Hearth and Home in Medieval Iceland
Understanding Chronic Respiratory Infection, Environment and the Vulnerable Child
DOI:
https://doi.org/10.29173/scancan279Keywords:
Hearing loss, palaeopathology, respiratory infection, archaeology of childhood, environmental archaeologyAbstract
The study of otitis media in palaeopathology holds tremendous implications for transforming understanding of the impact of partial or total hearing loss in past populations. The lived experience is scaffolded in the human and environmental entanglements which acknowledge the dwellings, landscapes and the embodiment of biological, social and cultural experiences. Analysis of the prevalence of otitis media and sinusitis at four medieval Icelandic sites: Hofstaðir, Keldudalur, Skeljastaðir and Skriðuklaustur revealed that a number of adults and children alike were affected by chronic respiratory infection, and specifically featuring endemic tuberculosis in this population, and consequently a number of individuals also likely suffered from pathological hearing loss. Finally, the methods allow new inferences in understanding the extent of hearing loss as a hidden disability in the past.
References
Aftab, Ammar, Amamah Noor, and Memuna Aslam. 2022. “Housing Quality and Its Impact on Acute Respiratory Infection (ARI) Symptoms among Children in Punjab, Pakistan.” PLOS Global Public Health 2.9: e0000949. https://doi.org/10.1371/journal.pgph.0000949.
Baxter, Jane Eva. 2022. The Archaeology of Childhood. 2nd ed. Rowman & Littlefield Publishers.
Beck, Anna Severine, Lehne Mailund Christensen, Jannie Ebsen, Rune Brandt Larsen, Dyveke Larsen, Niels Algreen Møller, Tina Rasmussen, Lasse Sørensen, and Leonora Thofte. 2007. “Reconstruction—and Then What? Climatic Experiments in Reconstructed Iron Age Houses in Winter.” In Iron Age Houses in Flames: Testing House Reconstructions at Lejre. Edited by Marianne Rasmussen, 135-173. Vol. 3. Studies in Technology and Culture. Historical-Archaeological Experimental Centre.
Bluestone, Charles D., and William J. Doyle. 1988. “Anatomy and Physiology of Eustachian Tube and Middle Ear Related to Otitis Media.” Journal of Allergy and Clinical Immunology 81.5 (Part 2): 997–1003. https://doi.org/10.1016/0091-6749(88)90168-6.
Bluestone, Charles D., and Jerome O. Klein. 2007. Otitis Media in Infants and Children. PMPH-USA.
Bohling, Solange, Karina Croucher, and Jo Buckberry. 2022. “The Bioarchaeology of Disability: A Population-Scale Approach to Investigating Disability, Physical Impairment, and Care in Archaeological Communities.” International Journal of Paleopathology 38 (September): 76–94. https://doi.org/10.1016/j.ijpp.2022.05.006.
Bolender, Douglas. 2007. “House, Land, and Labor in a Frontier Landscape: The Norse Colonization of Iceland.” In The Durable House: Architecture, Ancestors, and Origins. Edited by R.A. Beck, 400–21. Center for Archaeological Investigations Southern Illinois University.
Boocock, P., Charlotte A. Roberts, and Keith Manchester. 1995. “Maxillary Sinusitis in Medieval Chichester, England.” American Journal of Physical Anthropology 98.4: 483–95.
Callow, Chris. 2006. “First Steps towards an Archaeology of Children in Iceland.” Archaeologia Islandica 5: 55–74.
Christensen, J. M., and M. Ryhl‐Svendsen. 2015. “Household Air Pollution from Wood Burning in Two Reconstructed Houses from the Danish Viking Age.” Indoor Air 25.3: 329–40. https://doi.org/10.1111/ina.12147.
Cinamon, Udi. 2009. “The Growth Rate and Size of the Mastoid Air Cell System and Mastoid Bone: A Review and Reference.” European Archives of Oto-Rhino-Laryngology 266.6: 781–86. https://doi.org/10.1007/s00405-009-0941-8.
Collins, Cecilia. 2019. “The Palaeopathology of Maxillary Sinusitis, Otitis Media and Mastoiditis in Medieval Iceland: Assessing the Prevalence and Aetiology of Chronic Upper Respiratory Disease and the Presence of Tuberculosis Using Microscopy, Endoscopy and CT.” PhD diss., University of Reading. https://doi.org/10.48683/1926.00084764.
—. 2020. “Tuberculosis in Medieval Iceland: Evidence from Hofstaðir, Keldudalur and Skeljastaðir.” HOMO (November): 299–316. https://doi.org/10.1127/homo/2020/1098.
Crawford, Sally, Dawn M. Hadley, and Gillian Shepherd. 2018. “The Archaeology of Childhood: The Birth and Development of a Discipline.” In The Oxford Handbook of the Archaeology of Childhood. Edited by Sally Crawford, Dawn M. Hadley, and Gillian Shepherd. Oxford University Press. https://doi.org/10.1093/oxfordhb/9780199670697.013.1.
Crocker, Christopher, Yoav Tirosh, and Ármann Jakobsson. 2021. “Disability in Medieval Iceland: Some Methodological Concerns.” In Understanding Disability Throughout History. Edited by Hanna Björg Sigurjónsdóttir and James Gordon Rice, 12-28. Routledge.
Davies-Barrett, Anna, Charlotte Roberts, and Daniel Antoine. 2021. “Time to Be Nosy: Evaluating the Impact of Environmental and Sociocultural Changes on Maxillary Sinusitis in the Middle Nile Valley (Neolithic to Medieval Periods).” International Journal of Paleopathology 34 (September): 182–96. https://doi.org/10.1016/j.ijpp.2021.07.004.
Delacourt, Christophe. 2011. “Specific features of tuberculosis in childhood.” Revue Des Maladies Respiratoires 28.4: 529–41. https://doi:10.1016/j.rmr.2010.10.038.
Dimka, Jessica, Taylor P. van Doren, and Heather T. Battles. 2022. “Pandemics, Past and Present: The Role of Biological Anthropology in Interdisciplinary Pandemic Studies.” American Journal of Biological Anthropology 178 (S74): 256–91. https://doi.org/10.1002/ajpa.24517.
Friðriksson, Adolf, and Orri Vésteinsson. 2011. “Landscapes of Burial: Contrasting the Pagan and Christian Paradigms of Burial in Viking Age and Medieval Iceland.” Archaeologica Islandica 9: 50–64.
Fullerton, Duncan G., Nigel Bruce, and Stephen B. Gordon. 2008. “Indoor Air Pollution from Biomass Fuel Smoke Is a Major Health Concern in the Developing World.” Transactions of the Royal Society of Tropical Medicine and Hygiene 102.9: 843–51. https://doi.org/10.1016/j.trstmh.2008.05.028.
Graham, Stephen M., Ben J. Marais, and Farhana Amanullah. 2022. “Tuberculosis in Children and Adolescents: Progress and Perseverance.” Pathogens 11.4: 392 https://doi:10.3390/pathogens11040392.
Hamzaoui, Agnes, Sadok Yaalaoui, Fatma Tritar Cherif, Leila Slim Saidi, and Anissa Berraies. 2014. “Childhood Tuberculosis: A Concern of the Modern World.” European Respiratory Review 23.133: 278–91. https://doi.org/10.1183/09059180.00005314.
Haque, Md Atqul, N. Barman, M. T. Islam, M. Mannan, M. H. Khan, M. R. Karim, M. A. Rob, and M. A. Hossain. 2016. “Biomass Fuel Smoke and Tuberculosis: A Case-Control Study.” Mymensingh Medical Journal: MMJ 25.1: 31–38.
Hodson, Claire M. 2021. “New Prospects for Investigating Early Life-Course Experiences and Health in Archaeological Fetal, Perinatal and Infant Individuals.” Childhood in the Past 14.1: 3–12. https://doi.org/10.1080/17585716.2021.1905884.
van Hoof, Joost, and Froukje van Dijken. 2008. “The Historical Turf Farms of Iceland: Architecture, Building Technology and the Indoor Environment.” Building and Environment 43.6: 1023–30. https://doi.org/10.1016/j.buildenv.2007.03.004.
Horton, Katherine C., Peter MacPherson, Rein M. G. J. Houben, Richard G. White, and Elizabeth L. Corbett. 2016. “Sex Differences in Tuberculosis Burden and Notifications in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.” PLOS Medicine 13.9: e1002119. https://doi.org/10.1371/journal.pmed.1002119.
Jónsson, Sigurjón. 1944. Sóttarfar og sjúkdómar á Íslandi 1400–1800. Hið íslenzka bókmenntafélag.
Kristjánsdóttir, Steinunn, and Joe W. Walser. 2021. “Beneath the Surface: Disability in Archaeological and Osteobiographical Contexts.” In Understanding Disability Throughout History. Edited by Hanna Björg Sigurjónsdóttir and James Gordon Rice, 29-45. Routledge.
Lewis, Mary. 2017. Paleopathology of Children: Identification of Pathological Conditions in the Human Skeletal Remains of Non-Adults. Elsevier Science.
Lewis, Mary E., Charlotte A. Roberts, and Keith Manchester. 1995. “Comparative Study of the Prevalence of Maxillary Sinusitis in Later Medieval Urban and Rural Populations in Northern England.” American Journal of Physical Anthropology 98.4: 497–506. https://doi.org/10.1002/ajpa.1330980409.
Lewis-Simpson, Shannon. 2008. Youth and Age in the Medieval North. Brill.
Mackenzie, I., and A. Smith. 2009. “Deafness—the Neglected and Hidden Disability.” Annals of Tropical Medicine & Parasitology 103.7: 565–71. https://doi.org/10.1179/000349809X12459740922372.
Mandalakas, A. M., H. L. Kirchner, C. Lombard, G. Walzl, H. M. S. Grewal, R. P. Gie, and A. C. Hesseling. 2012. “Well-Quantified Tuberculosis Exposure Is a Reliable Surrogate Measure of Tuberculosis Infection.” The International Journal of Tuberculosis and Lung Disease 16.8: 1033–39. https://doi.org/10.5588/ijtld.12.0027.
Marais, B. J., A. C. Hesseling, R. P. Gie, H. S. Schaaf, D. A. Enarson, and N. Beyers. 2006. “The Bacteriologic Yield in Children with Intrathoracic Tuberculosis.” Clinical Infectious Diseases 42.8: e69–71. doi:10.1086/502652.
McCooey, Bernadette. 2021. “Aspects of Farm Labour in Medieval Iceland: Gender and Childhood c. 1100–1400.” In The Routledge Handbook of Medieval Rural Life. Edited by Miriam Müller, 242–63. Routledge.
Merrett, Deborah C., and Susan Pfeiffer. 2000. “Maxillary Sinusitis as an Indicator of Respiratory Health in Past Populations.” American Journal of Physical Anthropology 111: 301–18.
Michelson-Ambelang, Todd. 2015. “Outsiders on the Inside: Conception of Disability in Medieval Western Scandinavia.” PhD diss. University of Wisconsin-Madison.
Milek, Karen. 2012. “The Roles of Pit Houses and Gendered Spaces on Viking-Age Farmsteads in Iceland.” Medieval Archaeology 56.1: 85–130. https://doi.org/10.1179/0076609712Z.0000000004.
Niewöhner, Jörg. 2020. “Situating Biologies: Studying Human Differentiation as Material-Semiotic Practice.” In Biosocial Worlds. Edited by Jens Seeberg, Andreas Roepstorff, and Lotte Meinert, 44–68. Anthropology of Health Environments beyond Determinism. UCL Press. https://www.jstor.org/stable/j.ctv13xpsqt.7.
Niewöhner, Jörg, and Margaret Lock. 2018. “Situating Local Biologies: Anthropological Perspectives on Environment/Human Entanglements.” BioSocieties 13.4: 681–97. https://doi.org/10.1057/s41292-017-0089-5.
Openshaw, Peter J. 2009. “Crossing Barriers: Infections of the Lung and the Gut.” Mucosal Immunology 2.2: 100–02. https://doi.org/10.1038/mi.2008.79.
Panhuysen, Raphaël G. A. M., Vincent Coened and Tjasse D. Bruintjes. 1997. “Chronic Maxillary Sinusitis in Medieval Maastricht, The Netherlands.” International Journal of Osteoarchaeology 7.6: 610–14. https://doi.org/10.1002/(SICI)1099-1212(199711/12)7:6<610::AID-OA366>3.0.CO;2-Q.
Perez-Velez, Carlos M., Claudia L. Roya-Pabon, and Ben J. Marais. 2017. “A Systematic Approach to Diagnosing Intra-Thoracic Tuberculosis in Children.” Journal of Infection, Hot Topics in Infection and Immunity in Children 74: S74–83. https://doi:10.1016/S0163-4453(17)30195-0.
Perry, Megan A., and Rebecca L. Gowland. 2022. “Compounding Vulnerabilities: Syndemics and the Social Determinants of Disease in the Past.” International Journal of Paleopathology 39 (December): 35–49. https://doi.org/10.1016/j.ijpp.2022.09.002.
Phatak, Sandeep A., Yang-soo Yoon, David M. Gooler, and Jont B. Allen. 2009. “Consonant Recognition Loss in Hearing Impaired Listeners.” The Journal of the Acoustical Society of America 126.5: 2683–94. https://doi.org/10.1121/1.3238257.
Phipps, C. David, W. Edward Wood, William S. Gibson, and William J. Cochran. 2000. “Gastroesophageal Reflux Contributing to Chronic Sinus Disease in Children: A Prospective Analysis.” Archives of Otolaryngology–Head & Neck Surgery 126.7: 831–36. https://doi.org/10.1001/archotol.126.7.831.
Pokhrel, Amod K., Michael N. Bates, Sharat C. Verma, Hari S. Joshi, Chandrashekhar T. Sreeramareddy, and Kirk R. Smith. 2010. “Tuberculosis and Indoor Biomass and Kerosene Use in Nepal: A Case-Control Study.” Environmental Health Perspectives 118.4: 558–64. https://doi.org/10.1289/ehp.0901032.
Roberts, Charlotte A. 2007. “A Bioarcheological Study of Maxillary Sinusitis.” American Journal of Physical Anthropology 133.2: 792–807.
—. 2012. “Re-Emerging Infections: Developments in Bioarchaeological Contributions to Understanding Tuberculosis Today.” In A Companion to Paleopathology. Edited by Anne L. Grauer, 434–57. Wiley-Blackwell.
Roberts, Charlotte A., and Cox, Margaret. 2003. Health & Disease in Britain: From Prehistory to the Present Day. Sutton.
Sahito, Ambreen, Asaad Ahmed Nafees, Unaib Rabbani, Ambreen Kazi, and Zafar Fatmi. 2015. “Biomass Fuel Use Is a Risk for Pulmonary Tuberculosis: Case Control Study.” European Respiratory Journal 46 (suppl 59). https://doi.org/10.1183/13993003.congress-2015.PA3413.
Samúelsson, Sigurður. 1998. Sjúkdómar og dánarmein íslenskra fornmanna: Sjúkdómsgreiningar byggðar á frásögnum fornritanna. Háskólaútgáfan.
Sayle, Kerry L., W. Derek Hamilton, Gordon T. Cook, Philippa L. Ascough, Hildur Gestsdóttir, and Thomas H. McGovern. 2016. “Deciphering Diet and Monitoring Movement: Multiple Stable Isotope Analysis of the Viking Age Settlement at Hofstaðir, Lake Mývatn, Iceland.” American Journal of Physical Anthropology 160.1: 126–36. https://doi.org/10.1002/ajpa.22939.
Sebastian, Susan K., Vikas Vijayan, Vibhor B. Kumar, and Payal Garg. 2020. “Tuberculous Otitis Media in Children: Series of 4 Cases.” International Journal of Pediatric Otorhinolaryngology 135 (August): 110118. https://doi.org/10.1016/j.ijporl.2020.110118.
Sens, Patrícia Maria, Clemente I. R. Almeida, Lupércio O do Valle, Luís H. C. Costa, and Miguel L. S. Angeli. 2008. “Tuberculosis of the Ear, a Professional Disease?” Brazilian Journal of Otorhinolaryngology 74.4: 621–27. https://doi.org/10.1016/S1808-8694(15)30614-5.
Sharma, P. P., Ashok Kumar, and Padam Singh. 2010. “A Study of Gender Differentials in the Prevalence of Tuberculosis Based on NFHS-2 and NFHS-3 Data.” Indian Journal of Community Medicine: Official Publication of Indian Association of Preventive & Social Medicine 35.2: 230–37. https://doi.org/10.4103/0970-0218.66869.
Sigurðsson, Sigurður. 1976. “Um berklaveiki á Íslandi.” Læknablaðið 62: 3–50.
Sigurjónsdóttir, Hanna Björg, Ármann Jakobsson, and Kristín Björnsdóttir, eds. 2013. Fötlun og menning: Íslandssagan í öðru ljósi. Félagsvísindastofnun Háskóla Íslands/ Rannsóknarsetur í fötlunarfræðum.
Sigurjónsdóttir, Hanna Björg, and James G. Rice, eds. 2022. Understanding Disability Throughout History: Interdisciplinary Perspectives in Iceland from Settlement to 1936. Interdisciplinary Disability Studies. Routledge.
Smith, Eiríkur. 2013. “Í skuld við fjölskyldu og Guð: Staða fatlaðs fólks fyrir upphaf læknisfræðilegs skilnings á Íslandi.” In Fötlun og menning: Íslandssagan í öðru ljósi. Edited by Hanna Björg Sigurjónsdóttir, Ármann Jakobsson, and Kristín Björnsdóttir, 93–126. Félagsvísindastofnun Háskóla Íslands.
Southwell-Wright, William. 2013. “Past Perspectives: What Can Archaeology Offer Disability Studies?” In Emerging Perspectives on Disability Studies. Edited by Matthew Wappett and Katrina Arndt, 67–95. Palgrave Macmillan US. https://doi.org/10.1057/9781137371973_4.
Stodder, Ann L. W., and Jennifer F. Byrnes. 2019. “(Re)Discovering Paleopathology: Integrating Individuals and Populations in Bioarchaeology.” In Evaluating Evidence in Biological Anthropology: The Strange and the Familiar. Edited by Cathy Willermet and Sang-Hee Lee, 103–25. Cambridge Studies in Biological and Evolutionary Anthropology. Cambridge University Press. https://doi.org/10.1017/9781108569125.007.
Sumpter, Colin, and Daniel Chandramohan. 2013. “Systematic Review and Meta-Analysis of the Associations between Indoor Air Pollution and Tuberculosis.” Tropical Medicine & International Health 18.1: 101–8. https://doi.org/10.1111/tmi.12013.
Sundman, Elin Ahlin, and Anna Kjellström. 2011. “Chronic Maxillary Sinusitis in Medieval Sigtuna, Sweden: A Study of Sinus Health and Effects on Bone Preservation.” International Journal of Osteoarchaeology, 23.4: 447-58. https://doi.org/10.1002/oa.1268.
Tasker, Andrea, Peter W. Dettmar, Marguerite Panetti, James A. Koufman, John P. Birchall, and Jeffrey P. Pearson. 2002. “Is Gastric Reflux a Cause of Otitis Media with Effusion in Children?” The Laryngoscope 112.11: 1930–34. https://doi.org/10.1097/00005537-200211000-00004.
Tilley, Lorna. 2015. Theory and Practice in the Bioarchaeology of Care. Springer International Publishing. https://doi.org/10.1007/978-3-319-18860-7.
Tirosh, Yoav. 2020. “Deafness and Nonspeaking in Late Medieval Iceland (1200–1550).” Viator 51.1: 311–44.
Torres-Duque, Carlos, Darío Maldonado, Rogelio Pérez-Padilla, Majid Ezzati, Giovanni Viegi, and Forum of International Respiratory Studies (FIRS) Task Force on Health Effects of Biomass Exposure. 2008. “Biomass Fuels and Respiratory Diseases: A Review of the Evidence.” Proceedings of the American Thoracic Society 5.5: 577–90. https://doi.org/10.1513/pats.200707-100RP.
Trbojevic, Nikola, Dawn Elise Mooney, and Aidan Bell. 2011. “A Firewood Experiment at Eiríksstaðir: A Step towards Quantifying the Use of Firewood for Daily Household Needs in Viking Age Iceland.” Archaeologia Islandica 9 (January): 29–40.
Tsai, Kuo-Sheng, Hsiao-Ling Chang, Shun-Tien Chien, Kwo-Liang Chen, Kou-Huang Chen, Ming-Hsin Mai, and Kow-Tong Chen. 2013. “Childhood Tuberculosis: Epidemiology, Diagnosis, Treatment, and Vaccination.” Pediatrics and Neonatology 54.5: 295–302. https://doi.org/10.1016/j.pedneo.2013.01.019.
Uys, Pieter, Hilmarie Brand, Robin Warren, Gian van der Spuy, Eileen G. Hoal, and Paul D. van Helden. 2015. “The Risk of Tuberculosis Reinfection Soon after Cure of a First Disease Episode Is Extremely High in a Hyperendemic Community.” PLOS ONE 10.12: e0144487. https://doi.org/10.1371/journal.pone.0144487.
Uys, Pieter, Ben J. Marais, Simon Johnstone-Robertson, John Hargrove, and Robin Wood. 2011. “Transmission Elasticity in Communities Hyperendemic for Tuberculosis.” Clinical Infectious Diseases 52.12: 1399–1404. https://doi.org/10.1093/cid/cir229.
Walser III, Joe W., Steinunn Kristjánsdóttir, Darren R. Gröcke, Rebecca L. Gowland, Tina Jakob, Geoff M. Nowell, Chris J. Ottley, and Janet Montgomery. 2020. “At the World’s Edge: Reconstructing Diet and Geographic Origins in Medieval Iceland Using Isotope and Trace Element Analyses.” American Journal of Physical Anthropology 171.1: 142–63. https://doi.org/10.1002/ajpa.23973.
Whaley, Diana. 1993. “Nicknames and Narratives in the Sagas.” Arkiv för nordisk filologi 108: 122–46.
World Health Organization. 2020. “Deafness and Hearing Loss.” https://www.who.int/news-room/fact-sheets/detail/deafness-and-hearing-loss.
Zoëga, Guðný. 2018. “The Old and The Young in Early Medieval Iceland: The Evidence for Three-Generational Families in the Household Cemeteries of Skagafjorður, Northern Iceland.” AmS-Skrifter 26: 105–18. https://doi.org/10.31265/ams-skrifter.v0i26.213.
Zoëga, Guðný, and Kimmarie A. Murphy. 2020. “Resources, Stress, and Response in Late Viking Age Iceland.” In The Routledge Handbook of the Bioarchaeology of Climate and Environmental Change. Edited by Gwen Robbins Schug, 103-21. Routledge.
Zoëga, Guðný, Sigríður Sigurðardóttir, and Bryndís Zoëga. 2023. “Turf Building in Iceland: Past, Present, and Future.” Open Archaeology 9 (December). https://doi.org/10.1515/opar-2022-0345.
Þorvaldsson, Reynir Berg. 2010. Saga heyrnarlausra á Íslandi. Félag heyrnarlausra.
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