Some brief comments on the Amish and Cancer by Dr Chris Barnes Bangor Scientific and Educational Consultants.

Abstract

The Amish culture and occupations are briefly described. The studies of others have shown that the Amish have an almost unexplainably low cancer rate except for breast cancer and childhood leukaemia. The paper accounts for this. Furthermore the paper suggests that when occupational adjustment is made all cancer rates of the Amish are both low and explainable. It is suggested that more than just sexual monogamy, alcohol and tobacco abstention and clean living plays a part and that the Amish policy on no mains electricity, radios, TVS or telephones is also relevant.

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Introduction

The Amish are a close knit Ohio religious community who work mainly in farming and joinery. They are sexually monogamous for life, they rarely use tobacco or alcohol and they do not use mains electricity or have landline telephones connected to their living accommodation. Nor do they use internal combustion engines.

When cancer rates and lots of other illness rates are analysed amongst this community they are found to be at least 40% lower than in none Amish communities.

It has been postulated that the Amish style of clean, healthy outdoor living and sexual monogamy together with abstinence from harmful substances and lower exposure to hydrocarbon fumes accounts for their lower cancer rates.

Certain epidemiological studies have shown an association between electromagnetic fields and childhood leukaemia. Others have shown association with such fields and lymphoma, breast cancer, prostate cancer and even melanoma. Simply on the basis of the Amish not using electrical appliances and telephones one ought then to see less of all of these cancers as well.

A detailed look at Amish Cancers

A detailed look at Amish cancers and those of other religious sects was made by Trover (1988). On the basis of their limited gene pool aberrations causing cancer ought to lead to its prevalence in the Amish but the reverse has been found. Genetic mutations are still, however, found in the Amish, for example, in the STRAD-alpha gene can cause a disease called PMSE (polyhydramnios, megalencephaly, and symptomatic epilepsy) syndrome, found in a handful of Amish children.

Regarding cancer in the Trover study, the exceptions were Childhood Leukaemia and Breast Cancer which actually appear more prevalent in the Amish community than in the population at large.

Trover appears to have been unable to account for this discrepancy.

Hazards of farming

The present author feels the answer is really quite simple. The Amish are mainly farming communities. Although they live their lives to a very old rule back and use non-mechanised farming, i.e horse drawn ploughs rather than tractors, research shows that the majority do use pesticides and agro-chemicals in general.

Brophy and Keith (2010) found a very strong association between farming and breast cancer in farms around Windsor Ontario http://www.lfpress.com/news/london/2010/05/14/13944886.html. A similar association has been found for leukaemia and childhood leukaemia http://www.ocfp.on.ca/docs/pesticides-paper/chapter-5---leukemia

P Reynolds ( 2002) 'Childhood cancer and agricultural pesticide use: an ecologic study in California'. Also finds childhood leukaemia rates were significantly elevated (RR = 1.48; 95% CI,) in the presence of farm type pesticides. R Meinert ( 2000) finds similarly RR = 1.5, 95% CI: 1.0, 2.2).

Relative risks are summarised by the document http://www.pesticides.org/docs/1can-chn-tab.pdf for leukaemia child leukaemia and various other cancers and some of the documents document even higher RR values between 3-10, for various types of agriculture and farming. Mirmohammadi SJ concludes that framers should use pesticides with a great deal more care.

Gouveia-Vigeant (2003) has provided an excellent review of the evidence and has shown that even childhood consumption of well water in a region where pesticides were in use produces an RR of 5.4.

It would appear that risk factor is not always passed on genetically to offspring and stragley one study actually shows a reduced risk factor for the children of male pesticide applicatiors, see Rodvall et 2013. The difference here is that presumably these children neither lived in the presence or vicinity of pesticide nor did they help on farms from an early age as do Amish children. Also presumably, professional pesticide applicators would wear proper PPE often ignored by farmers.

Lu et al (1999) suggests that children's OP ( Organophosphate ) exposure is some 7 fold greater if their parents work in agriculture.

The present author feels that the above evidence is more than sufficient to account for the extra childhood leukaemia in Amish communities without resting to a genetic explanation. Furthermore some of these excess risk values outweigh what be gained in terms of reduced risk through not using electricity.

Turning to excess risk of breast cancer in the Amish, nor is this a great surprise either. Many pesticides are hormonally active and even in the UK women in agriculture face such an excess risk by starting farming work in their teens http://news.bbc.co.uk/1/hi/scotland/6045852.stm.

The study of Brophy http://www.mdrgf.org/pdf/NYAS_1076_765_777%20final.pdf shows women in farming and agriculture to have an occupation risk factor of almost 3 times for breast cancer and once again regards the Amish this would outweigh any benefits to be gained by not having electricity, telephones or radio where the excess risk factors associated are usually lower than 2.

Of particular interest is the work of Duell et al (2000) which shows a slightly reduced risk for female farm workers who wear proper PPE but an increased risk for people who report being in fields after pesticide application. Generally we do not see Amish girls and women wearing PPE in their fields but rather traditional Amish costume. Hardly surprising then that the Amish seem to have increased risk of breast cancer.

Finally Waxman (2012) http://healthland.time.com/2012/11/20/can-your-job-increase-your-risk-of-developing-breast-cancer/ reports on female occupations and breast cancer and suggest that any time spent for a women in farming can yield up to a 42% increase in her chance of developing breast cancer.

Occupational adjustment

It is the present author's contention then, that when occupationally adjusted the risk of all cancers in the Amish community is significantly lower than elsewhere.

Whereas sexual monogamy can explain the lower rates of genital, womb and to some extent oral and lingual and throat cancer and similarly smoking and alcohol abstention can explain the decreased rates of oral, lingual, throat, lung, stomach, pancreatic and liver cancers; these two factors alone simply cannot explain the lower rates of all cancers. For that we are left with electricity and electromagnetic radiation as the common denominator.

Further work

Further work is urgently needed. Unfortunately living in the UK and of limited financial means, the author cannot perform his own experimental study on the Amish. This would easiest be done by scientists or epidemiologists in Ohio or the USA in general.

Two studies are proposed. Firstly high voltage overhead power transmission cables may pass over or close to some Amish homes. The study should seek to see if childhood leukaemia or any other cancer rates are enhanced in the Amish in such localities.

Secondly some Amish homes or communities might be in the main beam or secondary side lobe paths of TV, Radio or Mobile Phone Base station Antennas. The study should seek to see if there are enhanced cancer clusters in the Amish under these conditions. Positive results to either would strongly reinforce others findings of an association between firstly EMF or MF and cancer bearing in mind there could be a difference in effects of the two and secondly an association between EMR( RFR) and cancer.

The author's predication is if there is such an association in the latter, cancer rates should soon be seen to be rising in the whole of the Amish community as they are elsewhere. The lay reader must be careful not to mix cancer rates with cancer death rates and bear in mind that the former are instances of diagnosed disease yet with the advent of better available treatments death rates per se may still continue to fall.