55 (Hours) and (Barely) Alive

This will actually literally happen if you’re overworked. Seriously. (well at least in Yugioh…)

At this point there should be little doubt that working longer hours isn’t always healthy. Even within an eight hour you’re likely going to start slowing down. Either because you didn’t get enough sleep, work is stressful or a lack of time for yourself. Whatever the reason, after a certain amount of hours you likely can’t be as productive as you started.

But then your manager has a great idea.

What if you worked more?

So let’s say you have a sort of syndrome that makes you think you need to do this. You think you need to be the best, or the fact that other people are putting more bothers you, etc. Whatever the case is, you decide to work, let’s say, 55 hours a week.

Have fun with that increased chance of a stroke.

A group of scientists at the University College London has, to quote The Guardian, “…found that those who work more than 55 hours a week have a 33% increased risk of stroke compared with those who work a 35- to 40-hour week. They also have a 13% increased risk of coronary heart disease.”

But they didn’t do this finding through a few studies. Instead, they did a meta-analysis of studies over three different continents. They ended up analyzing 17 studies for strokes and 25 for coronary heart disease and in total gathered the information from over 600,000 men and women for the former and around 530,000 for the latter.

The study itself has some especially juicy parts. Well…juicy for me…because I’m a nerd.

Harmonised covariates, including potential confounding and mediating factors, were age, sex, SES, smoking, body-mass index (BMI), physical activity, and alcohol consumption. Additional covariates not available for all the studies were total cholesterol or hypercholesterolaemia, systolic blood pressure or hypertension, and diabetes.

This part is particularly exciting because it’s telling us that the researchers not only did a ton of statistical data but they also (as best as they could) controlled for significant confounding factor. Someone who would try to argue against longer working hours (in this case, 55 a week) increasing the likelihood of strokes could otherwise easily point to people’s weight, class, etc. as a way to say that there’s still no way to really know.

And even though their mistaken in the likelihood argument, they’re correct about the knowing bit. The scientists in this study aren’t claiming causality so much as high correlation between certain health risks and longer work hours. And past the scientific data that is mounting at this point, it just makes intuitive sense. The more you work, the more stressed you’ll be. And most of us are pretty familiar with the fact that stress isn’t good for us in the short-term, let along the long-term.

The study isn’t perfect of course, as the researchers explain the limitations:

A large proportion of the unpublished individual-participant data was from the IPD-Work Consortium, which is based on a convenience sample potentially contributing to availability bias. Exposure to long working hours was based on self-report and was measured only once. Because the tendency to work long hours is not necessarily stable over time, further research on prolonged exposure to long working hours, preferably with objective measures, is needed to establish whether our findings are underestimated because of misclassification of the exposure. In two studies, high loss to follow-up could also have contributed to an underestimation of associations, although this bias seemed to be small or absent in the total data.

We had harmonised data for multivariable adjustments for age, sex, SES, smoking, BMI, physical activity, and alcohol consumption, but not for salt intake and blood-based risk factors. Ascertainment of coronary heart disease and stroke varied, ranging from medical records of brain imaging and autopsy to repeated self-report questionnaires; therefore, some outcome misclassification is possible. However, the absence of heterogeneity in the study-specific estimates, and the uniform findings in the analyses stratified by method of ascertainment, suggest that this misclassification is not a major source of bias.

Stuff like this really makes me happy. When you have a study that no only has a lot of data, tries to account for confounding factors and acknowledges its limitations you’ve probably got a decent thing on your hands.

As well, most of the confounding factors this study controlled for didn’t even end up making much difference:

Furthermore, the association did not vary between men and women or by geographical region, and was independent of the method of stroke ascertainment, suggesting that the finding is robust. Long working hours were also associated with incident coronary heart disease, but this association was weaker than that for stroke.

That last part is especially interesting.

It doesn’t seem like coronary heart disease (CAD) is as correlative as some have suggested in the media. Even so, the risk for strokes is notable and worth considering. And it isn’t as if CAD is a negligible concern either, it may be less likely than a stroke but it’s still a potential risk of overworking.

As the years pass, it seems like more and more data comes through that proves the points of anti-work. Self-serving bias aside, I thnik there’s real scientific merit to a lot of the basic demands of the anti-work philosophy. Namely that we probably shouldn’t have to risk death just so we don’t live in poverty…and then die.

Finally, it’s worth noting that people who work 30-40 hours aren’t nearly as likely to have these health risks. But that doesn’t mean that the 30-40 hours a week is a good idea. There’s still the issue of the eight hour work day itself and the burnout people can have from it as I mentioned before. But even without that there are still structural issues that capitalism and the state create. For example, the power disparity between bosses and workers, the wages stolen from workers by the state through taxes, and the bureaucratization of unions that ultimately disempower workers.

The problem of overwork is real, no doubt.

But the problem of work itself is even more real.

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