The History of Workplace Wellbeing and Burnout

By Victor Hoang · Updated Oct 24, 2026

Picture a munitions factory in Britain in the autumn of 1915. Shells are urgently needed, and hours are long. In September the government appoints a committee to ask what all that time is doing to the people and to the output.

Burnout as a named idea dates to 1974. The New York clinical psychologist Herbert Freudenberger first described it among staff at a free clinic. The worry behind it is far older. In 1700 an Italian physician published the first comprehensive study of how trades damage the people who work them. That book was a precursor, not a theory of burnout, because it dealt with dust, metals and posture rather than exhaustion of the mind. The throughline is that every era found a new way to see the cost of work, and the name came decades after the harm.

The 1915 committee was an early official attempt to treat worker fatigue as something a business can measure.

Timeline at a Glance

The Physician of Trades (1700-1914)

A doctor asks what work does to the body

Bernardino Ramazzini was born in Carpi on October 4, 1633, and died in Padua on November 5, 1714, according to the Encyclopedia of World Biography. His De Morbis Artificum Diatriba (often translated as the diseases of workers) was printed in Modena in 1700, with a second edition in Padua in 1713. The same entry describes him as dealing with over 50 dirty or dangerous trades, and notes that he inspected workplaces, questioned workers and advised remedies. The American Journal of Public Health adds that he asked his patients what work they did and urged every physician to do the same.

That habit is the real gift. A doctor who asks about work sees patterns that a doctor who asks only about symptoms misses. Ramazzini wrote about chemicals, dust and metals, though, and not about mental strain or the pace of a shift. The entry calls his book the first comprehensive work on occupational disease, and it argues, in effect, that a job can make a person ill. Nobody in his century would have called that workplace wellbeing.

The two centuries that followed brought factories, and with them fights over how long a day should be. That story, from Egyptian tomb builders to the 1938 law, is told in our history of the 8-hour workday. What matters here is that health arguments were one of the levers in those fights, while the science to measure fatigue did not yet exist.

What it teaches teams today: the oldest wellbeing practice is still the cheapest. Ask people what their work is actually like, and ask it before something breaks.

The Fatigue Years (1915-1920s)

Wartime Britain tests whether longer hours produce more

In mid-September 1915 the Minister of Munitions appointed the Health of Munition Workers Committee, with the Home Secretary's concurrence. Its charge, as the US Bureau of Labor Statistics reprinted it in 1917, was to consider and advise on questions of industrial fatigue and hours of labor in munition factories. Its memoranda recommended that men's average weekly hours should not exceed 65 to 67, including overtime. On seven-day working the committee wrote that, except for short periods, continuous work was "a profound mistake and does not pay".

That sentence is an early version of an argument still made today. The committee was not asking whether workers were unhappy. It asked whether tired workers were productive, and it measured output against hours. The reprint also records its concern about accidents, lost time and sickness.

In 1918 the Medical Research Committee set up an industrial fatigue board. The National Archives records that it was called the Industrial Fatigue Board until 1929, when it became the Industrial Health Board, and that it was wound up in 1959. Fatigue had become a permanent subject of study, not a wartime emergency.

The approach sat alongside the efficiency movement. Taylor-style work measurement, covered in our history of time and motion studies, tried to squeeze more from each hour. The fatigue researchers asked where the squeeze stopped paying. The new problem was that fatigue was a physical idea. It could say when hours were too long, but it said little about how people felt about the work, a gap that mass production at the pace of the assembly line made harder to ignore.

What it teaches teams today: treat hours as a variable you can test. A schedule that adds time without adding output is a cost, not a commitment.

The Human Factor (1924-1960s)

Researchers discover that how people feel changes how they work

Western Electric's Hawthorne Works in Chicago began testing ways to raise productivity in 1924, and changes such as brighter lighting produced no clear result. The Harvard Gazette reports that Elton Mayo, a Harvard Business School professor, and his protege Fritz Roethlisberger then ran the work from 1928 to 1933, shifting to six women in a relay assembly test room. They conducted more than 21,000 interviews between 1928 and 1930, and concluded that workers were motivated by more than pay, including family obligations and friendships with coworkers. The Gazette adds that the term "Hawthorne effect" was coined in the 1950s. The studies are credited with helping launch the human relations movement.

A dozen years after the first Hawthorne tests came the biologist's view. In July 1936 Hans Selye published a 74-line letter in Nature titled "A Syndrome Produced by Diverse Nocuous Agents". A 2023 editorial in Brain Sciences summarizes his general adaptation syndrome as three stages: an alarm reaction, a stage of resistance and a stage of exhaustion. Selye was born in Vienna in 1907 and died in Montreal in 1982. His idea was that the body responds in a common way to many different demands, and that the response can wear it down if the demand lasts. He did not write about offices or about burnout, but later writers on work would borrow his vocabulary.

Meanwhile the first workplace programs aimed at personal problems were forming, and they began with drinking. A 1982 article in the Milbank Memorial Fund Quarterly by Diana Chapman Walsh, drawing on National Institute on Alcohol Abuse and Alcoholism figures, says there were 4 to 6 occupational alcoholism programs in the United States from 1940 to 1945 and 50 in 1950. The size of the idea was small. The principle that an employer might help a troubled employee, not just dismiss them, was new.

These years gave the field two pieces it still uses: the claim that social conditions at work shape wellbeing, and the claim that a long demand can exhaust a person. The problem that remained is that neither piece had a name for the particular state that follows years of caring for others.

What it teaches teams today: being listened to changed behavior at Hawthorne before any physical change did. A real conversation with staff is a legitimate intervention, and it costs little.

The Burnout Years (1969-1981)

A free clinic gives the exhaustion a name

The word predates the field. A 2020 review in the American Journal of Lifestyle Medicine reports that "burnout was first mentioned in passing" in a 1969 publication by H. Bradley, who was proposing a work schedule for staff in a community-based youth treatment program. The same review says Freudenberger is often given credit for coining the term and for the first formal definition.

Freudenberger volunteered at a free clinic in New York's East Village, then a drug-ridden neighborhood. A narrative review in Cureus says he borrowed the term from drug-addict slang and applied it to the clinic's caregivers. A 2024 chapter by Robert Motta says Freudenberger noticed that staff who worked long hours showed fatigue and emotional exhaustion, which he called burnout syndrome.

Across the country, Christina Maslach was reaching a similar finding by a different route. A chapter by Dirk Enzmann and Wilmar Schaufeli says Freudenberger and Maslach's team identified burnout almost simultaneously in the early 1970s, on the east and west coasts, and argues that burnout emerged as a social problem before it became a scholarly construct. Maslach and Ayala Pines, the chapter says, then brought it into scientific research.

The key step was measurement. Maslach, working at the University of California, Berkeley, proposed three dimensions: emotional exhaustion, depersonalization and a diminished sense of personal accomplishment. The Cureus review says the Maslach Burnout Inventory was proposed in 1981 with a subscale for each. A 2016 paper by Maslach and Michael Leiter in World Psychiatry notes that the early research was exploratory and qualitative, and calls the inventory the first burnout measure built on comprehensive psychometric research.

The new problem was scope. Maslach and Leiter say burnout was first studied in people-oriented fields, and Enzmann and Schaufeli say early writing was largely anecdotal and appeared across many professions. The question of what it was, a trait of the worker or a defect of the workplace, stayed open. The same tension runs through our guide on burnout culture.

What it teaches teams today: a vague feeling becomes manageable once it has parts. Exhaustion, distance and a drop in effectiveness are three different conversations.

The Overwork Reckoning (1980s-2018)

Japan, employers and lawmakers make overwork a public matter

In the second half of the 1980s, Japan recognized karoshi, death from overwork, as a social problem. The country's government did not pass a law addressing it until 2014, as the same source notes. A 2026 article in Japan Labor Issues by Tomohiro Takami says the Act Promoting Measures to Prevent Death and Injury from Overwork was enacted in 2014 after movements led by bereaved families. It was followed by an outline of measures in 2015, a first white paper in 2016, a Stress Check Program in 2015 for workplaces with 50 or more workers, and a Work Style Reform Act in 2018 that set upper limits on overtime.

Japan's compensation system turns hours into a test. Under its criteria for heart and brain disease, work is regarded as strongly causal when an employee worked about 100 hours of overtime in the month before onset, or more than about 80 hours a month on average over the two to six months before. Takami reports that in fiscal 2024 there were 241 compensated cases of this kind and 1,055 for mental disorders, including 88 suicides, and that 167 of the 241 involved 80 or more overtime hours a month.

In the United States, the support system for troubled workers grew from the drinking programs of the 1940s into something broader. Walsh's 1982 article says the NIAAA charted 500 occupational alcoholism programs in 1973, 2,400 in 1977 and 4,400 in 1979-1980, and that large employers were beginning to offer counseling for mental distress and for marital and financial difficulties as well. That is the employee assistance program in recognizable form.

Wellness programs followed, and their results were mixed. A randomized study at a large employer with more than 12,000 employees, published as NBER Working Paper 24229, found no significant effect on self-reported health, medical spending or productivity in the first year, though more than 56 percent of eligible employees took part. The authors noted that such programs cover over 50 million workers. The study does not say wellness never helps, only that this design, in this setting, did not move those measures.

The problem this era left behind was the gap between programs and causes. Counseling and screening address the person. Japan's criteria point at the schedule, and our history of productivity measurement shows how the demand for output keeps raising it.

What it teaches teams today: a program that helps individuals cope will not fix a workload that keeps rising. Check hours and demand before adding a benefit.

The Official Phenomenon (2019-present)

WHO defines burn-out and tells employers what it is not

On May 28, 2019, WHO described burn-out as a syndrome "conceptualized as resulting from chronic workplace stress that has not been successfully managed". It named three dimensions: feelings of energy depletion or exhaustion, increased mental distance from one's job or feelings of negativism or cynicism about it, and reduced professional efficacy. The same page states that burn-out is listed as an occupational phenomenon and is not classified as a medical condition. WHO also notes that burn-out appeared in ICD-10 with a less detailed definition.

That wording is easy to misquote. WHO's entry is a definition for use in an occupational setting, and it does not make burnout a diagnosis. On February 11, 2022, WHO said ICD-11 was officially in effect, which put the classification into effect for recording and reporting.

The next steps were about hours and conditions. In a May 2021 release on a WHO and ILO analysis, the organizations reported that 745,000 people died from stroke and ischemic heart disease in 2016 linked to working 55 or more hours a week, a 29 percent increase since 2000. The Director-General said, "No job is worth the risk of stroke or heart disease."

In September 2022 WHO published guidelines on mental health at work with recommendations on organizational interventions, manager training, worker training and individual interventions. Its fact sheet estimates 12 billion working days lost each year to depression and anxiety, at a cost of US$1 trillion a year in lost productivity, and lists risks that include excessive workloads, long or inflexible hours and low control over work. The shift from home in 2020 sits in the background of this period, and our history of remote work covers it. The limits of a schedule are also the subject of the history of the four-day week, and the way messages crowd the day is told in the history of workplace communication.

The open question is pace. AI promises more output per person, and our piece on pace and burnout in the AI era takes that up. Leaders who want high standards without wearing people down can start with high standards without burnout.

What it teaches teams today: the official definition puts the cause in the workplace, not the worker. That makes workload, control and hours the first things to review.

Key People

Key Facts

Key Facts: Workplace Wellbeing and Burnout History

• Ramazzini's De Morbis Artificum Diatriba was printed in Modena in 1700.
• Freudenberger first described burnout in 1974, borrowing a term from drug-addict slang.
• The NIAAA charted 500 occupational alcoholism programs in 1973 and 2,400 in 1977.
• Japan's criteria treat about 80 or more overtime hours a month as a strong link to heart and brain disease.
• WHO's ICD-11 lists burn-out as an occupational phenomenon and not a medical condition.
• A WHO and ILO study counted 745,000 deaths in 2016 linked to 55 or more weekly hours.

The Pattern Behind the History

We call this the Name-Measure-Mandate Pattern. It is our own synthesis of this timeline, not a published model.

1. The harm is seen before it has a name. Ramazzini's questions in 1700 and the munitions committee's findings in 1915 came decades before "burnout".
2. A name needs a measure. Freudenberger described it in 1974, and the 1981 inventory made it countable. Japan's 80-hour rule did the same for karoshi.
3. Hours are the first lever. The munitions committee, the Japanese criteria and the WHO and ILO study all start with time worked.
4. Programs arrive faster than proof. Employee assistance grew from a handful of programs to thousands, and a randomized wellness study found little effect in its first year.
5. Official status is narrow. WHO's definition is an occupational phenomenon, not a diagnosis, and it places the cause in the workplace.

What It Teaches Teams Today

• Ask about the work. Ramazzini's question still finds what a satisfaction score misses.
• Measure hours and demand. Every era that moved the field began with time worked.
• Separate the three parts of burnout. Exhaustion, cynicism and low effectiveness call for different responses.
• Look at the job before the person. WHO's definition points to the workplace, so start with workload and control.
• Be exact with the term. Say "occupational phenomenon" and do not call burnout a medical condition. Anyone who is struggling should see a qualified health professional.
• Place this in context. The long arc is in our history of productivity, and the way knowledge work changed the demands on people is in the history of knowledge work. A team that wants safe speaking-up can read about psychological safety at work.

Workplace wellbeing has moved from a physician's question about a patient's trade to a matter for laws, definitions and managers. The consistent lesson is that the first thing to examine is the work itself.