Maxillary Sinusitis as an Indicator of Respiratory Health in Past Populations DEBORAH C. MERRETT 1 * AND SUSAN PFEIFFER 2 1 Department of Anthropology, University of Manitoba, Winnipeg, MB, R3T 5V5, Canada 2 Department of Anthropology, University of Toronto, Toronto, ON, M5S 3G3, Canada KEY WORDS paleopathology; air quality; ossuary; Iroquoians; tuberculosis ABSTRACT 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 morphologi- cally 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 maxil- lary 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. Am J Phys Anthropol 111:301–318, 2000.  2000 Wiley-Liss, Inc. The presence of infectious disease is a universal phenomenon across all living or- ganisms including Homo sapiens. One mode of pathogen transmission is often the air- borne route. Inhalation of pathogens may result in infectious diseases of the upper respiratory tract such as maxillary sinus- itis. Sinusitis, an inflammatory disease of the sinuses, is one of the most commonly reported infectious diseases in modern hu- man populations, affecting an estimated 14% of North Americans (Kaliner et al., 1997). Between 1985 and 1992, sinusitis was the fifth leading cause for dispensing antibiotic prescriptions in the United States (McCaig and Hughes, 1995). Quality of life is often compromised by sinusitis, and productivity may be reduced (Gliklich and Metson, 1995). If left untreated, sinusitis may result in changes to bone morphology (Antonelli et al., 1992; Tovi et al., 1992). The ubiquity of respiratory disease in contemporary human populations (Tovi et al, 1992), the potential for chronic soft tissue infection to result in changes to bone mor- phology (Ortner and Putschar, 1981), and skeletal evidence of sinusitis in some past *Correspondence to: Deborah C. Merrett, Department of An- thropology, University of Manitoba, Winnipeg, MB, R3T 5V5, Canada. E-mail: ummerret@cc.umanitoba.ca Received 19 April 1999; accepted 13 October 1999. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 111:301–318 (2000)  2000 WILEY-LISS, INC.