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A large portion of the remaining risk may be attributable to environmental exposures and gene\u2013environment interactions. This review focuses on SLE risk associated with environmental factors, ranging from chemical and physical environmental exposures to lifestyle behaviors, with the weight of evidence supporting positive associations between SLE and occupational exposure to crystalline silica, current smoking, and exogenous estrogens (e.g., oral contraceptives and postmenopausal hormones). Other risk factors may include lifestyle behaviors (e.g., dietary intake and sleep) and other exposures (e.g., ultraviolet [UV] radiation, air pollution, solvents, pesticides, vaccines and medications, and infections). Alcohol use may be associated with decreased SLE risk. We also describe the more limited body of knowledge on gene\u2013environment interactions and SLE risk, including <jats:italic>IL\u201010, ESR1, IL\u201033<\/jats:italic>, <jats:italic>ITGAM<\/jats:italic>, and <jats:italic>NAT2<\/jats:italic> and observed interactions with smoking, UV exposure, and alcohol. Understanding genetic and environmental risk factors for SLE, and how they may interact, can help to elucidate SLE pathogenesis and its clinical heterogeneity. Ultimately, this knowledge may facilitate the development of preventive interventions that address modifiable risk factors in susceptible individuals and vulnerable populations.<\/jats:p>","DOI":"10.1111\/joim.13448","type":"journal-article","created":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T13:54:05Z","timestamp":1644501245000},"page":"755-778","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":123,"title":["The role of environmental exposures and gene\u2013environment interactions in the etiology of systemic lupus erythematous"],"prefix":"10.1111","volume":"291","author":[{"given":"Jennifer M. 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