We all agree to the unwritten contract when we enter the corporate world: put in long hours, toil twice as hard as the next guy, and forgo sleep and a social life long enough for you to climb the ladder. And sure, you put up with intense stress from tight deadlines, anxiety about the office bully, and the constant fear of job insecurity, but in the end, it’s all worth it, right? Well, it turns out the rat race could kill you after all.

Not only does the way labor, as it is designed, contribute to symptoms of burnout, but it may be making people physically sick, and could potentially lead to death. According to a new International Labour Organization report, more than 840,000 people die each year from health conditions linked to major psychosocial risks at work. The report examined how job strain, effort-reward imbalance, job insecurity, long working hours, and workplace bullying contribute to cardiovascular disease and mental disorders.

The report, titled “The psychosocial working environment: Global developments and pathways for action” estimates work-related psychosocial risk factors are associated with 840,088 deaths annually worldwide and nearly 45 million disability-adjusted life years, a measure of healthy years lost to illness, disability, or premature death. The ILO estimates the combined burden from cardiovascular disease and mental disorders associated with those workplace risks is equivalent to a loss of 1.37% of the global GDP each year.

The overwhelming share of the estimated death toll comes from cardiovascular disease, with the ILO attributing 783,694 deaths to cardiovascular conditions such as ischemic heart disease and stroke, compared with 56,394 deaths linked to mental disorders including depression. But mental disorders account for the larger share of healthy life years lost, reflecting the chronic and disabling nature of many mental health conditions.

The physiosocial effects of work, at a global scale

The findings are directly associating a number to common phrases we’ve heard through years of overworking: burnout, stress, disengagement, toxic culture, or low morale.

The ILO defines the psychosocial working environment as the way jobs are designed, how work is organized and managed, and the broader policies and practices that govern daily working life. When those systems are poorly designed, hazards can emerge from excessive demands, low control, unclear roles, weak support, unstable work arrangements, harassment, discrimination, or a mismatch between effort and reward.

Long hours remain one of the biggest and most measurable culprits, with the report saying 35% of workers globally work more than 48 hours a week—occupational-health research often defines long working hours as 55 hours or more a week. Previous estimates attributed roughly 745,000 deaths annually to long working hours, largely through ischemic heart disease and stroke.

Across the world, some countries fared worse than others. In 2019, 47% of workers in Asia and the Pacific worked more than 48 hours a week, compared with a global average of 35%. Long hours were more common in informal employment than formal employment, affecting 41% versus 28% of workers respectively. Wholesale and retail trade, transport and communications, and manufacturing were among the sectors with the highest reported burden of long hours.

Bullying and harassment are another major part of the workplace health picture. The ILO estimates 23% of workers globally have experienced at least one form of violence or harassment during their working life, with psychological violence the most commonly reported form at 18%. Physical violence was reported by 9% of workers and sexual violence or harassment by 6%, with women reporting higher exposure to sexual violence and harassment than men.

The ILO argues psychosocial risks should be managed through occupational safety and health systems, with policies that address the design and organization of work. It calls for better national data, clearer regulation, stronger enforcement and guidance, and workplace-level changes such as reviewing workloads, staffing, task allocation, supervision, working hours, and mechanisms for workers to raise concerns.