Are plague pits of particular use to palaeoepidemiologists?

BACKGROUND: The demography and pattern of disease of skeletal assemblages may not accurately reflect those of the living population of which they were once a part. The hypothesis tested here was that skeletons from a mass disaster would more closely approximate to a living population than those from a conventional cemetery. METHOD: Six hundred skeletons recovered from a Black Death plague pit in London were compared with 236 skeletons recovered from an overlying medieval cemetery. Age and sex were determined by standard anthropological means by a single observer and adjustments were made to correct for those skeletons for which either or both could not be established. An estimate of age structure of the living medieval population of London was made, using model life tables. RESULTS: The age and sex distribution and the pattern of disease in the Black Death skeletons did not differ substantially from those in the control group of skeletons. Both assemblages tended to overestimate the numbers in the younger age groups of the model population and underestimate the numbers in the oldest age group. CONCLUSIONS: On the evidence from this single site, a skeletal assemblage from a mass disaster does not provide a better representation of the living population from which it was derived than that from a conventional cemetery.

Acute myeloid leukaemia and exposure to organic solvents--a case-control study.

The objective was to study the relation between exposure to organic solvents and the risk of developing acute myeloid leukaemia (AML) in Caucasians aged 18 years and more. Ninety-eight cases of AML were diagnosed from September 1986 to March 1990 in Novi Sad, Yugoslavia, and in two London hospitals from September 1988 and May 1994 and from July 1992 and July 1994, respectively. Two controls were matched to each case by hospital, year of admission, gender and 5-year age group. Information on solvent exposure was collected by interview. Odds ratios (ORs) were derived with conditional logistic regression. The degree of solvent exposure was determined by three experts blind to the status of the subject with good agreement between them (the kappa coefficient ranged between 0.52 and 0.86). The response rate for cases was 80%. Exposure to solvents was associated with the increased risk of AML (OR: 2.52; 95% CI: 1.45-4.39; p = 0.001) and those with probable exposure to solvents were found to have an odds ratio of AML over three times greater than non-exposed. We also found an elevated OR for exposure to oils (OR: 1.56) but this was not statistically significant. There is no clear pattern of increasing risks with increasing duration of employment but a significant risk was found for exposures of 10 years or less. An induction period of less than 10 years or more than 30 years was associated with a significantly raised OR. There was a significant excess of machinery mechanics and fitters among the cases.

The earliest case of extracranial aneurysm of the vertebral artery.

A lesion is described on the body of C4 from the skeleton of an adult male recovered from a 15th century site in Gloucester. The most plausible explanation for the lesion is that it represents the negative image of an extracranial aneurysm of the vertebral artery and thus is the earliest case described.

Association between osteoarthritis of the hand and knee in a population of skeletons from London.

OBJECTIVE: To examine the relation between osteoarthritis of the hand and knee in a group of skeletons dating to the 18th and early 19th centuries from two sites in London. METHODS: This was a case-control study of 115 cases and controls matched for age and sex. Cases were skeletons with osteoarthritis of the hands; cases and controls were assessed for the presence of osteoarthritis of any compartment of the knee. RESULTS: Cases had a significant odds ratio (OR) for osteoarthritis of the knee compared with controls: OR 5.98, 95% confidence interval (CI) 1.25 to 56.37. Cases with osteoarthritis of the distal interphalangeal (DIP), proximal interphalangeal (PIP), and first carpometacarpal (CMC1) joints had increased but non-significant odds ratios for osteoarthritis of the knee in the order DIP > PIP > CMC1. Cases with multifocal osteoarthritis of the hands had a significantly increased odds ratio for osteoarthritis of the knee: OR 11.67, 95% CI 1.13 to 379.57. CONCLUSIONS: The study confirms the association between osteoarthritis of the hand and the knee seen in contemporary populations and suggests that it is not of very recent origin.

Osteoarthritis of the hands in early populations.

A study of the distribution of osteoarthritis of the hands was carried out in a series of 168 skeletons (77 males, 87 females, four unknown sex) from archaeological sites in England. There were substantial differences in the distribution of the disease between the sexes, but the only significant differences between the hands were shown for the second and third metacarpophalangeal joints, which were more often affected on the right side. In the males, the disease was predominantly unifocal (in 45 of the 77 cases), but in the females it was predominantly multifocal (56 of the 87 cases). Where only a single joint was affected, it was most often the first carpometacarpal joint in females, whereas in males, this joint and the first metacarpophalangeal joints were equally likely to be involved. Single-linkage cluster analysis showed that the strongest link in males was between the trapezoscaphoid and trapezoidoscaphoid joints; in the females, the strongest links were between the first carpometacarpal, the distal interphalangeal and the first metacarpophalangeal joints.

Respiratory symptoms and respiratory function in workers exposed to tea fluff.

A questionnaire survey of respiratory symptoms was carried out on a group of subjects with exposure to tea fluff in a packaging plant and compared with a group of unexposed workers. The subjects had a higher prevalence of rhinitis, bouts of coughing and chest tightness than the controls. Except in the case of rhinitis however, the differences disappeared when allowance was made for either hay fever or smoking. From the original group of subjects, two smaller groups were chosen, one with and one without symptoms, and peak expiratory flow rates were measured over a 12-day period, including eight working and four non-working days. The mean difference in peak flow was greater on the non-working than on the working days and was not related to age, sex, years of exposure, smoking or atopy. We conclude that there is little evidence to suggest that this group of tea packers shows signs of sensitization but that they are probably exposed to an irritant in the tea fluff.

Sickness in the medical profession.

A questionnaire was sent to 200 doctors randomly selected from the Medical Register and replies were received from 63%. Of these, approximately 53% had had at least 1 day off sick in the previous 2 years but very few had taken more than 6 days off in that time. Of those who had not required hospital treatment, most had treated themselves and c. 82% of the respondents stated that they had prescribed treatment for themselves at some time or other. None of the doctors who had taken sick leave had ever consulted their occupational health service but just over 87% reported that they had worked when they felt too unwell to carry out their duties to the best of their ability.