for reducing work–related stress, possibly reducing chances of stroke.

In many countries, working long hours is considered a badge of honour. Busier people are generally considered more successful. Youngsters, who wish to move up the career ladder, may even choose professions needing long working hours.

However, long working hours (LWH) are known to come with health challenges, stroke being a prominent one. LWH are defined as working time of 10 hours or more for at least 50 days a year.

Types of strokes

Strokes are mainly of two types:

• Haemorrhagic stroke, where a blood vessel bursts or leaks, causing internal bleeding; and
• Ischemic stroke, wherein a blood vessel gets an internal clot, blocking blood flow.

In both the cases, blood supply to brain is hampered. As a result, some brain cells die, leading to stroke.

Actually, there is also a third type of stroke called Transient Ischemic Attack (TIA). TIA is a sort of a mini–stroke.

Read: Types of strokes: causes, symptoms and treatments.

LWH and stroke

An article in the journal Scandinavian Journal of Work, Environment and Health showed that LWH is a risk factor for stroke and cardiovascular disease.

A meta–analysis published in the journal Lancet showed that employees who work long hours have a higher risk of stroke than those working standard hours.

A Danish study published in 2017 in Scandinavian Journal of Public Health showed that LWH are associated with haemorrhagic stroke. However, the study could not show that LWH are associated with overall stroke. Keep in mind that working conditions in Denmark are among the best in the world.

New study

A research paper published in the journal Stroke in Jun 2019 has now shown that long working hours are associated with an increased risk of stroke, in those who were exposed to LWH for more than 10 years. This is especially true for people younger than 50 years.

This was a very large study involving more than 143,000 French participants.

Findings

1. The study found 29% increase in the incidence of stroke in people who had LWH for more than 10 years.
2. In participants below 50 years of age, who had LWH for more than 10 years, the stroke incidence increased by whopping 128%.
3. There was no difference between men and women about the increased risk of stroke with LWH.
4. The study found lesser increase in stroke incidence in some professions. Owners, managers, CEOs, professionals, and farmers showed less increase in stroke compared to other occupations.

Discussion

1. The researchers proposed that the professions, where an individual has more decision-making freedom, may involve lesser incidence of stroke. Perhaps, less decision–making power involves more stress, and therefore, more chances of stroke.
2. The study found the relationship to be of dose–response type. That is, there was no mere association between LWH and stroke. It involved exposure to LWH for a certain duration—10 years or more, in this case—to see the effect.
3. Different studies have suggested working conditions may be affecting stroke directly or indirectly. Irregular shifts, night work, and job strain may be involved. Decision–making latitude may affect stress levels on the job.

Comments

Note that in the entire population, the stroke incidence was about 0.85%, or about 9 in 1,000. An increase of 29% means 11 out of 1,000 people ended up with stroke. And an increase of 128% means 19 out of every 1,000 people ended up with stroke.

In other words, statistics can highlight how statistically significant the findings are. However, they cannot tell you about the medical significance of the outcomes.

Whether an increase in the chance of getting stroke from 8 out of 1,000 people to 19 is bad enough for you to worry, only you can decide.

Actionable tips

1. Here are 12 ways to eliminate stress at work, as per Forbes magazine.
   Eliminate interruptions.
   Schedule your day.
   Eat right.
   Sleep properly for adequate hours.
   Identify self–imposed stress.
   Prioritise.
2. Here is how to cope with stress at work, as per American Psychological Association.
   Track what gives you stress.
   Develop healthy response to stress.
   Establish boundaries.
   Take time to recharge.
   Learn to relax.
3. Here is how to handle stress at work, as per Harvard Medical School.
   Pay attention to the present moment (mindfulness).
   Reappraise negative thoughts.
   Learn problem–solving techniques.

First published on: 27th January, 2020

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