Ambient PM2.5 and O3 and their combined effects on the onset of acute cardiovascular events: a time-stratified case-crossover study in Jining, China (2015–2023)

PM2.5 and O₃ are risk factors for ACE onset, particularly on the day of onset and the day before. Moreover, we found no significant interaction of PM2.5 and O₃ on ACE onset. Reducing PM2.5 and O₃ concentrations and avoiding exposure to high levels of these pollutants in the early phase may mitigate ACE onset. Targeted policies aimed at reducing PM2.5 and O₃ pollution should be developed to mitigate their adverse health effects among high-risk populations, including older adults and males.