Policy changes for preventing and recognizing overwork-related cardiovascular diseases in Taiwan: An overview.

OBJECTIVE

Overwork-related cardiovascular and cerebrovascular disease (CVD) has a large impact on workers' rights and labor standards across East Asian countries. This article describes the background and impact of policies regarding overwork-related CVD in the past decades in Taiwan.

METHODS

We reviewed government policies, guidelines, literature, and news addressing the problems and impact of policy changes to prevent and recognize overwork-related CVD since the 1990s, and collected data on overwork-related CVD cases in Taiwan from 2006 to 2017.

RESULTS

In 2017, overwork-related CVD accounted for 13% of all cases of occupational diseases, but 79% of all deaths due to occupational diseases. Guidelines for recognizing overwork-related CVD cases were established in 1991; however, under-recognition exists in Taiwan due to poor exposure data on working hours and psychological factors and because most medical expenses are covered by the national health insurance system. Amendments on the guidelines, and stricter policies on overwork prevention were enforced following calls from labor unions, nongovernmental organizations, and legislators, but health disparities were introduced when certain industries were exempted from restrictions.

CONCLUSIONS

Long working hours and other work characteristics increase the risk of overwork-related CVD. By reviewing the changes in policy for preventing overwork and recognizing overwork-related disease, we identified the need for clearly defined guidance on evaluating overwork-related CVD, with specific criteria for working hours and other risk factors regarding work characteristics. National policies that lead to better working conditions and prevent overwork-related diseases must be developed.