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Evidence on the causal relationship between working overtime and the risk of coronary heart disease is limited.We surveyed 2355 workers in Japan and conducted propensity-matched logistic regression analysis, using propensity-matched 438 pairs, to evaluate the associations between working overtime (more than 50 hr per week) and coronary risk factors: physical inactivity, cigarette smoking, sleep deprivation (<5 hr/day), psychological stress, overweight/obesity, and excessive alcohol consumption. The exposure and outcomes were self-reported.Among 2355 workers, 476 participants worked overtime. Propensity-matched analysis revealed that the associations between working overtime and sleep deprivation (odds ratios (OR) and 95% confidence intervals: 2.33, 1.39–3.88) and high stress (2.13, 1.60–2.82). The associations between working overtime and physical inactivity, current smoking, and overweight/obesity were not statistically significant. Excessive alcohol consumption was inversely associated with working overtime.Working overtime was positively associated with two coronary risk factors: sleep deprivation and increased psychological stress. Am. J. Ind. Med. 58:229–237, 2015. © 2015 Wiley Periodicals, Inc.