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From the large array of environmental risk factors that have been examined over the past century, infection with Epstein\u2010Barr virus, ultraviolet light exposure\/vitamin D status, and cigarette smoking stand out because of the strength of supporting evidence. Epstein\u2010Barr virus infection early in life appears to be necessary permissive step for disease development and probably acts in adolescence and early adulthood. Vitamin D\u2013related mechanisms and cigarette smoking probably modify baseline disease risk and could plausibly do so at several stages of life; smoking appears to negatively affect disease course. This review summarizes current evidence for these 3 putative multiple sclerosis risk factors and early attempts to develop risk models and examine gene\u2010environment interactions for this complex disease. <jats:bold><jats:italic>Mt Sinai J Med 78:221\u2013230, 2011<\/jats:italic><\/jats:bold> \u00a9 <jats:italic>2011 Mount Sinai School of Medicine<\/jats:italic><\/jats:p>","DOI":"10.1002\/msj.20240","type":"journal-article","created":{"date-parts":[[2011,3,21]],"date-time":"2011-03-21T20:21:24Z","timestamp":1300738884000},"page":"221-230","source":"Crossref","is-referenced-by-count":51,"title":["Environmental Factors in Multiple Sclerosis: Epstein\u2010Barr Virus, Vitamin D, and Cigarette Smoking"],"prefix":"10.1002","volume":"78","author":[{"given":"Dean 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