Impact of Long Working Hours on Health Outcomes

Long working hours are increasingly recognised as a significant occupational and public health concern worldwide. Prospective and cross-sectional studies have linked working beyond standard schedules—often defined as above 40–55 hours per week—to elevated risks of cardiovascular disease, stroke and metabolic disorders. Extended hours undermine physiological recovery and exacerbate stress, disrupting circadian rhythms, increasing blood pressure and promoting unhealthy coping behaviours such as poor diet, physical inactivity and excessive alcohol consumption. Mental health outcomes, including depressive symptoms and anxiety, also rise in tandem with prolonged work schedules, reflecting both psychosocial strain and reduced time for leisure and sleep. Economically, these health burdens translate into greater sickness absence and healthcare utilisation, while socially they magnify inequalities, as lower-status workers often endure the longest hours with the fewest compensatory benefits. International agencies have recognised long working hours as a leading modifiable occupational risk factor, prompting guidelines to limit weekly hours, regulate overtime and promote enhanced workplace autonomy and social dialogue.

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Impact of Long Working Hours on Health Outcomes publication trend

The graph below shows the total number of articles in impact of long working hours on health outcomes across all publications each year (not limited to Nature Index journals).

Technical terms

Cardiovascular disease: A group of disorders affecting the heart and blood vessels, including coronary heart disease and stroke.

Disability-adjusted life year (DALY): A composite measure of health loss that combines years of life lost due to premature mortality and years lived with disability.

Population-attributable fraction: The proportion of incidents in a population that is attributable to a specific risk factor, indicating potential reduction if the exposure were eliminated.

Meta-analysis: A statistical method that synthesises results from multiple independent studies to produce a pooled estimate of effect size.

References

1. Global, regional, and national burdens of ischemic heart disease and stroke attributable to exposure to long working hours for 194 countries, 2000–2016: A systematic analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. Environment International (2021).
2. Diversity of flexible working time arrangements and workers' health: An analysis of a workers’ panel and linked employer-employee data for France. Social Science & Medicine (2024).
3. Long working hours and risk of coronary heart disease and stroke: a systematic review and meta-analysis of published and unpublished data for 603 838 individuals. The Lancet (2015).
4. Long working hours and alcohol use: systematic review and meta-analysis of published studies and unpublished individual participant data. The BMJ (2015).
5. Workhours in relation to work stress, recovery and health.. Scandinavian Journal of Work, Environment & Health (2006).
6. Long working hours and depressive symptoms: systematic review and meta-analysis of published studies and unpublished individual participant data.. Scandinavian Journal of Work, Environment & Health (2018).