Respiratory health in the past: a bioarchaeological study of chronic maxillary sinusitis and rib periostitis from the Iron Age to the Post Medieval Period in Southern England

Abstract

Respiratory disease has affected human populations throughout our history and remains a significant cause of morbidity and mortality today. In spite of this, there is a dearth of bioarchaeological research on this important subject. Previous research has suggested a relationship between poor air quality and the prevalence of chronic maxillary sinusitis and rib periostitis. These conditions have many causes (e.g. congenital disorders, allergies, poor air quality, climate, infectious disease). Chronic maxillary sinusitis and rib periostitis are recognised as bone formation and/or destruction, indicating long-term inflammation of the soft tissues of the sinuses and ribs in some upper and lower respiratory tract conditions.
If air quality is a significant contributor to respiratory disease, the highest prevalence rates would be expected in populations exposed to high concentrations of indoor and outdoor pollutants. This study examines 12 skeletal samples from cemeteries located in southern England, ranging in date from the Iron Age to the Post Medieval Period. The samples were chosen to examine both synchronic and diachronic trends in respiratory disease, contrasting contemporaneous populations living in rural and urban contexts, as well as populations from high and low social status groups. A total of 1203 individuals were examined for this study. Of these, 1101 had at least one sinus preserved, and of these individuals, 546 (49.6%) had sinusitis in one or both sinuses. A total of 2091 sinuses were recorded. Of these, 854 (40.8%) had chronic maxillary sinusitis. 50.42% of 720 males and analysed had sinusitis and 47.85% of 372 females (not significant). Prevalence rates ranged from 30.6% (Post Medieval) to 75.44% (Iron Age) for chronic maxillary sinusitis and 1.59% (Iron Age) to 29.7% (Post Medieval) for rib periostitis, but, when combining the skeletal and archaeological/historical data, the hypothesis posed is not consistently supported. Based on archaeological evidence for lifestyle and housing, these results suggest that the causes of respiratory disease are more complex than this current hypothesis presumes.