The first case of karoshi was reported in 1969 with the death from a stroke of a 29-year-old, married male worker in the shipping department of Japan's largest newspaper company. It was initially called occupational sudden death. Shift work and an increased work load, together with excessive overwork in spite of ill health just before the stroke, were finally recognized as the occupational causes of death. It took five years for the family to receive compensation. In 1982, the first book entitled "Karoshi" was published by three physicians. This was the origin of the term karoshi. Karoshi is not a pure medical term but a sociomedical term. Karoshi-deaths were associated with long working hours, shift work, stress, and irregular work schedules.