Short-term PM2.5 exposure among 3-year cancer survivors with incident cardiovascular disease before and during the COVID-19 pandemic period

Particulate matter (PM_2.5) exposure is suggested to the development of cardiovascular disease (CVD) in cancer survivors. During the COVID-19 pandemic, PM₂.₅ concentration levels exhibited temporal variability, which may have contributed to differential health impacts on populations. The purpose of this study is to explore the association between the variance in PM_2.5 exposure prior to and during the COVID-19 period and the incidence of CVD among cancer survivors. Utilizing big data from the Korea National Health Insurance Service, three-year cancer survivors diagnosed between 2009 and 2018 and new CVD event after 2015 were extracted. The association between short-term exposure PM_2.5 and the incidence of CVD was analyzed by using the conditional logistic model in the design of time-stratified case-crossover. 39,581 cancer survivors who developed CVD were collected. Elevated levels of PM_2.5 were associated with increased CVD risk before COVID19 social distancing (lag 0 aOR 1.030, 95 % CI 1.014–1.046; lag 0–1 aOR 1.027, 95 % CI 1.009–1.045). On the other hand, the association between outdoors exposure of PM_2.5 and the incidence of CVD disappeared in cancer survivors during COVID19 period (lag 0 aOR 0.998, 95 % CI 0.916–1.087; lag 0–1 aOR 1.001, 95 % CI 0.971–1.032). This study aims to investigate the association between PM₂.₅ exposure variability and CVD incidence among cancer survivors during the pre-pandemic and COVID-19 pandemic periods. Further research is required to elucidate the mechanistic pathways and establish causal relationships underlying the cardiovascular consequences of PM₂.₅ exposure fluctuations in cancer survivor.