20
57, 2015
J Occup Health 2015; 57: 2027
Long working hours and psychological distress among school
teachers in Japan
Akira Bannai1, Shigekazu Ukawa1 and Akiko Tamakoshi1
Department of Public Health, Hokkaido University Graduate School of Medicine, Japan
1
Abstract: Long working hours and psychological
distress among school teachers in Japan: Akira
BANNAI, et al. Department of Public Health, Hokkaido
University Graduate School of MedicineObjec-
tives: Long working hours have the possibility to inu-
ence human health. In Japan, it is well known that
teachers have long working hours, and the number of
leaves of absence due to mental disorders among public
school teachers increased from 2,687 in 2002 to 4,960
in 2012. The aim of this study was to investigate the
association between long working hours and psycho-
logical distress among school teachers. Methods: This
cross-sectional study was conducted from mid-July to
September in 2013 in Hokkaido Prefecture, Japan.
Questionnaires were distributed to 1,245 teachers in
public junior high schools. Information about basic
characteristics, including working hours, and responses
to the General Health Questionnaire-28 were collected
anonymously. Multiple logistic regression analysis was
used to calculate odds ratios (ORs) for the association
between long working hours and psychological distress
by gender. Results: Of the 1,245 teachers contacted,
558 (44.8%) responded. After excluding responses with
missing data, the nal sample included 522 teachers
(337 males and 185 females). Psychological distress
was identied in 47.8% of males and 57.8% of females.
Our results showed a signicantly increased risk only
in males working >60 hours per week (adjusted OR=4.71
[95% CI 2.0411.56]) compared with those working 40
hours per week. There were no signicant associations
between long working hours and psychological distress
for females. Conclusions: There is a signicant asso-
ciation between long working hours and psychological
distress in male teachers. However, the causal relation-
ship remains unclear. Further studies such as cohort
studies with large sample sizes are needed.
(J Occup Health 2015; 57: 2027)
Received Jun 3, 2014; Accepted Sept 29, 2014
Published online in J-STAGE Nov 21, 2014
Correspondence to: A. Tamakoshi, Hokkaido University Graduate
School of Medicine, Department of Public Health, Kita 15 Jo Nishi
7 Chome, Kita-ku, Sapporo-shi, Hokkaido 060-8638, Japan (e-mail:
tamaa@med.hokudai.ac.jp)
J Occup Health, Vol.
Journal of
Occupational Health
Key words: Gender, Mental health, Occupational
health, School teacher, Work time
Long working hours is a problematic issue for
workers, because it not only deprives workers of free
time but may also have detrimental effects on human
health. A great deal of research has been conducted
to clarify the association between long working hours
and health; however, the conclusions remain contro-
versial1). Therefore, a previous systematic review1)
focused on differences in definitions of long working
hours among past studies and on the harmful effects
on health brought on by shift work schedules, and
clarified that long working hours is associated with
increased risks of coronary heart diseases, anxiety,
depressive state, and sleep conditions.
A c c o r d i n g t o O rg a n i s a t i o n f o r E c o n o m i c
Co-operation and Development (OECD) statistics,
the average annual hours actually worked per worker
in OECD countries decreased gradually from 1,881
hours in 1990 to 1,773 hours in 20122). However,
a report issued in 2007 by the International Labour
Organization (ILO) estimated that, worldwide, 22.0%
of workers (or 614.2 million) were working more than
48 hours per week3). Thus, some workers continue to
work long hours.
In Japan, it is well known that school teachers
work long hours. Sakai4) reported 2005 survey results
showing that school teachers, on average, worked
53.1 hours of overtime per month. Recently, the
Teaching and Learning International Survey (TALIS)
20135), conducted by the OECD, also revealed that
school teachers in Japan had the longest working
time (53.9 hours per week) of school teachers in the
34 participating countries and regions. Additionally,
the increasing number of leaves of absence taken by
school teachers in Japan is an urgent issue against
which countermeasures have been implemented. Over
the last decade (20022012), the leaves of absence
taken by public school teachers because of illness
increased from 5,303 to 8,341, and the proportion
of mental disorders among them also increased from
 Akira BANNAI, et al.: Long working hours and psychological distress among teachers
50.7% (n=2,687) to 59.5% (n=4,960)6, 7).
To the best of our knowledge, no study has investi-
gated the association between long working hours and
mental disorders among school teachers. Furthermore,
the association between long working hours and
psychological distress among school teachers appears
to have been investigated only in a part of one previ-
ous study8). However, no association was found in
that study, and detailed data were not shown in the
article.
We identified several previous studies815) about the
association between long working hours and psycho-
logical distress that targeted occupational groups
other than school teachers. However, the results of
those studies were inconsistent. Long working hours
increased the risk of psychological distress significant-
ly among both male and female participants in three
studies 8, 10, 11). However, the results for males and
females were not in the same direction. For males,
one study12) indicated no association, but two other
studies13, 14) revealed that long working hours signifi-
cantly increased the risks of psychological distress.
For females, two previous studies9, 12) showed signifi-
cantly increased risks of psychological distress for
those working long hours, but three other studies1315)
indicated no association. Referring to past work16, 17),
we were able to infer several reasons for the inconsis-
tency in previous findings. These include the indis-
tinct definition of long working hours; differences of
working hours categories including the reference cate-
gories; the lack of data about shift work schedules,
which have a detrimental influence on psychological
distress18); the disparity in participant characteristics
such as occupation; and geographic variation in study
sites. With this background, we aimed to investi-
gate the association between long working hours and
psychological distress among school teachers in this
study.
Subjects and Methods
Study design and participants
We conducted a cross-sectional study in Hokkaido
Prefecture, an island located in the north of Japan.
The study participants were teachers working at public
junior high schools in Hokkaido Prefecture except for
Sapporo City. Out of the total 8,873 teachers at 534
public junior high schools in the region, we invited
1,245 teachers from 84 schools to participate in our
study. In this study, we regarded teachers without
any occupational position as eligible for participation.
This meant that we did not include principals, vice-
principals, or chief teachers in the sample. We also
did not include lecturers, school nurses, or nutrition
teachers because of the distinctive nature of these
jobs.
21
Sample size was estimated at 1200 based on the
following assumptions: power (1 )=80%; two-sided
test at =0.05; effect size of odds ratio (OR)=2.0 for
psychological distress, estimated with reference to
a previous study10); and predicted return rate=50%.
Hokkaido Prefecture has 14 administrative districts,
and the total sample size of 1,200 was divided accord-
ing to the proportion of the total number of teachers
working in each of these districts. The Hokkaido
Government Board of Education randomly selected
public junior high schools from all 14 districts. All
teachers working in the selected schools were eligible
for participation in this study, and the Board contin-
ued to select schools in each district until the number
of teachers exceeded the number initially set.
The questionnaires, along with a letter explaining
the purpose of the study and a stamp-addressed enve-
lope, were distributed to all 1,245 teachers via the
selected schools in mid-July 2013. Reminders about
participation in the study were issued in late August
by principals or vice-principals in each school through
teacher conferences. Teachers agreeing to participate
answered the questionnaires anonymously and posted
them by themselves. Data collection was conducted
until September 30, 2013. Because this survey was
both voluntary and anonymous, completing the ques-
tionnaire and sending it back was regarded as provid-
ing consent to participate in this study. This study
protocol was approved by the Ethics Committee of
Hokkaido University Graduate School of Medicine.
Psychological distress and working hours
Psychological distress was assessed by the General
Health Questionnaire-28 (GHQ-28)19, 20), which was
developed by Goldberg et al. This scale reflects the
respondents mental state in the previous 23 weeks.
We used the GHQ method19, 20) to rate each question
across four answers, and added the score on each item
to calculate the total GHQ-28 score. The GHQ meth-
od assigns a score of 0 to the two least symptomatic
answers and a score of 1 to the two most symptom-
atic answers. A higher total score indicates heavier
psychological distress. We regarded a total score of
6 as a case of psychological distress20).
We asked about working hours in the questionnaire
using the following question: In the month prior
to the summer vacation of your students, how many
hours on average in a week did you work, including
work brought home? The participants could select
from four categories of working hours: 40, >40 and
50, >50 and 60, and >60 hours per week. The
summer vacation of junior high school students in
Hokkaido Prefecture typically starts in late July and
lasts until mid-August. All participants in the study
had 38.75 weekly contracted working hours. In this
 22
study, we regarded long working hours as >40 hours
per week. Working hours included hours of work
brought home, because participants with household
duties might have to return home at regular closing
hours, taking their unfinished work with them.
Other data collection
We collected data related to personal background
such as age (2029, 3039, 4049, or 50), gender
(male or female), and marital status (married or
others). Information related to work was also collect-
ed, including type of employment (regular or tempo-
rary), classes in the school (3 classes, 46 classes,
or 7 classes), subjects led (general, special support,
or others), and work experience in the current school
(<3 years or 3 years). Classes in the school were
used to approximate the size of the school. General
subjects included Japanese, social studies, mathemat-
ics, science, foreign languages, music, art, physical
and health education, technical courses, and home
economics. Because more than half (62.0%) of the
teachers who took leaves of absence owing to mental
disorders in 2012 had less than 3 years of work expe-
rience in their school21), we suspected that work expe-
rience in the current school affected psychological
distress. Based on previous studies about teachers8, 22),
information was also gathered on the respondents
perceptions of relationships with colleagues (very
good/good or neutral/bad/very bad), job satisfaction
(very satisfied/satisfied or dissatisfied/very dissatis-
fied), and having 5 hours per week of leisure time
(yes or sometimes/never). In this survey, we used the
Pittsburgh Sleep Quality Index (PSQ-I)23, 24) to assess
sleep problems (global scores of 5.5) for understand-
ing their prevalence among school teachers. We also
inquired about participants working patterns (working
daytime hours on weekdays, working several hours
per day on weekdays, or irregular working pattern) to
exclude those working less than the contracted work-
ing time or working irregularly.
Statistical analysis
First, we showed the descriptive statistics about
the basic characteristics of the participants according
to working hours. Second, we calculated ORs and
95% confidence intervals (95% CI) using multiple
logistic regression analysis to investigate the associa-
tion between long working hours and psychologi-
cal distress. We presented the results separately by
gender, because the prevalence of psychological
distress has been shown to differ between the genders
in previous studies10, 1214), and Ervasti et al.25) pointed
out that one of the predictors for teachers long
sick leave was female gender. Participants work-
ing 40 hours per week were used as the reference
J Occup Health, Vol. 57, 2015
category. Two models were constructed. Model 1
was adjusted for personal factors (age and marital
status) and work-related factors (type of employment,
classes in the school, subjects led and work experi-
ence in the current school). Model 2 was additionally
adjusted for variables gauging perceptions about the
job (relationships with colleagues and job satisfaction)
and having leisure time. The results of the PSQ-I
were not used as covariates, because the GHQ-28
also included questions about sleep problems. Tests
for linear trends were calculated for the associations
between working hours converted into a continuous
variable (0, 1, 2, 3) and psychological distress.
Two-tailed tests were used, and P-values below 0.05
were considered statistically significant. All statisti-
cal analyses were performed using JMP Pro 11 for
Windows (SAS Institute Inc., Cary, NC, USA).
Results
A total of 558 (44.8%) of the distributed question-
naires were returned. We excluded responses from
five school nurses and one teacher working irregu-
larly as well as 30 participants with missing data on
working hours, psychological distress, marital status,
subjects led, or job satisfaction. The final analyses
were performed on 522 teachers (337 males and 185
females) working daytime hours and not working on
a shift schedule. The prevalence of psychological
distress was 47.8% for males (n=161) and 57.8% for
females (n=107). In this study, 84.6% of males and
90.8% of females worked >40 hours per week.
Table 1 shows the characteristics of male and
female participants by working hours. The prevalence
of psychological distress in male and female teach-
ers, respectively, was 25.0% (n=13) and 64.7% (n=11)
among those working 40 hours per week, 45.2% (n=19)
and 54.1% (n=20) among those working >40 and 50
hours per week, 42.1% (n=37) and 55.0% (n=33)
among those working >50 and 60 hours per week,
and 59.4% (n=92) and 60.6% (n=43) among those
working >60 hours per week.
Compared with those working 40 hours per week,
respondents of both genders working >40 hours per
week were more likely to be younger, to be in charge
of general subjects or special support classes, and
to have <3 years of work experience in the current
school. Those working long time were less likely
to be married, to perceive good relationships with
colleagues, to be satisfied with their job, and to have
leisure time compared with those working 40 hours
per week. Male participants working >40 hours per
week were more likely to belong to schools with 7
classes compared with those working 40 hours per
week; however, female participants showed oppo-
site results. Female participants working >40 hours
 Akira BANNAI, et al.: Long working hours and psychological distress among teachers 23

Table 1. Characteristics of the male (n=337) and female (n=185) participants by working hours
Male (n=337) Female (n=185)

Working hours (h/wk) 40 >40 and 50 >50 and 60 >60 40 >40 and 50 >50 and 60 >60

n 52 42 88 155 17 37 60 71

n (%) n (%) n (%) n (%) n (%) n (%) n (%) n (%)

Psychological distressa
13 (25.0) 19 (45.2) 37 (42.1) 92 (59.4) 11 (64.7) 20 (54.1) 33 (55.0) 43 (60.6)
Age (years)
2029 4 (7.7) 8 (19.1) 18 (20.4) 25 (16.1) 3 (17.7) 6 (16.2) 14 (23.3) 16 (22.5)
3039 14 (26.9) 11 (26.2) 33 (37.5) 67 (43.2) 4 (23.5) 9 (24.3) 16 (26.7) 23 (32.4)
4049 22 (42.3) 15 (35.6) 24 (27.3) 51 (32.9) 6 (35.3) 16 (43.3) 23 (38.3) 21 (29.6)
50 12 (23.1) 8 (19.1) 13 (14.8) 12 (7.8) 4 (23.5) 6 (16.2) 7 (11.7) 11 (15.5)
Marital status
Married 38 (73.1) 27 (64.3) 61 (69.3) 109 (70.3) 8 (47.1) 24 (64.9) 23 (38.3) 30 (42.3)
Othersb 14 (26.9) 15 (35.7) 27 (30.7) 46 (29.7) 9 (52.9) 13 (35.1) 37 (61.7) 41 (57.7)
Type of employment
Regular worker 49 (94.2) 37 (88.1) 80 (90.9) 152 (98.1) 14 (82.3) 35 (94.6) 55 (91.7) 69 (97.2)
Temporary worker 3 (5.8) 5 (11.9) 8 (9.1) 3 (1.9) 3 (17.7) 2 (5.4) 5 (8.3) 2 (2.8)
Classes in the school
3 classes 8 (15.4) 4 (9.5) 11 (12.5) 8 (5.2) 2 (11.8) 8 (21.6) 6 (10.0) 7 (9.9)
46 classes 14 (26.9) 17 (40.5) 17 (19.3) 31 (20.0) 3 (17.6) 15 (40.6) 18 (30.0) 17 (23.9)
7 classes 30 (57.7) 21 (50.0) 60 (68.2) 116 (74.8) 12 (70.6) 14 (37.8) 36 (60.0) 47 (66.2)
Subjects led
Generalc 38 (73.1) 32 (76.2) 62 (70.5) 132 (85.2) 9 (52.9) 22 (59.5) 40 (66.7) 45 (63.4)
Special support 4 (7.7) 6 (14.3) 14 (15.9) 9 (5.8) 2 (11.8) 4 (10.8) 8 (13.3) 10 (14.1)
Othersd 10 (19.2) 4 (9.5) 12 (13.6) 14 (9.0) 6 (35.3) 11 (29.7) 12 (20.0) 16 (22.5)
Work experience in the current
school
<3 years 22 (42.3) 25 (59.5) 58 (65.9) 84 (54.2) 10 (58.8) 25 (67.6) 41 (68.3) 40 (56.3)
3 years 30 (57.7) 17 (40.5) 30 (34.1) 71 (45.8) 7 (41.2) 12 (32.4) 19 (31.7) 31 (43.7)
Relationships with colleagues
Very good/good 42 (80.8) 32 (76.2) 69 (78.4) 103 (66.4) 13 (76.5) 27 (73.0) 43 (71.7) 42 (59.1)
Neutral/bad/very bad 10 (19.2) 10 (23.8) 19 (21.6) 52 (33.6) 4 (23.5) 10 (27.0) 17 (28.3) 29 (40.9)
Job satisfaction
Very satisfied/satisfied 39 (75.0) 29 (69.1) 63 (71.6) 101 (65.2) 11 (64.7) 20 (54.0) 39 (65.0) 41 (57.7)
Dissatisfied/very dissatisfied 13 (25.0) 13 (30.9) 25 (28.4) 54 (34.8) 6 (35.3) 17 (46.0) 21 (35.0) 30 (42.3)
Having 5 h/wk of leisure time
Yes 26 (50.0) 15 (35.7) 40 (45.5) 55 (35.5) 9 (52.9) 12 (32.4) 30 (50.0) 26 (36.6)
Sometimes/never 26 (50.0) 27 (64.3) 48 (54.5) 100 (64.5) 8 (47.1) 25 (67.6) 30 (50.0) 45 (63.4)
Sleep problemse, f
5.5 of PSQ-I global score 17 (32.7) 16 (38.1) 32 (36.4) 71 (45.8) 8 (47.0) 12 (32.4) 24 (40.0) 35 (49.3)
<5.5 of PSQ-I global score 32 (61.5) 24 (57.1) 55 (62.5) 80 (51.6) 8 (47.0) 24 (64.9) 36 (60.0) 32 (45.1)

h/wk, hours per week; PSQ-I, Pittsburgh Sleep Quality Index. aPsychological distress means total scores of the General Health Questionnaire-28 of
6. bOthers means unmarried, divorced, widowed, and separated. cGeneral subjects include Japanese, social studies, mathematics, science, foreign
languages, music, art, physical and health education, technical courses, and home economics. dOthers means teachers who led multiple subjects
simultaneously. eSleep problems refer to global scores of PSQ-I of 5.5. fTotal proportion does not add to 100% owing to the missing data.

per week were more likely to be regular workers female participants.

compared with those working 40 hours per week.
The prevalence of sleep problems was 40.4% (n=136)
in males and 42.7% (n=79) in females. Male partici-
pants working >40 hours per week were more likely
to have sleep problems compared with those working
40 hours per week, but the results were reversed for
Table 2 shows the association between long work-
ing hours and psychological distress by gender.
Significant results were observed only in male partici-
pants. In the crude model for males, long working
hours significantly increased the risk of psychological
distress compared with working 40 hours per week
 24 J Occup Health, Vol. 57, 2015

(p for trend <0.001). After adjusting for personal and

adjusted for relationships with colleagues (very good/good or neutral/bad/very bad), job satisfaction (very satisfied/satisfied or dissatisfied/very dissatisfied), and having 5 h/wk of
Table 2. Odds ratios for the association between long working hours and psychological distress by gender (male n=337 and female n=185). Results from multiple logistic regression

CI, confidence interval; h/wk, hours per week; OR, odds ratio. aAdjusted for age (2029, 3039, 4049, 50), marital status (married, others), type of employment (regular, tempo-

leisure time (yes or sometimes/never). cCase means total scores of General Health Questionnaire-28 of 6. dThe test for trend was calculated across increasing categories of working
rary), classes in the school (3, 46, 7), subjects led (general, special support education, others) and work experience in the current school (<3 years, 3 years). bModel 1 additionally
(0.111.92)
(0.162.12)
(0.152.02)
(95% CI)
work-related factors (Model 1), significantly increased

p=0.68
adjusted ORs (aORs) were observed for males work-
Model 2b

ing >50 and 60 hours per week (aOR=2.24 [95%

CI 1.025.13]) and >60 hours per week (aOR=5.09
1.00
0.48
0.61
0.58
[95% CI 2.4211.32]) compared with those working
OR

40 hours per week (p for trend <0.001). The fully

adjusted model (Model 2) showed significant results
(0.222.83)
(0.222.27)
(0.262.66)
only for males working >60 hours per week (aOR=4.71
(95% CI)

p=0.90
[95% CI 2.0411.56]) for psychological distress
Model 1a

compared with those working 40 hours per week (p

Female (n=185)

for trend <0.001). The results for females showed

decreased ORs and aORs for all other working hours
1.00
0.82
0.73
0.86
OR

categories compared with those working 40 hours per

week, but these results were not significant.
(0.192.06)
(0.211.99)
(0.262.47)
(95% CI)

Discussion
p=0.88

In this study, we explored the association between

Crude

long working hours and psychological distress

among male and female junior high school teachers.
1.00
0.64
0.67
0.84
OR

Significant results were observed only in male partici-

pants. After adjusting for age, marital status, type of
n (Casec)

employment, classes in the school, subjects led, work

17 (11)
37 (20)
60 (33)
71 (43)

experience in the current school, relationships with

colleagues, job satisfaction, and having leisure time,
males working >60 hours per week had a significantly
(2.0411.56)

increased 4.71-fold risk of psychological distress

(0.887.04)
(0.985.93)
(95% CI)

p<0.001

compared with those working 40 hours per week. In

b
Model 2

contrast, in females, working long hours showed no

association with psychological distress.
In this study, the prevalence of psychological
1.00
2.45
2.35
4.71
OR

distress was higher in females (57.8%) than in males

(47.8%). This tendency coincided with previous stud-
ies10, 1214). The main findings from the present study
(2.4211.32)
(1.006.41)
(1.025.13)
(95% CI)

p<0.001

of increased risks for males were partially consistent

a

with previous studies1214). A previous study reported

Model 1
Male (n=337)

by Artazcoz et al. in 200913) indicated a significantly

increased risk of psychological distress in males
1.00
2.50
2.24
5.09
OR

working 5160 hours per week (maximum working

hours category). Takusari et al.14) also showed a
significantly increased risk of psychological distress
(1.046.05)
(1.044.76)
(2.219.15)
(95% CI)

in males working 45 hours per month of overtime.

p<0.001

However, another study reported by Artazcoz et al. in

Crude

200712) showed no association between long working

hours and psychological distress among male salaried
contract workers, but the results of that study might
1.00
2.48
2.18
4.38
OR

be attributable to the lack of covariates such as shift

work schedules.
n (Casec)

155 (92)
52 (13)
42 (19)
88 (37)

We observed a gender difference in the risks of

psychological distress by working hours. A previous
analysis

study by Virtanen et al.26) reporting the association

hours per week.
>40 and 50
>50 and 60

between long working hours and symptoms of anxiety

p for trendd
Working

and depression by gender showed that only females

(h/wk)
hours

had significantly increased hazard ratios for these

>60
40

two symptoms. The reasons discussed by the authors

 Akira BANNAI, et al.: Long working hours and psychological distress among teachers
might also explain the gender difference in our
results. The first was that females often had an extra
burden due to extended hours of work and domestic
chores. The second was that working long hours was
less normative for females and might be more stress-
ful, for example, in terms of workfamily conflict.
Females may be more influenced by domestic life
than males, especially in Japan, where husbands spend
less time on housework than husbands in Western
countries27). This might relate to the high prevalence
of psychological distress among females despite the
difference in working hours. Therefore, it might be
difficult to discover the disparity of risks of psycho-
logical distress by working hours among females in
this study.
We compared the prevalence of psychological
distress in our study with findings on other occupa-
tional groups in Japan to explore potential explana-
tions for our results. Urakawa et al.28) revealed that,
among factory workers, 27.1% of males and 30.4%
of females had psychological distress. Takusari et
al.14) observed psychological distress in 31.4% of male
workers and 33.5% of female workers in medium-
sized business establishments including construc-
tion, information and communication, manufacturing,
combined services, retail trade, and medical welfare.
Hayasaka et al. 9) investigated the work environ-
ment among female doctors, reporting a prevalence
of 41.6% for psychological distress. Nagai et al.8)
showed that 46.4% of civil servants had psychological
distress.
Our study showed that the prevalence of psycho-
logical distress among school teachers was 47.8% in
males and 57.8% in females (total prevalence=51.3%).
These numbers were higher than the results for other
professions but lower than those for school teachers
in a previous study8) (62.9%, including both genders).
Furthermore, a higher prevalence (68.8%) has been
reported among female hospital nurses29). Based on
these results, school teachers showed a relatively high
prevalence of psychological distress compared with
other kinds of workers in Japan. Hospital nurses
also had a high prevalence of psychological distress.
These are both human service industry occupations,
and have a common background that has been well
researched in terms of burnout syndrome in Japan
since the 1980s30). These characteristics might be
related to the high prevalence of psychological
distress.
As mentioned in the introduction, only one previ-
ous study reported the association between long work-
ing hours and psychological distress among school
teachers8). However, the result was not significant
and detailed data were not shown in the article.
Therefore, our study is considered the first to focus
25
on the association between long working hours and
psychological distress among school teachers. Our
results revealed that school teachers of both genders
worked long hours, and about 40% or more worked
>60 hours per week. We also confirmed an increased
risk of psychological distress among male school
teachers working >60 hours per week.
A plausible explanation for the association between
long working hours and psychological distress is that
long working hours may influence workers mental
health by reducing the amount of private time avail-
able to them. Jansen et al.31) found that workers with
long working time need more time to recover from
work-induced fatigue. However, they do not have
enough time to rest, and are unable to recover. Our
study showed that 50.0% of males and 47.1% of
females working 40 hours per week did not have
leisure time. This proportion increased to 61.4% for
males and 59.5% for females among those work-
ing >40 hours per week. These results indicated the
insufficiency of rest among participants.
Moreover, reduced private time may lead to a
decrease in sleeping time and may also affect sleep
quality. This study showed that the prevalence of
sleep problems, as measured by the PSQ-I, was
40.4% in males and 42.7% in females. These preva-
lence were higher than those for other occupational
groups in Japan: 21.2% in males and 31.4% in
females among civil servants in 200332) and 35.8%
among male white-collar workers in 200433). Sleep
problems such as sleep onset insomnia, sleep mainte-
nance insomnia, and subjective sleep insufficiency are
associated with depression or anxiety34, 35). Therefore,
lack of rest including sleep problems might affect the
mental health of individuals working long hours.
Another plausible explanation for this association
is that individuals working long hours might develop
psychologically unhealthy states through occupational
stress as suggested by the demand-control model36)
and the effort-reward imbalance model37). In previous
studies38, 39), long working hours has been associated
with these two models through variables such as high
strain and effort-reward imbalance. These two occu-
pational stress models are considered to be associated
with major depressive disorder40).
There are several strengths in our study. First, this
study is considered the first to document the associa-
tion between long working hours and psychological
distress measured by the GHQ among school teach-
ers. Second, this study defined long working hours
as >40 hours per week, confined the participants to
non-shift workers, and defined the reference group
as those working 40 hours per week. We believe
that this approach to the research contributed to the
investigation of the association between long working
 26
hours and health, because the clear definition of long
working hours, the exclusion of detrimental effects to
human health by shift work, and the selection of this
reference group allow for a clear interpretation of the
results1). Though there have been several previous
studies815) related to our study, the working hours
categories were different in these studies, so it is not
straightforward to compare the results of these studies.
Moreover, because the information on shift work was
almost unknown in prior studies, the interpretation
of the reported results is difficult. This means that
the studies without information on shift work do not
exclude the increased risk for psychological distress
caused by the shift work itself, as indicated by a prior
study18). Because our reference group did not include
participants working less than the contracted working
time, we believe our analysis was properly conducted.
A third strength of the present study is our use of the
GHQ to evaluate psychological distress. This ques-
tionnaire has been confirmed in terms of its valid-
ity and reliability and has been used throughout the
world. Fourth, because this study was conducted in
mid-2013, the results obtained are relatively new and
reflect recent patterns in working hours.
Our study has some limitations. First, this study is
a cross-sectional study, so we could not directly infer
the causal relationship between long working hours
and psychological distress. Second, we collected
data on working hours from self-reported question-
naires. Self-reported working hours might lead to
recall bias, and this might have affected our results.
Third, our study might include participants who had
medical histories of mental disorders. Because indi-
viduals with mental disorders are suspected to have a
higher risk of psychological distress, our results may
have been influenced to some extent. Fourth, the
participants in our study may not be representative of
school teachers because of the relatively low response
rate (44.8%). Though our results may be difficult to
generalize, our study is valuable as a first step toward
elucidating the association between long working
hours and psychological distress among school teach-
ers.
In this cross-sectional study, we investigated the
association between long working hours and psycho-
logical distress among school teachers in Japan. Our
results indicated that males working >60 hours per
week had a significantly increased risk for psychologi-
cal distress compared with those working 40 hours
per week. However, the causal relationship between
long working hours and psychological distress remains
unclear because of our study design. Additional stud-
ies including cohort studies with large sample sizes
are needed.
J Occup Health, Vol. 57, 2015
Acknowledgments: We appreciate the cooperation of
all of the participants, the public junior high schools
in Hokkaido, and the Hokkaido Government Board
of Education. This study was supported by grants
from the Health Care Science Institute in Japan. All
authors declare that they have no conflicts of interest.
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