Cribra orbitalia,sinusitis and linear enamel hypoplasia in Swedish Roman Iron Age adults and subadults

Maxillary and frontal sinusitis, cribra orbitalia and linear enamel hypoplasia were recorded as indicators of nutritional and environmentally related stress in an Early Iron Age (0–260 AD ) population from Sweden. The material comprised the skeletal remains of 99 adults and 45 subadults (aged 20 years and under). Maxillary sinusitis and cribra orbitalia were recorded in the majority of subadults and adults. In contrast, linear enamel hypoplasia was uncommon and occurred mainly in the subadults. In seven cases (12.7%) there was a clear co‐occurrence of periapical lesions and maxillary sinusitis. A significant co‐occurrence of maxillary sinusitis and frontal sinusitis was found in the adults. The least common combination in sex‐determined adults was cribra orbitalia and enamel hypoplasia, only 7.7% exhibiting both lesions. The significantly higher incidence of this combination among subadults suggests an association with life‐threatening conditions. Overall, the results showed that the Early Iron Age community studied suffered foremost from upper respiratory diseases. Copyright © 2010 John Wiley & Sons, Ltd.     

Health Consequences of European Contact in the Great Plains: A Comparison of Systemic Stress Levels in Pre‐ and Post‐Contact Arikara Populations

The biocultural effects of European contact varied considerably throughout the Americas. Some populations were decimated by colonialism, while others benefited from trade relationships and access to new technologies. It has been suggested that initial contact with European fur traders and explorers was economically favourable for Plains village populations, thereby facilitating a period of cultural florescence. In this study, we evaluate the hypothesis that Plains groups were better off than their predecessors during the initial contact period by comparing frequencies of enamel hypoplasia, cribra orbitalia, and porotic hyperostosis in pre‐ and post‐contact Arikara skeletal assemblages. We included both juveniles and adults in our sample to capture variation in the stress experience of different segments of the population. Our analysis revealed similarly low frequencies of cribra orbitalia in the pre‐ and post‐contact groups and no observed cases of porotic hyperostosis. Enamel hypoplasia, however, was significantly more prevalent among post‐contact Arikara villagers when compared to their pre‐contact counterparts, which suggests that stress levels were higher after European contact. Additionally, enamel hypoplasia was most common among post‐contact juveniles. The elevated frequency of enamel hypoplasia in the post‐contact sample combined with the low frequencies of cribra orbitalia and porotic hyperostosis suggests that disease stress, rather than nutritional deficiencies, was likely responsible for the decline in overall health following European contact. These results also suggest that juveniles are sensitive indicators of systemic stress within a population and should be included in bioarchaeological analyses of prehistoric health when available. Copyright © 2015 John Wiley & Sons, Ltd.     

Cribra orbitalia: a non‐human primate perspective

Cribra orbitalia, a porous lesion involving the orbital roofs, is one of the most‐studied skeletal pathologies in bioarchaeology, and yet uncertainty still exists regarding its aetiology and significance. In contrast to the hundreds of reports of cribra orbitalia in human skeletal remains, little is known of this condition in non‐human primates. Previously, cribra orbitalia has only been reported in catarrhines, with just two cases in cercopithecoids. To provide a broader, phylogenetic perspective on cribra orbitalia, a sample of primate skeletal material was examined to evaluate the occurrence of this condition. The taxonomically diverse sample consists of 380 non‐hominoid (non‐ape) modern primates from both wild and captive populations. Cribra orbitalia is present in 16 individuals, including cercopithecines, colobines, platyrrhines and a prosimian, substantially expanding the known taxonomic range of this condition. Modern primates—with their varied habitats, diets, levels of parasitism, etc.—provide a set of natural experiments regarding conditions and physiologies which may influence the aetiology and impact of cribra orbitalia. More generally, it is suggested here that studies of non‐human primate skeletal pathologies have the potential for providing significant insight on human paleopathologies. Copyright © 2009 John Wiley & Sons, Ltd.     

Child Health in Five Early Medieval Irish Sites: A Multidisciplinary Approach

With the aim to reconstruct child health in five early medieval (5th–12th c. CE) Irish sites, an osteoarchaeological study of three biological stress indicators – cribra orbitalia, linear enamel hypoplasia (LEH) and periostitis – has been conducted on 229 skeletons. In addition, Irish early medieval written sources testifying on child health during this period were consulted. These data were furthermore combined with the results of stable isotope analyses (nitrogen and carbon) conducted on subadult bone specimens. Cribra orbitalia was found in 27.5% of the studied individuals (48.6% of subadults were affected), with only two cases active at the time of death. The prevalence of LEH per individual is 63.5% (78.9% in subadults and 59.7% in adults). The age ranges of LEH formation vary between 1.9 and 4.8 years for the maxillary teeth and between 1.8 and 6.2 years for the mandibular teeth. Periosteal inflammations were recorded in over one third of the studied subadults (36.2%) with six cases active at the time of death. The stable isotope results suggest a diet based on terrestrial food sources, with little or no marine input. The presented data strongly suggest that most of the individuals were exposed to a high level of physiological stress during their childhood, and as such does not support the so called ‘osteological paradox’ hypothesis. The observed disturbances were probably caused by a synergistic effect of various biological and socio‐cultural factors. Although the historical records indicate certain differences in diet and lifestyle between social classes and the sexes, this study showed that the children of all ages had poor health in all social classes across a wide geographical location for the full time period of the early medieval. Copyright © 2016 John Wiley & Sons, Ltd.     

The necropolis of Vallerano (Rome, 2nd–3rd century AD): an anthropological perspective on the ancient Romans in the Suburbium

The present study investigates the skeletal remains of individuals who were part of a Roman suburban community, in order to assess lifestyle and living conditions in the town's outskirts during the Roman Imperial age. The existence of the community was linked to the functioning of one of the many villas that surrounded the town of Rome at that time. In order to assess health, several indicators were explored, including mortality, oral pathologies and specific (cribra orbitalia) and aspecific (linear enamel hypoplasia) indicators of nutritional and physiological impairment. The sample, which probably represents the labour force of the villa, shows a high number of individuals dying in the early adult age and very few living beyond 50. Subadults were frequently affected by pathological conditions which may indicate anaemia and/or inflammations and infections, as witnessed by the frequency of cribra orbitalia. Growth was also impaired, as the individuals suffered from systemic disturbances during the early years of life that led to the formation of linear enamel hypoplasia (LEH) in their teeth. Frequency of LEH is very high, as well as its multiple occurrence through time (2.44 defects per individual) and its onset occurs from the earliest age classes. Diet, on the other hand, does not seem to have been particularly carbohydrate based. Oral pathologies are very low, which is consistent with meat consumption complementing a diet rich in low‐calorific products of agriculture and seemingly low in refined carbohydrates. Copyright © 2005 John Wiley & Sons, Ltd.     

A Case of Maternal and Perinatal Death in Neolithic Southern Vietnam,c. 2100–1050 BCE

Despite ostensibly elevated rates of young female mortality in the past, believed to be associated with the risks of pregnancy and child birth, surprisingly few cases of pregnant female burials are reported in the bioarchaeological literature. This paper describes and discusses the case of a young female who died and was interred with an unborn full‐term breech foetus at the Neolithic site of An Son, southern Vietnam c. 2100–1050BCE. Her exceptionally poor oral health, evidence for cribra orbitalia, linear enamel hypoplasia, small stature and compromised gynaecological competence, contributes to a differential diagnosis that explores a range of additional complications that may have contributed to the death of both mother and unborn child. An examination and appreciation of this case contribute to our knowledge of the reproductive age and health of young females in Neolithic Southern Vietnam and the challenges they faced during pregnancy and childbirth. Copyright © 2011 John Wiley & Sons, Ltd.     

Porotic lesions in immature skeletons from Stara Torina,late medieval Serbia

Porotic lesions of immature skeletons have been attracting scientific attention for more than a century. These changes have been documented worldwide and are considered to be one of the indicators of health and/or nutritional status of past human populations. These lesions have frequently been referred to as a nutritional stress indicator, a manifestation of iron‐deficiency anaemia, and a condition caused by chronic infections. In this study, 327 immature skeletons from the medieval graveyard of Stara Torina (Serbia) were examined for macroscopic signs of four types of porotic lesions: cribra orbitalia, femoral cribra, humeral cribra, and porotic hyperostosis. Femoral cribra was observed in 83.25% of femora, humeral cribra in 58.46% of cases, cribra orbitalia in 46.12% of orbits, while porotic hyperostosis was recorded in only 2.94% of skulls. The majority of skeletons affected by cribra presented symmetrical lesions. Association between all types of cribra was recorded in 33.33% of skeletons. Historical data supported the hypothesis that the investigated population was exposed to frequent infections, especially parasitic ones, which led to the development of porotic bone lesions via several mechanisms: parasite‐induced blood loss and diarrhoea (both iron and magnesium malabsorption) or anaemia as a hepcidin‐mediated body adaptive response to infection. Copyright © 2008 John Wiley & Sons, Ltd.     

Cribra orbitalia and cribra cranii in Roman skeletal remains from the Ravenna area and Rimini (I–IV century AD)

Cribra orbitalia and cribra cranii are considered good indicators of the health and nutritional status of ancient populations, as their presence is often associated with chronic acquired anaemia. The distribution of these lesions in two Roman samples from the Ravenna area and Rimini was considered as a measure of health in relation to their respective environments. Enamel hypoplasia was also assessed as it is symptomatic of childhood physiological stresses such as malnutrition, infectious diseases, physiological traumas, and the like. The differential analysis suggests that the lesions observed are due to chronic acquired anaemia, probably caused by a poor diet, worm infestation, infections and parasitic diseases. Copyright © 2004 John Wiley & Sons, Ltd.     

Nutritional and disease stress of juveniles from the Dakhleh Oasis,Egypt

Bioarchaeologists use skeletal health indicators to measure how ancient populations adapted to their physical, cultural and biological environments. Skeletons of infants and children are rarely included in these kinds of analyses because of factors such as poor preservation, small sample size, incomplete recovery or research design. In this study, skeletal remains of juveniles aged from foetal to 15 years (N = 238) from Kellis 2, a Romano‐Byzantine cemetery in the Dakhleh Oasis, Egypt, are analysed to shed light on how infants and children were affected by Roman policies during the early years of the Christianisation of Egypt. Non‐specific indicators of physiological stress (cribra orbitalia, enamel hypoplasia and osteoperiostitis) are analysed for post‐natal individuals and interpreted in the context of the physical, cultural and biological landscapes. Results from these analyses suggest moderate levels of skeletal and dental stress with a marked improvement in general health from pre‐Roman times. This study contributes to a better understanding of juvenile paleoepidemiology and mortuary practices in Egypt during the Romano‐Byzantine period. Copyright © 2010 John Wiley & Sons, Ltd.     

In sickness or in health? Assessment of Early Iron Age human skeletons from Toutswe sites,east central Botswana

The general health of Early Iron Age (AD 700 to 1300) mixed farmers in east central Botswana has not been studied before. In this study the bones and teeth of 84 individuals from ten Toutswe sites were analysed for osteological manifestations of disease, with the aim of assessing the general health of the Toutswe communities. These individuals were aged between newborn and 75 years old, and include both sexes. Results indicate the presence of diseases commonly found in archaeological populations such as osteoarthritis, spina bifida occulta, cribra orbitalia, porotic hyperostosis and enamel hypoplasias. One possible case of DISH was found. The frequency of lesions was comparable with or even lower than at other similar sites, such as K2 and Mapungubwe and other parts of southern Africa. The samples represent communities with relatively low levels of stress and infections. This seems to support the results of the palaeodemographic analysis, which indicated that the Toutswe people were better off than those of neighbouring K2 and Mapungubwe. Copyright © 2008 John Wiley & Sons, Ltd.     

The relationship of bone mineral density and other growth parameters to stress indicators in a medieval juvenile population

In this study the radii of 34 juveniles from Wharram Percy, a British medieval site, were measured for bone mineral density (BMD) using dual energy X‐ray absorptiometry (DXA) in order to investigate evidence of stress including Harris lines, cribra orbitalia and deficient cortical index, which is usually attributed to poor nutrition. BMD measurements are used in modern children to assess growth and development and generally correlate with linear growth. Only rare chronic illnesses affect bone mineral accrual in children. Radiographs of the radii were examined to assess cortical index and of the femora and radii for Harris lines. The results indicate that BMD is well correlated with dental age and linear growth, but is poorly correlated with cortical index. The variability in cortical index indicates the influence of environmental factors. There is no relationship between BMD and the presence or absence of Harris lines or cribra orbitalia. Thus, despite obvious evidence of skeletal stress in this juvenile population, bone was not under‐mineralised and bone mineral accrual proceeded normally with growth. This reinforces the conclusion that cortical index is a more sensitive indicator of environmental stress than either Harris lines or cribra orbitalia, and may be compared with BMD measurements to assess the effect of stress on growth. Copyright © 2005 John Wiley & Sons, Ltd.     

Health status of the Venda,a post‐antibiotic community in rural South Africa

This paper examines the health status of a rural African community during the emergence of Westernisation. A total of 157 skeletons, which included 120 adults (55 males and 51 females), 37 juveniles, and 14 individuals of unknown age, were analysed. Date of death ranged from 1910 to 1999, with the majority of individuals (52%) being buried after 1960. The bones were examined for infectious diseases, trauma and degenerative changes. More than half of the individuals in the sample had no pathological lesions on their skeletal remains. No cribra orbitalia was present. One case of leprosy and three cases of osteomyelitis were recorded. The most common findings were osteophytes on the vertebral bodies (syndesmophytes) (17%) and osteoarthritis (7%). The low occurrence of chronic disease is unexpected given that malaria was endemic and intestinal worms were common. Explanations for these results include adequate intake of iron from dietary sources, death from acute infectious diseases, administration of antibiotics, and poor preservation of adult skeletal remains. Copyright © 2007 John Wiley & Sons, Ltd.     

Cribra orbitalia and porotic hyperostosis in a Greek colonial population (5th to 3rd centuries BC) from the Black Sea

Cribra orbitalia and porotic hyperostosis in Greek skeletal remains have typically been attributed to a genetic anaemia, most notably thalassemia due to the presence of endemic malaria in the Mediterranean region. This paper reports the results of an analysis of cribra orbitalia and porotic hyperostosis in a Greek colonial population (5th to 3rd centuries BC) from the Black Sea. Archaeological evidence, stable isotopic data, and other skeletal indicators of physiological stress are examined to determine the most likely cause(s) of these lesions. While the possibility that some of the colonists of Apollonia suffered from thalassemia cannot be entirely discounted, the skeletal evidence examined in this study is not consistent with a diagnosis of thalassemia. We must therefore be cautious in assuming that cribra orbitalia and porotic hyperostosis in Greek skeletal remains, and indeed skeletal remains from any region where malaria was endemic in the past, is always indicative of this condition. Nutritional deficiencies and exposure to infectious diseases probably played an equally, if not more, important role in the development of these lesions. Copyright © 2006 John Wiley & Sons, Ltd.     

Linear Enamel Hypoplasia and Age‐at‐Death at Medieval (11th–16th Centuries) St. Gregory's Priory and Cemetery,Canterbury, UK

Linear enamel hypoplasia (LEH) is a macroscopically detectable band‐like dental defect, which represents localized decrease in enamel thickness caused by some form of disruption to a child's health. Such dental deformations are utilized in osteoarchaeological research as permanent markers of childhood physiological stress and have been extensively studied in numerous ancient human populations. However, currently there is no such data for medieval populations from Canterbury, UK. Here, LEH is examined in the context of age‐at‐death in human burials from the medieval St. Gregory's Priory and adjacent cemetery (11^th–16^th centuries), Canterbury, UK. The cemetery and Priory burials represented lower (n = 30) and higher status (n = 19) social groups, respectively. Linear enamel hypoplastic defects were counted on mandibular and maxillary anterior permanent teeth (n = 374). The age and sex of each skeleton were estimated using standard methods. Differences in LEH counts, age‐at‐death, and LEH formation ages were sought between the two social groups. Results indicate significantly greater frequencies of LEH in the Cemetery (mean = 17.6) compared to the Priory (mean = 7.9; t = −3.03, df = 46, p = 0.002). Adult age‐at‐death was also significantly lower in the Cemetery (mean = 39.8 years) compared to the Priory burials (mean = 44.1 years; t = 2.275, df = 47, p = 0.013). Hypoplasia formation ages differed significantly between the Priory (mean = 2.49 years) and Cemetery (mean = 3.22 years; t = 2.076; df = 47; p = 0.034) individuals. Results indicate that childhood stress may reflect adult mortality in this sample, and that the wellbeing of individuals from diverse social backgrounds can be successfully assessed using LEH analyses. Results are discussed in terms of the multifactorial etiology of LEH, as well as weaning‐related LEH formation. Copyright © 2012 John Wiley & Sons, Ltd.     

Multiple Injury and Health in Past Societies: An Analysis of Concepts and Approaches,and Insights from a Multi‐Period Study

Earlier clinical and bioarchaeological studies found that injury recidivists were most likely to be young adult males. Since then, the clinical meaning of the injury recidivist has expanded to include all individuals with multiple injuries, and other aspects of health have been considered. Our study sought to apply these advances to paleopathology and place multiple injuries in a wider context by investigating: the age and sex distribution of those with single and multiple fractures, and if people with multiple injuries had poorer general health. The sample of 213 males and 190 females (≥18 years old) from six populations in England, Siberia, and Sudan ranged in date from the 3rd century BC to the mid‐19th century AD. Health variables included cribra orbitalia, porotic hyperostosis, periostitis, Schmorl's nodes, enamel hypoplasias, dental caries, and periodontitis. Ante‐mortem injuries were: fractures (0/1/≥2), myositis ossificans, dental trauma, and sharp‐force injuries. The data were analysed using chi‐square and hierarchical loglinear analyses (P = 0.05). No significant three‐way association between age, sex, and injury was found. There was no difference between the sexes when individuals with single versus multiple injuries were compared. There were significant differences in the age‐distribution of people with 0 and 1/≥2 fractures. Males and those 26–35 years old were most likely to have fractures and multiple injuries. Porotic hyperostosis was significantly associated with fractures. There was no significant relationship between general poor health and multiple injuries. Copyright © 2016 John Wiley & Sons, Ltd.     

Developmental Stress in Immature Hominines from Late Pleistocene Eurasia: Evidence from Enamel Hypoplasia

The differences between Middle and Upper Palaeolithic cultures from Europe have been likened to the contrast between generalized and complex hunter–gatherers. A test of this model is undertaken by comparing the types, amount, severity and timing of episodes of enamel hypoplasia between the two periods among specimens from western Europe and the circum-Mediterranean area. The earlier sample consists of 59 dentally immature individuals with 128 primary and 154 permanent teeth while the later sample consists of 47 dentally immature individuals with 162 primary and 125 permanent teeth. It was predicted that the Upper Palaeolithic would show more variation in the attributes noted above as a consequence of increased social differentiation. While the prevalence (50% of individuals) and severity of enamel hypoplasia do not differ between the samples, the Upper Palaeolithic component is significantly more variable in the types and timing of enamel defects. Localized hypoplasia of the primary canine is absent from the Middle Palaeolithic but very common among Upper Palaeolithic children. Earlier work has linked this enamel defect to craniofacial osteopenia due to low bioavailability of vitamin A. Linear enamel hypoplasia peaks at age 3·5 years in the Middle Palaeolithic sample but is as common at age 2·0 as 5·0 years in the Upper Palaeolithic sample. The age distribution differs significantly. Peak age at stress, combining all types of enamel hypoplasia, is 3·5 years in the Middle Palaeolithic and 0·5 years in the Upper Palaeolithic. The major contrast between the Middle and Upper Palaeolithic in terms of enamel hypoplasia is the advent of stressful episodes in early infancy in the Upper Palaeolithic. This is attributed to the low bioavailability of vitamin A due to the synergistic effects of malnutrition and infection exacerbated by a net increase in population density among socially competitive family lineages.     

Retracted: A Possible Case of Hypopituitarism in Neolithic China

A human skeleton with a possible case of hypopituitarism is reported. The individual (burial M53) is from the site of Guanjia, a Neolithic settlement in northern China, dated to the Late Yangshao period (6000–5500 bp ). On the basis of the fully erupted third permanent molars and moderate occlusal dental wear resulting in substantial exposure of dentine, the initially estimated age‐at‐death was placed between 26 and 33 years. However, dimensions of the postcranial skeleton fall significantly below and outside the range from contemporaneous adult populations, and along with delayed epiphyseal fusion present throughout the skeleton, the postcranial age is concordant to that of an 11‐ to 13‐year‐old child. Most long bone epiphyses display incomplete fusion or are entirely unfused, but a lack of microporosity in the metaphyseal areas near growth plates indicates a cessation of longitudinal bone growth. Because no signs of porotic hyperostosis, cribra orbitalia, periosteal lesions or linear enamel hypoplasia are observed, the restricted growth of this individual is likely caused by a growth hormone disorder and is unrelated to nutritional deficiencies or systemic infection. Copyright © 2011 John Wiley & Sons, Ltd.     

Diet and Oral Health of Populations that Inhabited Central Argentina (Córdoba Province) during Late Holocene

The aim of this work is to study, from a bioarchaeological perspective, the diet and oral health of the populations that inhabited Central Argentina in two periods which would reflect changes in subsistence strategies: earlier late Holocene (ca. 2500–1500 years BP) and later late Holocene (ca.1500–400 years BP). The sample is composed by 83 adult individuals from 47 archaeological sites. We considered five non‐specific indicators of stress, infectious and degenerative diseases: hypoplasia of dental enamel, dental caries, abscesses, antemortem teeth loss, and calculus. We also considered hypercementosis, dens in dens, and agenesis. We test intraobserver error by means of intraclass correlation coefficient and analysis of variance of repeated measures. We calculated prevalence by sex, age, geographic subregion, and chronological period. We applied Chi‐square (X²) to test statistical significance of observed differences. Considering the sample as a whole, low prevalence of dental caries (10.27%), abscesses (16.52%), and hypoplasia (10.84%) are coincident with values observed for populations with mixed or hunter‐gathering subsistence strategy. In later late Holocene, high incidence of caries should be considered as indicator of consumption of C4 vegetables or other carbohydrate‐rich vegetables, such as legumes of Prosopis sp. Also, moderate values of dental enamel hypoplasia should be related with metabolic‐systemic stress episodes. Summarizing, these results are coincident with isotopic, archaeological, and ethnohistorical evidences which suggest climatic, social, and demographic pressures that might have affected the lifestyle of these populations before the Spanish conquest. Copyright © 2012 John Wiley & Sons, Ltd.