Over-work is a consequence of excessive competition and stress in the modern-day workplace, as well as of an imbalance in relations between labor and management. And death from over-work has become a working nightmare of this new economic age. In the past it was thought that acute diseases of the circulatory system, like myocardial infarction, caused by over-work were mostly concentrated among middle-aged males over 40. But in 2010, the sudden death of a 29-year-old engineer raised a social outcry, thrusting the topic of over-work to the fore once again.

With respect to their role in the global economy, Taiwan's businesses are gradually shifting their emphasis from manufacturing to R&D and brand marketing. But many manufacturers still demand long working hours to offset costs, resulting in overwork among both blue- and white-collar workers.

In September 2010, the parents of the engineer, surnamed Xu, who had worked for Nanya Technology, appealed to legislator Huang Sue-ying for help. Their son had died suddenly on January 11 at a computer desk in his home. In the month before his death, he had logged 111.5 hours of overtime, and during his tenure of over three years he had routinely worked 16 to 19 hours a day. Also, over a year before his death, the status of his job was shifted to the so-called "responsibility system," and he was not only made responsible for the company's manufacturing production rate, but also had to be available for rotating night shifts and be on call 24 hours a day, often bringing his work home with him.

According to Xu's father's complaint, the medical examiner's report said the cause of death was cardiogenic shock, with "cardiac complications from over-work" as a contributing physical condition. A physician from the CLA's Center of Occupational Disease and Injury Service corroborated this with a diagnosis of "sudden death related to over-work." Yet when the family applied to the Bureau of Labor Insurance for compensation due to death from an occupational hazard, the BLI refused to pay up on the grounds that the "sudden death from cardiogenic shock was unrelated to his hours of overtime." The BLI accepted the employer's formula for calculating Xu's working hours, under which 1.5 hours per day was deducted for lunch and dinner, so his overtime came to only 94.5 hours; this was clearly a conscious effort to keep Xu's hours below the legal definition of over-work (in this case, 100 hours of overtime in the month preceding the fatal illness).

The publicity given to this case led to pressure from public opinion and labor organizations on the CLA to revise the criteria for defining over-work.

The CLA admitted that although it had amended the Criteria for Diagnosis of Acute Occupational Diseases of the Circulatory System in 2004 to adapt to changes in the workplace, the approval criteria remained too stringent, resulting in over-work being accepted as the cause of occupational illness less in Taiwan than in other countries.

Statistics for 2008 show that 1,513 employees died from cardiovascular and cerebrovascular disease, and since the International Labour Organization estimates that occupation contributes to 23% of cases of circulatory system diseases, some 347 of these deaths can be attributed to work. Yet in that year, only 34 cases of over-work received compensation, less than one tenth of the ILO estimates.

The old system was unreasonable in that to count as death from overwork, one of the following four conditions had to be met: (a) 24 hours of constant work prior to death; (b) 16 hours of work per day during the week preceding death; (c) over 100 hours of overtime during the month before the onset of sickness; or (d) over 80 hours of total overtime per month during the two to six months prior to the onset of illness.

Moreover, in the past, the burden of proof was on labor. However, employers were unlikely to admit to having records showing that any of the above criteria had been met, as this would have put them in violation of the Labor Standards Act. Also, many jobs involve field work and can't be recorded by a time clock; some employees bring their work home with them, carrying on with their jobs in the evenings or on days off; and some employees are required to be on call and ready to work at any time-thus, merely looking at records such as punch cards and time sheets are insufficient to reflect the reality of the work situation.

There are four key elements in the new standards for defining over-work. First, even workers with a history of cerebrovascular or cardiovascular disease are included. As long as a doctor certifies that "work-related factors have caused the disease to become significantly worse than would be expected by natural progression," then in principle their illnesses can also be considered occupational.

The CLA notes that even when patients' medical conditions are exacerbated by aging, poor diet, drinking and/or smoking, these cannot be used to rule out occupation as an important aggravating risk factor for the disease. In future case reviews, investigation into the degree of contribution of occupation toward illness will be of priority.

Second, the number of hours under the four criteria listed earlier for defining over-work have been reduced by eight hours each. More importantly, for short-term over-work, the inflexible criteria of working hours alone will be nullified; the new criteria will include both "working hours" and "nature of work." Factors to be considered will henceforth include not only long hours but also irregular shifts, frequent business trips, exposure to extreme temperatures or noise, and mental stressfulness of the work, with final judgment to be made by a doctor specializing in occupational diseases.

Third, there are four new recognized categories of illness. In addition to the seven diseases recognized under the old rules, ischemic heart disease, acute arrhythmia, cardiac arrest, and sudden cardiogenic death will be added.

Fourth, the CLA has adopted in principle placing the burden of proof on the employer. In determining workload, the opinions of the employee or family will be heard first, and then the employer will be asked to provide evidence. If the employer is unable to disprove the claims, the party representing the employee will be believed.

As to the efficacy of this new system of standards, the CLA predicts that the number of applications for such cases will rise to around 350. Assuming a third of them are approved, that means that the number of cases to be adjudicated will grow to well over 100.

In any event, incorporating over-work into occupational disease is merely a baseline for safeguarding worker dignity. Labor organizations are appealing to the government for more than just rectifying outdated definitions; there is also a need to prevent over-work, including better enforcement of the Labor Standards Act and related regulations, penalizing employers that violate the law, and curbing corporate abuse of the "responsibility system" at its source.

More importantly, the general public should remain vigilant: the phenomenon of over-work should not be ascribed to improper maintenance of personal health, but recognized as a problem with the social structure and work system. Only by striving together for a more reasonable and humane work ethic can we modern people avoid the anguish of over-work and enjoy the fruits of our labor.