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Growing evidence has shown that occupational physical activity increases the risk for cardiovascular disease and mortality. Performing strenuous physical activities at work remains a daily reality for a significant part of workers in different sectors. There is thus a critical need to develop preventive measures against premature cardiovascular disease risk in workers with high physical demands. It is particularly important to elucidate structural preventive measures at the collective workplace level for primary prevention of cardiovascular disease in this group. The psychosocial work stress environment offers opportunities to counter the harmful effects of physical work demands.An overview will be presented of available studies addressing moderating effects of psychosocial stress measures in the relation between occupational physical activity and cardiovascular disease. A limited number of studies have shown that psychosocial resources – like social support at work and level of job control – may buffer the harmful effect on health from physical work demands. In addition, this presentation will focus on the potential mechanisms by which the psychosocial work environment might play a role in the effects of occupational physical activity on cardiovascular health outcomes.Research showing that occupational physical activity does not produce cardiovascular health benefits – like leisure time physical activity does – has rapidly expanded over the past decade. On the contrary, more and more evidence confirms that engaging in high levels of occupational physical activity generates increased risk of cardiovascular disease. One of the current challenges in this research field is to investigate how the psychosocial work environment may play a role in this relation. Empirical evidence on the buffering effect of psychosocial stress measures in the relation between occupational physical activity and cardiovascular outcomes is still quite scarce. More detailed investigations using objective measurements are needed.