Cancer Survivors' Myocardial infarction, Stroke Outbreak, and Change Before and After COVID-19
Jun 20, 2025
The results of the first study analyzing the association between exposure to ultrafine dust in Korea and the occurrence of cardiovascular disease in cancer survivors before and after the COVID-19 pandemic were published in international journals. In particular, during the COVID-19 period, the association between fine dust exposure and cancer survivors' cardiovascular disease disappeared, reaffirming the importance of health care in life.
The Seoul St. Mary's Hospital-Seoul National University Hospital joint research team (first author Shin Hyun-young, professor of family medicine at Seoul St. Mary's Hospital, Lee Hyuk-jong, researcher of medical life science at Seoul National University, and corresponding author Park Sang-min, professor of family medicine at Seoul National University Hospital) analyzed 39,581 cancer patients who survived for more than three years based on data from the National Health Insurance Corporation to derive such results.
The research team accurately analyzed the impact of short-term ultrafine dust exposure on cardiovascular disease outbreaks by correcting external environmental and climate factors using time-cross-research design for patients who were diagnosed with cancer and survived at least three years from 2009 to 2018.
As a result of the analysis, it was found that exposure to ultra fine dust (PM 2.5) increased cardiovascular disease before COVID-19 distancing, and the overall risk of cardiovascular disease increased by 3% every 10㎍/㎥ increase in daily average concentration. In particular, in the case of the highest exposure group of ultrafine dust (44.99±15.05㎍/㎥), the risk of cardiovascular disease increased by about 9% and was statistically significant.
In detail, the risk of myocardial infarction and ischemic stroke was high, with myocardial infarction rising by 10% and ischemic stroke rising by 11% in the highest exposure group of ultrafine dust before the pandemic.
However, after distancing implemented due to COVID-19 from March 22, 2020, this association disappeared, weakening the association between the occurrence of cardiovascular disease caused by ultrafine dust. During this period, the risk of occurrence in the ultrafine dust exposure group was not statistically significant, but rather decreased to a level where the exposure effect could be ignored.
This is mainly attributed to the decrease in actual air pollution exposure due to wearing masks, working from home, and refraining from going out due to distancing. It is also possible that the lower concentration of ultrafine dust in the atmosphere itself during the COVID-19 period due to a decrease in factory utilization and a decrease in traffic volume worldwide may have affected it.
For the first time, this paper compared and analyzed the association between exposure to ultrafine dust and the occurrence of cardiovascular disease in groups of cancer survivors by COVID-19 distancing period. Previously, ultrafine dust was classified as a first-class carcinogen designated by the World Health Organization (WHO), but this is the first study to quantitatively reveal the risk of short-term exposure in cancer survivors. In particular, it suggests that changes in the social environment, such as during the epidemic of infectious diseases, can reduce exposure to external harmful substances and mitigate health effects in immunocompromised groups like cancer survivors.
In addition, it was designed based on national big data, increasing the representativeness and statistical reliability of the analysis. By comparing time zones within individuals, disturbance variables were minimized and various climate and atmospheric factors such as temperature, precipitation, wind speed, and ozone were corrected to ensure precision of analysis. The use of the special situation of the pandemic like a natural experiment is also an advantage that differentiates it from similar studies at home and abroad.
Professor Park Sang-min emphasized that daily exposure management to environmental factors such as ultrafine dust is important because cancer survivors are sensitive to changes in the external environment.
Professor Shin Hyun-young said, "Inhalation of fine dust increases the intestinal microbiota change, lung inflammation, and systemic inflammation response, which is known to increase the incidence of cardiovascular diseases such as arrhythmia and endothelial dysfunction." As the health management of cancer survivors can vary depending on daily life management and environmental factors, it is helpful to use cancer health clinics that can advise integrated health management systems such as maintenance of care."
Professor Shin then expected that it could be useful not only for cancer survivors but also for establishing environmental policies for other health vulnerable groups such as the elderly and chronically ill, leading to follow-up studies to identify causal mechanisms between PM2.5 and cardiovascular disease and to prepare customized health policies.
Researcher Lee Hyuk-jong said "By applying the time-layer cross-design based on large-scale health insurance data, we were able to compare the effects of ultrafine dust before and after distancing statistically precisely."
The results of this study were published in the international academic journal 『Atmospheric Pollution Research" in the field of environmental health.
The Seoul St. Mary's Hospital-Seoul National University Hospital joint research team (first author Shin Hyun-young, professor of family medicine at Seoul St. Mary's Hospital, Lee Hyuk-jong, researcher of medical life science at Seoul National University, and corresponding author Park Sang-min, professor of family medicine at Seoul National University Hospital) analyzed 39,581 cancer patients who survived for more than three years based on data from the National Health Insurance Corporation to derive such results.
The research team accurately analyzed the impact of short-term ultrafine dust exposure on cardiovascular disease outbreaks by correcting external environmental and climate factors using time-cross-research design for patients who were diagnosed with cancer and survived at least three years from 2009 to 2018.
As a result of the analysis, it was found that exposure to ultra fine dust (PM 2.5) increased cardiovascular disease before COVID-19 distancing, and the overall risk of cardiovascular disease increased by 3% every 10㎍/㎥ increase in daily average concentration. In particular, in the case of the highest exposure group of ultrafine dust (44.99±15.05㎍/㎥), the risk of cardiovascular disease increased by about 9% and was statistically significant.
In detail, the risk of myocardial infarction and ischemic stroke was high, with myocardial infarction rising by 10% and ischemic stroke rising by 11% in the highest exposure group of ultrafine dust before the pandemic.
However, after distancing implemented due to COVID-19 from March 22, 2020, this association disappeared, weakening the association between the occurrence of cardiovascular disease caused by ultrafine dust. During this period, the risk of occurrence in the ultrafine dust exposure group was not statistically significant, but rather decreased to a level where the exposure effect could be ignored.
This is mainly attributed to the decrease in actual air pollution exposure due to wearing masks, working from home, and refraining from going out due to distancing. It is also possible that the lower concentration of ultrafine dust in the atmosphere itself during the COVID-19 period due to a decrease in factory utilization and a decrease in traffic volume worldwide may have affected it.
For the first time, this paper compared and analyzed the association between exposure to ultrafine dust and the occurrence of cardiovascular disease in groups of cancer survivors by COVID-19 distancing period. Previously, ultrafine dust was classified as a first-class carcinogen designated by the World Health Organization (WHO), but this is the first study to quantitatively reveal the risk of short-term exposure in cancer survivors. In particular, it suggests that changes in the social environment, such as during the epidemic of infectious diseases, can reduce exposure to external harmful substances and mitigate health effects in immunocompromised groups like cancer survivors.
In addition, it was designed based on national big data, increasing the representativeness and statistical reliability of the analysis. By comparing time zones within individuals, disturbance variables were minimized and various climate and atmospheric factors such as temperature, precipitation, wind speed, and ozone were corrected to ensure precision of analysis. The use of the special situation of the pandemic like a natural experiment is also an advantage that differentiates it from similar studies at home and abroad.
Professor Park Sang-min emphasized that daily exposure management to environmental factors such as ultrafine dust is important because cancer survivors are sensitive to changes in the external environment.
Professor Shin Hyun-young said, "Inhalation of fine dust increases the intestinal microbiota change, lung inflammation, and systemic inflammation response, which is known to increase the incidence of cardiovascular diseases such as arrhythmia and endothelial dysfunction." As the health management of cancer survivors can vary depending on daily life management and environmental factors, it is helpful to use cancer health clinics that can advise integrated health management systems such as maintenance of care."
Professor Shin then expected that it could be useful not only for cancer survivors but also for establishing environmental policies for other health vulnerable groups such as the elderly and chronically ill, leading to follow-up studies to identify causal mechanisms between PM2.5 and cardiovascular disease and to prepare customized health policies.
Researcher Lee Hyuk-jong said "By applying the time-layer cross-design based on large-scale health insurance data, we were able to compare the effects of ultrafine dust before and after distancing statistically precisely."
The results of this study were published in the international academic journal 『Atmospheric Pollution Research" in the field of environmental health.
|
This article was translated by Naver AI translator.
