INDIVIDUALS who work long hours may be at an increased risk of stroke. A new meta-analysis of research done across the world has shown that working 55 hours or more each week is associated with an increased risk for stroke, and the more hours worked beyond the 55 hours, the greater the increase in risk.

The results suggest that long working hours was also associated with an increased risk for coronary heart disease, but this association was weaker than that for stroke.

The comprehensive work was done by the Department of Epidemiology and Public Health at the University College in London, and was published in the medical journal The Lancet on August 20, 2015.

The meta-analysis was larger than any previous one, and included 25 research studies from the USA, Australia, Finland, Denmark, Sweden, the Netherlands, Belgium, Germany, the United Kingdom, Northern Ireland, and Israel. In total, the meta-analysis included 603,838 men and women.

THE FINDINGS OF RESEARCH

During the seven to eight year follow-up, 4,768 participants had a coronary (heart) event and 1,722 people had a stroke. Compared with standard working hours of 40 hours per week, working long hours was defined as 55 or more hours per week, and the risk remained high after adjustments were made for age, sex and socio-economic status. Analyses were done for the weekly work ranges of 41-48 hours, 49-54 hours and 55 or more hours each week. The associated stroke findings were surprisingly robust.

In the past, research has emphasised the great importance of people getting adequate sleep. People deprived of sleep are more disagreeable, lack energy, are inattentive, have an impaired ability to focus and concentrate, and are more prone to disorders of the immune system. These people may suffer anxiety and depression, and social relationships may also suffer.

Caffeine has also been shown to make it harder for some people to fall asleep, and it also disturbs the quality of sleep for some. Attempting to withdraw from the use of caffeine (present in coffee and all cola beverages) can cause headache, fatigue, sleepiness, and difficulty concentrating. People even reported having “flu-like symptoms”, anxiety and depression when they tried to reduce their intake of coffee. Therefore, situations of overwork, insufficient sleep, and caffeine intake, are generally not good for our health and well-being.

RISK FACTORS

We often associate incidences of stroke and heart disease with high blood pressure, uncontrolled diabetes and high cholesterol. However, we do not realise that other aspects of our lifestyle may also have a bearing on our risk for stroke and heart disease. It is always ideal that we have a good balance to our lives, which on a daily basis means eight hours of work, eight hours sleep, and eight hours for family, exercise, recreation, and other personal pursuits. There are only 24 hours in a day, and so once we regularly go beyond eight hours of work each day, other aspects of our existence are likely to suffer.

The demands of our job, or our desire to earn more money, or our valiant effort to make ends meet, invariably means that something has to give. We are usually aware of these effects on our family and our loved ones, as we deprive them of our time and attention. We may also be concerned about our progressive weight gain, as allotted time to exercise daily is reduced or totally absent. We will be aware of our high level of frustration as we try to pack everything else on our things to do into the few remaining hours after a prolonged day’s work.

However, what this new research tells us is that there are even more dire, if not fatalistic consequences to our working more than 55 hours each week, or 11 hours each day.

FAR-REACHING CONSEQUENCES

The consequences of a stroke or heart attack resonate far beyond our personal selves to affect our families and loved ones (emotional distress, loss of income from the main or only breadwinner, etc), our friends, and our various communities (civic, religious, etc). We often underestimate just how much our individual lives positively touch others. Yet, to continue to do so requires us to remain healthy. We must therefore be mindful of all this when we seek to put in an extra three to four hours of work each day with regularity.

An exceptional day or two, or even a week in order to meet a work deadline at the end of the month, might be allowable, but to work those extra three hours each day, regularly and consistently, has been found to increase your risk for stroke and heart disease.

In light of all this, will you cut back on your work hours to come closer to eight hours each day? If given a choice – would you choose to make more money for a period of time and die earlier than you would if you had a healthy body, or would you choose to forgo the extra work and income, and live longer? If this is your dilemma, what will your choice be?

Derrick Aarons MD, PhD is a consultant bioethicist/family physician, a specialist in ethical issues in medicine, the life sciences and research, and is the ethicist at the Caribbean Public Health Agency – CARPHA. (The views expressed here are not written on behalf of CARPHA)