Environmental Risk Factors of Systemic Lupus Erythematosus: A Case Control Study

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Abstract Background: Systemic Lupus Erythematosus (SLE) was suggested to be a condition of multifactorial etiology. Several genetic and environmental factors were suggested to be implicated in its pathogenesis. Recognizing these factors that trigger the disease onset and progression is pivotal to help taking measures to reduce the individual’s risk.Methods: The main objective of this study was to examine how exposure to selected environmental factors was associated with SLE risk.This case control study was conducted at the Rheumatology outpatient clinic of Alexandria Main University Hospital, in Alexandria, Egypt. The study sample consisted of 29 female SLE patients, and 27 healthy controls, who matched the cases on age and parity. Data were collected by a structured interviewing questionnaire, additionally; blood levels of lead, cadmium, and zinc of all participants were assessed by flame atomic absorption spectrometry. SPSS version 21 was used for data entry and analysis.Results: The findings of this study add to the evidence that SLE can be environmentally induced. The multivariate stepwise logistic regression model revealed that five factors showed significant association with SLE, namely living near agricultural areas, passive smoking, blood lead levels ≥ 0.075 mg/L, and exposure to sunlight (OR =58.556, 95% CI =1.897-1807.759, OR =24.116, 95%CI =1.763-329.799, OR =18.981, 95%CI =1.228-293.364, OR =9.549, 95%CI =1.299-70.224 respectively). Whereas walking or doing exercise were significantly protective to SLE (P =0.006).Conclusion: Efforts should be made to decrease the environmental pollution and reduce the effect of environmental risk factors on disease occurrence.

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