Paleopathology of the Ychsma: Evidence of respiratory disease during the Late Intermediate Period (AD 1000-1476) at the Central Coastal site of Pachacamac, Peru

Objective To investigate evidence for maxillary sinusitis and pulmonary inflammation in archaeological skeletons dating to the Late Intermediate Period (AD 1000-1476) at the site of Pachacamac, Peru. Materials Thirty-nine individuals (male, female, and unknown sex; 16+ years age-at-death) were analyzed for inflammatory periosteal reaction (IPR) on the visceral (inner) surfaces of the ribs, and 16 individuals were analyzed for evidence of maxillary sinusitis. Methods All individuals were macroscopically examined for bony changes in the maxillary sinuses and new bone formation on the ribs according to pre-established criteria. Results Some 33.3% (13/39) of individuals had IPR on the ribs and 93.8% (15/16) had bony changes in the maxillary sinuses. Conclusions Respiratory disease was likely prevalent in people buried at Pachacamac during the Late Intermediate Period. A number of factors may have increased the risk of developing respiratory disease, including exposure to poor air quality and increased crowding and social mixing, resulting from pilgrimage to this important ritual center. Significance This paper represents one of the first systematic analyses of evidence for respiratory disease in Peruvian and South American human skeletal remains, demonstrating the suitability of the region for further study. Limitations A limited sample was available for analysis. Additionally, the site’s skeletal preservation was excellent, meaning the sample available for assessment of maxillary sinusitis was smaller, being limited to individuals with post-mortem breakage. Further Research The results of this study should stimulate further much needed systematic investigation of evidence for respiratory disease in other Peruvian and South American populations