Karōshi (過労死?), which can be translated literally as "overwork death" in Japanese, is occupational sudden mortality. The major medical causes of karōshi deaths are heart attack and stroke due to stress and a starvation diet. This phenomenon is also widespread in South Korea, where it is referred as 'gwarosa' (과로사). In China, overwork-induced suicide is called 'guolaosi' (过劳死).
The first case of karōshi was reported in 1969 with the stroke-related death of a 29-year-old male worker in the shipping department of Japan's largest newspaper company. The term was invented in 1978 to refer to an increasing number of people suffering from fatal strokes and heart attacks attributed to overwork. A book on the issue in 1982 brought the term into public usage, but it was not until the mid to late 1980s, during the Bubble Economy, however, when several high-ranking business executives who were still in their prime years suddenly died without any previous sign of illness, that the term emerged into Japanese public life. This new phenomenon was immediately seen as a new and serious menace for people in the work force. In 1987, as public concern increased, the Japanese Ministry of Labour began to publish statistics on karōshi.
Japan's rise from the devastation of World War II to economic prominence in the post-war decades has been regarded as the trigger for what has been called a new epidemic. It was recognized that employees cannot work for 12 or more hours a day, 6–7 days a week, year after year, without suffering physically as well as mentally. It is common for the overtime to go unpaid.
In an International Labour Organization article about karōshi, the following four typical cases of karōshi were mentioned:
- Mr. A worked at a major snack food processing company for as long as 110 hours a week (not a month) and died from a heart attack at the age of 34. His death was recognized as work-related by the Labour Standards Office.
- Mr. B, a bus driver, whose death was also recognized as work-related, worked 3,000 hours a year. He did not have a day off in the 15 years before he had a stroke at the age of 37.
- Mr. C worked in a large printing company in Tokyo for 4,320 hours a year including night work and died from a stroke at the age of 58. His widow received workers’ compensation 14 years after her husband's death.
- Ms. D, a 22-year-old nurse, died from a heart attack after 34 hours of continuous duty five times a month.
As well as physical pressure, mental stress from the workplace can cause karōshi. People who commit suicide due to mental stress are called "karōjisatsu (過労自殺)." The ILO also lists some causes of overwork or occupational stress that include the following:
- All-night, late-night or holiday work, both long and excessive hours. During the long-term economic recession after the collapse of the bubble economy in the 1980s and 1990s, many companies reduced the number of employees. The total amount of work, however, did not decrease, forcing each employee to work harder.
- Stress accumulated due to frustration at not being able to achieve the goals set by the company. Even in economic recession, companies tended to demand excessive sales efforts from their employees and require them to achieve better results. This increased the psychological burden placed on the employees at work.
- Forced resignation, dismissal, and bullying. For example, employees who worked for a company for many years and saw themselves as loyal to the company were suddenly asked to resign because of the need for staff cutbacks.
- Suffering of middle management. They were often in a position to lay off workers and torn between implementing a corporate restructuring policy and protecting their staff.
Effects on society
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Suicide can be induced by overwork related stresses or when businessmen are laid off from their jobs. The deceased person's relatives demand compensation payments when such deaths occur. Life insurance companies started putting one-year exemption clauses in their contracts. They did this so that the person must wait one year to commit suicide in order to receive the money.
There is a new movement of Japanese workers, as a result of Karoshi. Young Japanese are choosing part-time work over their elder counterparts who work over-time. This is a new style of career choice for the young Japanese people who want to try out different jobs in order to figure out their own potential. This is where they work for "hourly wages rather than regular salaries."  They are called "freeters." The number of "freeters" have increases throughout the years. It increased from 200,000 in the 1980s to about 400,000 in 1997. A special kind of employment defined by Atsuko Kanai, as those who are currently employed and referred to as, "part-time workers or arbeit (temporary workers), who are currently employed but wish to be employed as part time workers, or who are currently not in the labor force and neither doing housework nor attending school but wish to be employed as part-time workers."  "Freeters" are not in school but they are ages 15–34 and if women, are unmarried. The movement of the "freeters" has its problems, however. Most "freeters" are failing to launch a successful career based on a few reasons. Due to their part-time work, their annual income is around 1 million yen or around $8,500 USD. Also, the economic growth in Japan is slow, making it difficult for "freeters" to switch to regular employment. Another problem is "freeters" are given menial tasks, which makes it almost impossible to gain any real experience, which is necessary when converting to full-time employment. (Kanai, 2003) It may seem as if being a "freeter" is the answer to the over worked, near Karoshi individual suffering from long work hours, however, being a non-regular employee or "freeter" who are supposedly wanting to only work part-time, are finding themselves working 60 hours a week or more. Since non-regular employees wages are so low, it is necessary for them to work longer hours, negating the desire to be a "freeter". "Freeters" are now facing the risk of karoshi just as regular workers due to their long hours.
There are other undesirable results, other than karoshi, that arise from working long hours. A psychological trait, known as workaholism has been shown to lead one to work long hours. (Spence & Robbins, 1992) There are three defining factors of workaholism, they are as follows: High work involvement, being driven to or compelled to work by inner pressures, and thirdly, low enjoyment of work. (Kanai, 1996). The latter suggests a contradiction. However, Kanai, argued that workaholism is not a psychological trait but rather results from adaptation to that work demand overload. Individuals that overload on work is not because they are workaholics but that the demand of the workload brings out psychologically and behavioral characteristics similar to those with workaholism. Management welcomes hard work and rewards with promotions. Morioka (2005), suggests that in order to eliminate the harmful effects of workaholism, the workplace should be responsible for managing workload issues.
Overworking also has a negative effect on the family. Men who become too busy with their jobs think less about their family. There is high family depression as a result. As the men focus on their jobs, they tend to develop negative feelings towards family. They take on less role in family life as they continue to overwork. The men see the family as something that is taking away from his work, which creates a resentment toward the family. As a result, avoiding family time increases, even though it is their family that inspires them to work hard in the first place (Kanai, 2002). The findings from Kanai suggest that excessive working hours are harmful to family life in that not only are they spending less time with their families, but they develop hostility towards the family.
However, it could also be said that the men had taken on these jobs for the sake of providing for their family, but ultimately become less effective as a resource due to their exhaustion and complete focus on earning money. It is likely salarymen go into that lifestyle simply for the money, because the jobs pay well, and if they work long hours they can earn large sums of money and send it to their families to help provide for them since in traditional Japanese families, the father is usually the main worker in the household. In an interview a man had said that "the best thing about being born male was, 'having a family, and being able to support that family.' Conversely the worst thing was 'being unable to quit your job even if you want to' due to the same responsibility."  The responsibility men have to provide for the family correlates with their masculinity, so if a man gets laid off they may think that "their own ability is really poor, and would get quite depressed."  These pressures are ones that society puts on them since it is expected that the men work and provide for the family.
The suicide prevention hotline in Japan is often so busy, callers on occasion have to try between 30 to 40 times until they can get an answer. And each year, roughly 300,000 people in Japan commit suicide - which is a number similar to the population of Iceland. A potential reason why the number is so high, could be the kind of camaraderie in the process of committing suicide, where people will spend time searching online to find other suicidal individuals and then "make plans to die together."
A Japanese businessman, also known as a salaryman サラリーマン ("'sararīman'"), is often a victim of 'karōshi' due to the strenuous work hours their job requires, in addition to the mandatory after-hours socializing and drinking that their jobs require. Often these salarymen are invited to nomikai, or "drinking parties," to build better connections between coworkers in the company. According to an article on Gaijinpot, "A common saying in Japan is, 'if you want to work your way up the corporate ladder you have to drink.' This was how many older generation workers established relationships and considered this the normal way of doing business." According to that, a key to success in business was to go out and participate in this mandatory socializing with coworkers. Since not everyone can keep up with the pace and immersion of salaryman life, stress-induced death became fairly common. Due to this high-stress nature of a salaryman's job, death by cardivascular diseases or mental disorders were some of the two biggest factors.
Since Japanese businessmen are under a lot of work-related pressures, karōshi suicides have increased, especially due to economic crises. Even those that were able to keep their jobs, after their company laid off multiple employees, experienced a large increase in work. "In 2000, 28% of regular Japanese employees worked 50 hours or more per week, compared to 16% to 21% in New Zealand, USA, Australia and the UK and less than 6% in 13 other industrialized nations."
Businessmen in Japan have been overworked, but physicians specifically have been feeling great pressures of being overworked, while still facing a moral obligation to continue. Physicians work an average of 65 hours a week or more. "They are reaching the limit in terms of the number of service hours they can provide without risking their own health.”  The government used to have restrictions on the number of physicians that could attend medical school, but now they have increased medical school enrollment. It takes years for physicians to become qualified, so it is critical that alternate measures come into play before karōshi takes a toll on physicians in Japan.
A number of companies have been making an effort to find a better work-life balance for their employees. Toyota, for example, now generally limits overtime to 360 hours a year (an average of 30 hours monthly), and, at some offices, issues public address announcements every hour after 7 p.m. pointing out the importance of rest and urging workers to go home. Nissan offers telecommuting for office workers to make it easier to care for children or elderly parents. Dozens of large corporations have also implemented "no overtime days", which require employees to leave the office promptly at 5:30 p.m. However, since their workload is too high, few workers can actually take advantage of this, and opt to stay in the office with the lights off or to simply take their work home, "cloaked overtime" called "furoshiki" (風呂敷) after the Japanese traditional wrapping cloth.
In 2007, Mitsubishi UFJ Trust & Banking, a division of Japan's largest banking group, started to allow employees to go home up to 3 hours early to care for children or elderly relatives. As of January 5, 2009, just 34 of the company's 7,000 employees had signed up for the plan.
The problem with unpaid overtime in companies is that the overtime is simply not recorded in many cases. The amount of overtime is regulated by labor regulations, so, in order to not contradict labor regulations, workers are told not to record the overtime, since it would be considered an illegal action from the side of the company. The workers themselves often rationalize this by attributing the overwork to lacking skills from their side, describing a lack of familiarity with the work, "not being trained enough" as the cause for not being able to finish in a more timely manner. In general, overtime is something that is accepted as part of work, and protest against it is rare, due to concern for the reaction of colleagues, superiors and even family and friends. "Seken" (世間), or the "public gaze" (others' opinions about one's behavior) is a strong cultural factor in this. It is safe to assume that most statistics of overtime in Japanese companies are not accurate, since overtime is not recorded in many occasions. It is not uncommon for many Japanese employees to work late hours until 2-3am, and being expected to be in the office again at 9am. In some cases (especially in subsidiaries of big listed companies that have to cope with the pressure of parent companies, who generate margins through exploitation of daughter companies) employees have been reported to have worked 300 hours of overtime in a single month. These statistics are in almost all cases not official, and most employees would always refrain from making such statements to authorities or the press, nor would they agree to be named.
In China, the analogous "death by overwork" concept is guolaosi, which in 2014 was reported to be a problem in the country. In Eastern Asian countries, like China, many businessmen work long hours and then feel the pressures of expanding and pleasing their networks. Making these connections is called building guanxi. Connections are a big part of the Chinese business world, and throughout different parts of China, businessmen would meet up in teahouses to take their job outside of the work atmosphere. It was important for businessmen to broaden their guanxi relationships, especially with powerful officials or bosses. There is a lot of pressure to go to these nightclubs almost every night to drink heavily to move up in the business world. It has been shown that this kind of work could lead to health related problems down the line. For example, a businessman named Mr. Pan discussed with John Osburg, an anthropologist who wrote “Anxious Wealth: Money and Morality Among China’s New Rich,” about his health and the need to continue working. Mr. Pan, the ‘biggest boss in Chengdu,’ was in the hospital for ‘excessive drinking.’ This has happened to him before. Mr. Pan said, “I can’t stop or slow down. I have many people whose livelihoods depend on me (literally ‘depend on me to eat.’). I’ve got about fifty employees and even more xiongdi. Their livelihoods depend on my success. I have to keep going.” 
Even though this situation above is not a literal example of guolaosi where actual death has taken place, it demonstrates the demands businessmen have to face in order to succeed. After the long hours that businessmen work, they spend many more hours a few days a week going to these nightclubs and drinking. Just like it did to Mr. Pan, excessive drinking and long hour workdays can eventually lead to many other health issues to those participating in this kind of environment in the future.
The French-German TV channel Arte showed a documentary called "Alt in Japan" (Old in Japan) on 6 November 2006 dealing with older workers in Japan. In 2008, karōshi again made headlines: a death back in 2006 of a key Toyota engineer who averaged over 80 hours overtime each month was ruled the result of overwork. His family was awarded benefits after his case was reviewed.
Taiwanese media have reported a case of karōshi. An engineer had worked for Nanya Technology for 3 years from 2006 to 2009. It was found that he died in front of his computer which was surrounded by company documents. The prosecution found that the engineer had died of cardiogenic shock. The engineer's parents said that he had usually worked for 16–19 hours a day. CNN shows another reported case of karōshi in Taiwan. This short clip called "The Dangers of Overwork" shows a man who suffered a stroke and was left for three hours until taken to the hospital. It was made known that physicians are starting to make people more aware of these health deficits due to overworking. More people have been visiting their doctor, recognizing these signs and symptoms.
The Forest, a movie released in early 2016, uses suicide as its main focus. Aokigahara is a forest near Mt. Fuji in Japan where many people have gone to die, and is the main focus location of the movie. The trailer, shows Aokigahara and the mysterious happenings that go on there. While the movie itself is a fictional account, the concept of Aokigahara as a "suicide forest" remains intact.
Saving 10,000, a documentary about suicide in Japan, brings to light a lot of problems with Japan and its suicide mentality - mentioning that "death is always a best-seller and it made here (Tōjinbō) a tourist attraction." The reason being that a local author (Takami Jun, author of "From the Edge of Death") had committed suicide by jumping off the cliffs in that location and killed himself. Whether in inspiration or homage, these locations where authors commit suicide then become a hotspot for others to go to kill themselves as well. In addition, in Japanese TV and drama, it is very popular to have dramatic scenes of a character committing suicide.
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- Apple Daily, 27 September 2010 月加班 百小時 29歲工程師過勞死
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