1 Predicting Cardiovascular Disease from Psychosocial 2 Safety Climate : A Prospective Cohort Study from 3 Australia 4

Cardiovascular Disease (CVD) is the most prevalent disease worldwide, which has been 17 linked to work stress because of poor job design as explained by the Job Demand-Control (JDC) 18 and the Effort-Reward Imbalance (ERI) models. In this paper we explore for the first time relative 19 impact of a specific aspect of organisational climate, Psychosocial Safety Climate (PSC), on any 20 CVD including angina, myocardial infarction, hypertension, and stroke. We used two waves of 21 interview data from Australia, with an average lag of 5 years (excluding baseline CVD, final n = 22 1223). Logistic regression was conducted to estimate the prospective associations between PSC at 23 baseline on incident CVD at follow-up. It was found that participants in low PSC environments 24 were 59% more likely to develop new CVD than those in high PSC environments. Logistic 25 regression showed that PSC at baseline predicts lower CVD risk at follow-up (OR = 0.98, 95% CI 26 0.96-1.00), and this risk remained unchanged even after joint adjustment for measures of ERI and 27 JDC. These results suggest that PSC is an independent risk factor for CVD in Australia. Beyond job 28 design this study implicates organisational climate and prevailing management values regarding 29 worker psychological health as the genesis of CVD. 30