Environment, Occupation, and Chronic Maxillary Sinusitis in Pre-Roman Italy

To assess the frequency of chronic maxillary sinusitis (CMS) in a pre-Roman archeological skeletal assemblage from Italy and to evaluate the occurrence of CMS in combination with its environmental and sociocultural context.

A total of 131 adult individuals from the pre-Roman site of Pontecagnano (eighth to third centuries bce) in southern Italy with intact maxillary sinuses of ≥ 50% preservation were macroscopically and microscopically observed for the presence of osseous changes per published diagnostic criteria of CMS.

CMS was present in 57.2% of individuals. The prevalence of CMS was higher in females than in males, and this difference was statistically significant (p = 0.043). The frequency of CMS increased with age-at-death. Bilateral CMS occurred more frequently than unilateral CMS. The differences in the prevalence of CMS in the Etruscan (700-450 bce), Samnite (450-375 bce), and final pre-Roman (375-200 bce) phases of occupation were not statistically significant.

In combination with viral and bacterial infections, occupational activities (metallurgy, ceramic and textile production, and agriculture) and environmental factors (volcanic ash, marshy environments, and sub-Saharan dust plumes) likely stimulated respiratory disease and resultant CMS in the inhabitants of Pontecagnano. This study provides a framework for future research on CMS and respiratory diseases in the Mediterranean region, in relation to environmental, climatic, and anthropogenic influences. The limited number of individuals per period prevented a proper diachronic analysis. Osteoarcheological assemblages from the Mediterranean region should be systematically analyzed for CMS to increase understanding of how climate, environment, industrialization, and urbanicity affected human health through time.