Objective: Health problems caused by long working hours and work stress have gained growing concerns in Japan, Korea, and Taiwan. In all the three countries, cardiovascular, cerebrovascular, and mental disorders attributed to heavy workloads or stressful work events are considered compensable occupational diseases by workers' compensation systems. This study compared the trends of such cases and correlated the trends with changes in working hours during the period from 1980 to 2010. Methods: Data on occupational diseases were obtained from official statistics of the workers' compensation systems. Information on working hours was obtained from official statistics and national surveys of employees. Results: While occupational cardiovascular, cerebrovascular, and mental disorders attributed to work stress were increasingly compensated in all the three countries, the averaged working hours and the percentage of employees with long working hours had been in decline discordantly. Conclusion: Findings of this study suggested that reducing working hours alone is unlikely to reduce the problems of work stress. There is an urgent need to monitor and regulate a wider range of psychosocial work hazards. Especially, precarious employment and its associated health risks should be targeted for effective prevention of stress-related health problems in the workplace. © Springer-Verlag 2011.