Although this study is based primarily on European workers, the results likely apply to Australian workers as well. This paper reinforces a growing body of research that has linked long working hours to a variety of adverse health outcomes, as well as with work-family conflict and other social outcomes.  This evidence comes from both Australia and international studies. For example, we conducted a study of working hours and mental health on a national cohort of Australian workers that was published last month.* We found that compared to when a person was working standard fulltime hours, working over 49 hours was associated with lower mental health. Decreases in mental health were greater in women compared to men, and for those working in jobs at higher occupational skill levels.

It is unfortunate that the authors highlight only one implication of their findings: “that more attention should be paid to the management of vascular risk factors in individuals who work long hours.” Healthcare providers are not the only group that have an influence over the health of workers. Of at least equal, and probably greater, importance is the need to control working hours as a hazard to health just like we have controlled other workplace hazards in industrialised democracies, from traumatic fatalities on the job to asbestos-related cancers.

In the case of asbestos exposures, of course we pursue improvements in the early detection and treatment of asbestos diseases, but the most important action has been to ban asbestos - to apply what we learn to both prevention and treatment.  Both are essential.  Returning to the topic at hand improving the health of workers requires action from employers, unions, OH&S regulators and other workplace stakeholders to limit working hours, in addition to the authors’ acknowledged need for action by healthcare providers.

In short, the findings of this study, combined with those from others, suggest the need to consider long working hours as a hazard to employee health in Australia.

This paper systematically reviews the evidence for a relationship between long working hours and heart disease and stroke. It actually indicates a lower risk of coronary heart disease for workers than previously thought. However, the figure is still a 7 per cent increased risk and would apply to about 27 per cent of Australian male workers and 10 per cent of female workers.*

Using 2008/9 data, Safe Work Australia (2012)** estimated that there were 30,000 cases of heart disease attributable to work, but not compensated. So, heart disease is an issue in Australian workplaces, but under-recognised in workplace management.

The data on stroke, although representing a higher excess risk of 30 per cent, would account for much fewer cases.

For both stroke and coronary heart disease, an underlying risk factor is physical inactivity for extended periods. Long working hours is a proxy for other risk factors, which may be more common in workers of low socio-economic status.

The Lancet paper should provide a stimulus for workplaces and regulators to re-examine long working hours, and in particular long periods of physical inactivity for men in lower paid jobs.