Maxillary sinusitis as an indicator of respiratory health in past populations

Chronic infectious respiratory disease in a past human population is investigated through the quantification of maxillary sinusitis among Iroquoian horticulturists. Three hundred forty-eight right and left maxillae of a Southern Ontario Iroquoian skeletal sample, Uxbridge Ossuary, ca. AD 1440, were examined for evidence of chronic infection (minimum number of individuals = 207: 114 adults, 22 adolescents, 38 juveniles and 33 infants). Modern clinical criteria were applied to differentiate lesions of respiratory and dental origin. Osseous lesions of the maxillary sinuses were observed in 50% of the individuals examined. These lesions are morphologically consistent with nonspecific lesions observed in other past populations that have been attributed to the presence of pathogens. The prevalence of maxillary sinusitis increases with age. Osseous changes suggestive of maxillary sinusitis of respiratory origin are at a maximum prevalence in juveniles and adolescents. In adults, infection of dental origin becomes a confounding factor in the identification of sinusitis of respiratory origin. Fifteenth century Iroquoians were experiencing high airborne pathogen levels and poor indoor air quality. The prevalence of maxillary sinusitis and the exploration of the origin of tissue injury may contribute to our reconstruction of the quality of life and the respiratory health status of past human populations.