Abstract
OBJECTIVES: This research examines the prevalence of chronic maxillary sinusitis in pre-adults from multiple Dutch sites, while also considering the effects of associated risk factors such as time period (i.e., urbanization), living conditions, and socioeconomic status. Our aim was to investigate how different risk factors impacted childhood upper respiratory health throughout the Dutch medieval and Post-medieval periods. MATERIALS AND METHODS: We selected 13 sites representative of different time periods (475-1866 CE), living environments (i.e., rural and urban), and socioeconomic status to provide an in-depth overview of past Dutch societies. We macroscopically and endoscopically analyzed the maxillary sinuses of 227 pre-adult individuals to identify paleopathological signs of sinusitis. Adult data on chronic maxillary sinusitis from 11 of these populations were available for comparison. RESULTS: Statistical analysis revealed that time period had the most noteworthy impact on sinusitis prevalence. Post-medieval pre-adults were nearly three times more likely to develop sinusitis than their early-medieval counterparts, while post-medieval adolescents faced an eightfold increase in risk compared to adolescents from earlier periods. Neither living environment nor socioeconomic status showed a statistically significant effect on sinusitis prevalence. DISCUSSION: Our findings highlight the interplay of risk factors affecting respiratory health in pre-adults, contributing to a more comprehensive understanding of the historical burden of respiratory diseases in past populations. Factors such as increased population densities, limited access to resources (e.g., healthcare, nutritious food, and drinking water), and the institutionalization of child labor in the Dutch post-medieval period likely had negative impacts on the respiratory health of pre-adults.