Canadians don't have to stop golfing, gardening amid new ALS risk study, expert says. What to know about findings

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After a recent study linked activities like golfing, gardening and woodworking with an increased ALS risk in men, a Canadian expert is emphasizing the importance of understanding these findings in context.

According to a new study by Michigan Medicine from the University of Michigan, published to the Journal of the Neurological Sciences, participating in certain recreational activities like golfing, gardening or hunting, may increase your risk of developing amyotrophic lateral sclerosis (ALS).

"We know that occupational risk factors, like working in manufacturing and trade industries, are linked to an increased risk for ALS, and this adds to a growing literature that recreational activities may also represent important and possibly modifiable risk factors for this disease," said Dr. Stephen Goutman, director of the ALS Center of Excellence at the University of Michigan, in a release.

Researchers assessed the hobbies and non-work related activities of 400 people living with ALS and 300 without the disease. Their survey found that men who golfed were three times more likely to develop ALS. Men who participated in hunting, woodworking and gardening also had a heightened risk for the disease.

According to researchers, exposure to pesticides during certain outdoor activities like hunting, golfing or gardening and formaldehyde in woodworking could be attributed to the higher risk. 

"It is surprising that the risk factors we identified appear to be specific to males," Goutman told the University of Michigan. "While these activities may also increase ALS risk in females, the number of females in our study was too small for us to come to that conclusion."

But does this mean you should stop doing these outdoor activities? Read on to learn more.

Study highlights associations, not causation: Expert

Dr. David Taylor, vice president of research at ALS Canada, told Yahoo Canada the study's results, indicating potential risk factors for ALS, should not be interpreted as direct causes or reasons for alarm. "These are what we call associations, not causation," he clarified, suggesting the study is more a piece of the puzzle in understanding ALS.

"With exposure to pesticides, exposure to heavy metals, or, you know, smoking is another thing that's been connected to higher risk of ALS," the researcher explained, "It's ideal if you can avoid exposure to any of these toxic things."

However, when it comes to making lifestyle changes, Taylor was clear: "There's no reason for anyone to change their lifestyle based on this study." The benefits of these activities far outweigh the potential ALS risks, he said.

"We're a long way from really getting to something that's concrete." He also offered a personal assurance, "If it helps people to know: I think about ALS all the time, and I will continue to golf."

But what exactly is ALS and what other risks are associated with it? Here's what you need to know.

What is ALS?

Amyotrophic lateral sclerosis (ALS) is a progressive terminal disease that affects "what are essentially the living wires that connect our brain to our muscles," explained Taylor in a previous interview. These "wires" are called motor neurons through which the brain signals the muscles. With ALS, the motor neurons degenerate and die, leading to a progressive paralysis.

"You lose the ability to move, speak, swallow and then what makes it terminal is eventually, the ability to breathe," Taylor told Yahoo Canada.

Also known as Lou Gehrig's disease, or motor neuron disease, ALS is currently impacting about 200,000 people worldwide, approximately 4,000 of which are in Canada.

What causes ALS?

We still don't really know what causes ALS, according to the expert. For about 10 per cent of people who are diagnosed, ALS is passed down through genetics. "We can connect this to a specific genetic variant that can confer the disease in individuals.

"Otherwise, we don't know the exact cause — we're really honing in on that, and I think in the past several years, we've come a very long way. But it still continues to be something we're searching for," Taylor says.

Though genetics are the biggest known risk factor for ALS, Taylor adds that "to some extent" aging plays a part, as the disease is typically seen in middle-to-late stages of life.

It's also been linked to smoking and brain trauma, "but there's nothing that we have that's super definitive," he said.

What are the early symptoms of ALS?

Taylor explains ALS starts with a progressive weakness, either in the upper or lower body, as well as progressive slurring of speech or difficulty in speaking or swallowing.

Progressive weakness in the upper body can look like impaired handwriting, difficulty lifting or reaching, trouble with dressing or hygiene (for example, doing buttons, cutting fingernails, etc.) and other daily tasks.

In the lower body, it can include frequent tripping, difficulty on stairs, or getting out of a chair, as well as a foot dragging when walking or not being able to walk as far.

He notes people shouldn't be alarmed as many symptoms can overlap with other diseases. However, ALS Canada does have an online tool called ReferALS, with a checklist of early symptoms to encourage people to see an ALS specialist "as quickly as possible" if needed.

The current diagnostic delay in Canada is up to two years, which can be "most of an ALS patient's remaining life."

How is ALS treated?

There is no cure for ALS, but there are treatments that can improve the remaining quality of life or extend it. One treatment available is riluzole, an oral therapy in the form of a tablet.

"There are a couple other therapies that are more recently approved by Health Canada, we're still learning about what the effect of those are. But in clinical trials, they have shown that they can provide some slowing of the progression of the disease, but certainly not saving anyone," Taylor explains. "We're certainly looking to get better ones in the near future."

Taylor says it's an exciting time for research, saying "I think we're going to make some substantial strides." He encouraged Canadians to donate to ALS Canada for research and national advocacy, so "we can also ultimately fix this disease with the rest of the world."

For those who have a loved one who's been diagnosed, applying to register with a local ALS society can help get the right supports in moving forward.

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