Between Japan’s Meiji Restoration (1868) and the end of the Second World War (1945), the health implications of poor working conditions included pulmonary tuberculosis in the textile industry and silicosis among miners. There was a gradual move to protect workers, culminating in the 1947 establishment of the Ministry of Labour – now the Ministry of Health, Labour and Welfare) and the enactment of the Labour Standards Law. From the mid-1950s to the mid-1970s, high economic growth was achieved, but the number of occupational diseases (such as pneumoconiosis and chemical intoxication) increased. The Ministry of Labour established the Industrial Safety and Health Law (ISHL, still in effect today) in 1972, laying the legal foundation to specifically focus on occupational health and address occupational diseases. The ISHL designated countermeasures for pneumoconiosis, including the Health Management Diary System, to provide government-paid health examinations for retired workers with medical complaints. It thus ushered in a significant revision of the Pneumoconiosis Law (1960). Due to their long latency periods, occupational cancer cases surged many years after (but as a consequence of) exposure to hazardous substances (for example, benzidine, beta-naphthyl amine and asbestos) during the high growth era. Karoshi, or death from overwork, typifies the occupational mental health issues that are characteristic of modern-day Japan. Historically, administrative measures for occupational diseases have been retroactively responsive to public concern triggered by media reports. Today, however, there are promising signs of administrative measures shifting towards more preventive stances and actions.