Long Working Hours – Health and Productivity

The issue of long working hours has found itself in sharp focus following the remarks by head honchos of popular large corporates that suggested that employees should be willing to work longer hours than what is currently mandated or accepted. These remarks have since then become the butt of several jokes, memes, and reels on print and social media, as also stand-up comedy and talk shows.

The origins of the Factories Act in the 19^th Century United Kingdom can be largely attributed to the long working hours prescribed as a result of the Industrial Revolution, in addition to looking at child labor, the working environment, and the use of dangerous machinery. The first attempt at regulating working hours came through “The Health and Morals of Apprentices Act” of 1802, proposed by Sir Robert Peel which limited work to 12 hours per day.[1] The first Factory Act of 1819 called for the abolishment of children below the age of 9 in factories but suggested that those between 9 and 16 years of age could work 12-hour shifts.[2] This was hardly enforced, until the Factory Act of 1833 restricted the working hours for those aged 9–16 years to 48 hours per week.[3] Further iterations of the Act initially limited women’s work to 12 hours (1844), and later in 1847, it was reduced to 10 hours (Ten Hours Act).[4]

The Indian Factories Act of 1948[5] prescribes a daily limit of 9 hours and a weekly limit of 48 hours with a minimum 30-minute rest break after 5 hours of continuous work. The total time spent in the factory, including the rest breaks cannot exceed 10.5 hours per day. While the working hours for women were not different, the Act mandates that women cannot work between 7 pm and 6 am. Similarly, children between the ages of 14 to 18 years are not permitted to work for more than 4.5 hours per day, and they are not allowed to work between 10 pm and 6 am. Overtime rules permitted a maximum of 2 hours per day and a maximum of 50 hours per quarter.

The Occupational Safety, Health, and Working Conditions Code of 2020,[6] which consolidates multiple labor laws, including the Factories Act, sets the daily and weekly limit as 8 hours and 48 hours, respectively. The total time (spread-over time) spent in the workplace should not exceed 12 hours per day – the 30-minute break for every 5 hours of continuous still being in place. However, overtime rules have been relaxed with the factories being permitted to employ workers for up to 125 hours per quarter. Women are allowed to work between 7 pm and 6 am with consent and with adequate safety measures. Working hours for adolescents between 14–18 years remain the same, but night work (from 7 pm to 6 am) is not permitted.

While the companies that the said corporate leaders represent do not come under the purview of the Factories Act, it is pertinent to examine the health effects of long hours of work even in white-collar jobs.

A meta-analysis published by Wong et al.[7] of 46 papers that looked at the effect of long working hours and overtime on occupational is particularly revealing. The effects that were looked at included physiological health, mental health, health behaviors, related health, and non-specified health – all of these combined then to constitute occupational health. The odds ratio for each of the above, excluding non-specified health outcomes, was more than one with the lower limit of the 95% confidence interval also being more than one. Non-specified health outcomes also had an odds ratio greater than one, but the lower limit of the 95% confidence interval was 0.942. However, the overall odd ratio which looked at the association between long working hours and occupational health was 1.245 (95% CI: 1.195–1.298). A closer look at the data reveals that the odd ratio for working hours greater than 50 hours per week or greater than 10 hours per day (OR: 1.420, 95% CI: 1.337–1.508) was greater than that for working hours less than 50 hours per week or less 10 hours per day (OR: 1.097, 95% CI: 1.035–1.162). Also of interest is the working class of the population studied – this revealed that white-collar workers had a lower odds ratio of 1.095 (95% CI: 1.043–1.149) than pink-collar workers (OR: 1.168, 95% CI: 1.002–1.360) and blue-collar workers (OR: 1.275, 95% CI: 0.907–1.792) – the last mentioned being insignificant. The authors conclude that the “related health” condition showed the strongest association with long working hours – the related health conditions included short sleep duration, sleep disturbance, sleep “problem”, exhaustion, and injuries.

Perhaps, the more telling details are from the World Health Organisation and the International Labour Organisation, which gathered data from 37 studies on ischemic health disease covering more than 7,68,000 and 22 studies on stroke covering more than 8,39,000 participants.[8] This new release published in May 2021 stated long working hours (55 hours or more per week) led to 7,45,000 deaths from stroke and ischemic heart disease in 2016 – a 29% increase since the year 2000. Further between 2000 and 2016, the number of deaths from heart disease due to working long hours increased by 42% and from stroke by 19%.

The article suggested interventions at three levels – for employees to share working hours to ensure that the number of hours worked does not climb above 55 or more per week; for employers and workers’ associations (through bipartite or collective bargaining agreements) to arrange working time to be more flexible, while at the same time agreeing to a maximum number of working hours; and for governments to introduce, implement, and enforce laws, regulations and policies than ban mandatory overtime, and ensure maximum limits on working time.

The moot question has always been whether longer working hour actually results in better productivity. Data from across the world[9] [Figure 1] indicates the opposite, as can be seen from the infographic below. Studies do not show any linear correlation between long hours of work and productivity.

Figure 1.

Annual working hours versus per capita GDP(9) {9 = reference number}

Obviously, the statements by corporate leaders have not considered the potential impact on employee health and well-being which should be a key dimension within the ambit of overall Corporate Governance. Neither, do studies show any linear correlation between long hours of work and productivity. On the contrary, extended work hours have also been shown to lead to increased stress, with employees facing heavier workloads leading to anxiety and burnout. Long working hours impact health through reduced sleep and exercise and an increased likelihood of adopting unhealthy behaviors. From an organization’s perspective, it leads to increased absenteeism and higher employee turnover.

We have to acknowledge that though there are statutes and global conventions defining maximum working hours, it is impractical to apply these uniformly across all work situations. There are a variety of geopolitical and individual organizations’ financial goals that influence decisions on working hours. There are specific work situations, even in our own medical profession where it can be difficult to mandate an 8-hour working day. At the industry level, it is time to shift from the “hours worked” culture to a result-oriented focus. This may include flexible work policies in organizations that have the wherewithal to permit this. It is important that managers are trained to monitor workloads and set expectations that are achievable. The buzzwords these days are “work-life balance or work-life integration” – organizations should assess these by speaking to the employees and provide prerequisites and facilities that promote healthy work and life.

We should also recognize that individual employees are the final decision-makers. They are the ones who have to choose what their priorities should be – surely, this is the option of those in white-collar jobs inclusive of professional fields like Information Technology, Management, and Finance among others. Appropriate accommodation for working women with caregiver duties and appropriate policies on working from home is needed. For those whose voices are rarely heard, such as those on the shopfloor involved in manual labor, it is our responsibility as medical professionals to influence those in human resources departments to convince top management of the ultimate futility of increased working hours.

The key here is for the use of technological innovation including knowledge innovation as the key drivers of productivity, rather than working long hours. An organization’s HR department must be the torch bearers to educate the top management on the downside of trying to steer an organization to abnormal working hours. Occupational health professionals must work closely with their HR partners in advising organizations on employee health, well-being, and productivity. Work-life balance/integration is the key to enhanced employee well-being, talent attraction, retention, and organizational growth. Quality over quantity should be the mantra.