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Introduction Environmental factors operating on the background of hormonal factors and genetic vulnerability may be accelerating factors included in a long-held paradigm that helps explain the etiology of systemic autoimmune rheumatic disease (SARD), including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), systemic sclerosis (SSc), Sjgrens disease (SjD), idiopathic inflammatory myopathies (IIM) and others ( Extensive research over the past three to four decades has elucidated the environmental factors associated with SLE ( Environmental factors and autoimmunity The development of SARD has been associated with several lifestyle behaviors

doi: 10.1111/dom.16275 30 QinWYangJDengCRuanQDuanK

10.1016/j.chom.2013.12.006 33 BuvelotH.Posfay-BarbeK