Are We Working Ourselves to Death?

If you are an executive, manager, emergency medicine physician (EMP), Silicon Valley employee or struggling law associate, you and many like you are probably working more than 60 hours a week. According to a survey published in the Harvard Business Review a few years ago, you may be working an average of 72 hours a week.

Contrast this with the government’s desire to limit excessive working hours about 80 years ago when, on June 25, 1938, Franklin D. Roosevelt signed into law the Fair Labor Standards Act (FLS). This law banned oppressive child labor, set the minimum hourly wage at 25 cents, and the maximum workweek at 44 hours.

Moreover, more than a hundred years ago, workers were given an entire weekend off from work. (How many EMPs can expect this?) The five-day workweek was started in 1908 by a New England cotton mill owner to allow Jewish workers to observe their sabbath on Saturday. They were expected to make up the work on Sunday but complaints about having the mill operate on a Sunday resulted in closing the factory for the entire weekend. Later, in l926, Henry Ford shut down his automotive factories for the entire weekend. He wanted his employees to have leisure time to buy automobiles. The Amalgamated Clothing Workers of America Union demanded a five-day workweek in 1929, and received it; but it wasn’t until 1940 that the two-day weekend was adopted countrywide.

But now, many people work at least 10 hours daily or longer; some companies even provide dinner to make sure their employees stay late. Salaried employees often are tethered to their smartphones during the weekend and expected to be available. Their jobs often require working throughout the weekend. If their company, sensitive to criticism that their employees have no time off at all, tells them not to work one day during the weekend, the employees find themselves working twice as hard on the other day to catch up with the work handed to them on Friday afternoon. To be sure, their work load is not as relentless as that of a galley slave who was chained to his bench for the length of his servitude, rowed for up to 20 hours a day, was whipped incessantly and fed vanishingly small rations. They, by and large, did not live long. But now we are learning that the modern day equivalent of the galley slave may not live out his or her natural life expectancy either.

The medical journal, The Lancet Online First, published an article recently comparing health risks of people who worked 55 or more hours weekly compared with those who worked 35-40 hours. Working many more hours was associated with a 13% increase in the risk of cardiovascular disease and a 33% increase in the risk of a stroke compared to working 35-40 hours (the so-called normal work week). The report is sobering. The many researchers who contributed to the study pooled information from 25 different studies that tracked the health of adults for 7-8 years. When the study began, the more than 600,000 participants had no evidence of coronary heart disease and nearly 530,000 of them had no evidence of stroke. Seven or eight years later, the formerly healthy workers who had the greater work burden were now facing medical risks that might shorten their longevity. The scientists searched for reasons. Was it economic status, smoking, age, gender and/or weight? What might be contributing to these dire findings? The answer was none of the above. Only working 55 or more hours per week was associated with these risk factors. 4
Interestingly, the authors did not conclude their article by suggesting a decrease in working hours. Rather, they said that employers should pay attention to identifying and managing heart attacks, stroke, high blood pressure and other symptoms of cardiovascular risk among their employees. Maybe they meant that employers should be trained in CPR in case a worker keels over in his cubicle.

The reasons for a deterioration in health associated with galley slave-like hours are not hard to find: stress, depression, lack of sleep, lack of exercise, lack of fresh air and sunlight, too much sitting: the list goes on and on. The overworked worker is told to make better food choices, get more sleep, exercise and relax. These are all good suggestions, but if deadlines and excessive work assignments reduce free time to hours spent traveling back and forth to work, it is almost impossible to make use of this advice.
Yet one suggestion might be some help to those struggling under an impossible work burden: eat to perform better and to relax.

Lean protein helps maintain two brain chemicals that are involved in mental alertness and rapid mental processing. Caffeine also increases mental alacrity and focus. Water prevents silent dehydration associated by many hours in a dry environment. People don’t realize that their bodies are losing water because they are not sweating. However, consuming too little liquid often causes fatigue and headaches. And fat should be avoided: it makes the brain sluggish and the body slothful.

Starchy carbohydrates, in contrast, help the brain and body relax when, finally, work is over. Serotonin, the mood chemical produced when all carbohydrates, except fruit, are eaten, decreases stress and anxiety and soothes the mood and the brain into a calmer, less agitated state.

It doesn’t take much, perhaps a small baked potato, or a bowl of oatmeal, pasta or rice, to do this. But protein and relaxation do not mix. Protein prevents serotonin from being made. Eat it when you want to be alert, not tranquil.

Exercise, sleep, and recreational activities all help combat the health risks of extended working hours. Sleep is the most important; even the galley slaves were allowed to sleep, (maybe they did not row in the dark) but exercise and taking some personal time are also important.

Let us hope that we do not have to wait for a new version of the Fair Labor Standards Act to be enacted before the 21st century worker is given some relief from an impossible work schedule so that death does not precede retirement.

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