42 • Ann Stirland 



nonminers. This was attributed either to an unexplained 

 higher prevalence in nonminers or to a difference in working 

 environments in the two countries. Similarly, in a Finnish 

 study of lumberjacks, no correlation could be found between 

 the period of heavy work and disc degeneration when the age 

 factor was removed (Sairanen et al. 1981 ). The authors con- 

 cluded that various factors seem to be involved in the etiol- 

 ogy of disc degeneration, as well as age and mechanical 

 stress. Heredity and autoimmunization may be involved in 

 these changes, making it difficult to assess the role of heavy 

 work. Osteoarthritis was thought to have a multifactorial 

 etiology (Sairanen et al. 198 1 :27), and ergonomically correct 

 work was found to be very important in its lack of develop- 

 ment. Lindberg and Danielsson (1984) were also unable in 

 their study to demonstrate any relationship between occupa- 

 tion and coxarthrosis in shipyard workers involved in heavy 

 labor. 



Some of the preceding papers, and much of the fundamen- 

 tal work in this field, are excellently reviewed by Hagberg 

 (1984). In this review, the controversial nature of the etiology 

 of the degenerative arthropathies, the enthesopathies, and 

 their relationship to occupational stress are clearly discussed 

 and evaluated in the context of disorders of the neck and 

 shoulder (1984:270-275). This work emphasizes what must 

 by now be clear. The role of occupational stress as a factor in 

 osteoarthritis is far from unequivocal. This is partly a func- 

 tion of the classification of work by occupation (e.g., 

 "miners"), rather than by actual task or evaluation of stress, 

 or by loading on skeletal areas. The necessary information is 

 also .spread over many different specialized medical fields 

 and its interpretation can suffer from the constraints of differ- 

 ing opinions. 



The changes due to osteoarthritis or to degenerative joint 

 disease are not the only ones that may be related to activity in 

 the skeleton. Lesions may be present whose pathogenesis is 

 clear but in a different context. An example is the group of 

 enthesopathies. In this case, the lesion may be degenerative 

 (related to age) in one context, but occur in a young, robust 

 individual in another. If direct trauma or disease can be elimi- 

 nated as a causative agent, then another explanation has to be 

 found for the lesions. 



Other morphological variants used as occupational stress 

 markers are supinator crests and fossae of ulnae (Kennedy 

 1983). The hypertrophy of the crests, deepening of the fos- 

 sae, and "ridging" of the insertion of the anconeus muscle 

 were found in prehistoric samples in males "known" to have 

 used missile weapons such as spears (Kennedy 1983:872). 

 Similar changes also occurred in modem populations, in both 

 sexes, who were habitually engaged in occupational or ath- 

 letic activities involving similar patterns of arm movement. 

 Changes at the elbow which can be directly related to occupa- 

 tion are also apparent in baseball players (Bennett 1959). 

 Damage to hyaline cartilage, olecranon fractures, and spur 

 formation occur as a result of persistent, chronic strain. 



Chronic bursitis and fraying of both supraspinatus and biceps 

 tendons are recorded as a result of strain and overuse. 



The previous examples resulted in the formation of pro- 

 liferative new bone at various sites in the upper girdle. An- 

 other syndrome associated with activity-related stress is os- 

 teolysis of the distal clavicle (Kaplan and Resnick 1986). 

 This pathology is known to occur clinically after acute trau- 

 matic injury to the shoulder. In the cases cited here, it was 

 also found to occur secondary to repeated microtrauma of the 

 acromioclavicular joint. The main case is of a 39-year-old 

 male who worked in a bakery, lifting heavy pans of rolls in 

 and out of ovens all day. There had been no single traumatic 

 event. Similar, atraumatic pathological changes have been 

 noted in other occupations involving loading, such as air- 

 hammer operator or oxygen tank delivery man, and also in 

 athletes, such as weight-lifters and handball players. 



The clinical existence and reporting of pathological 

 changes other than those associated with osteoarthritis in the 

 human skeleton is encouraging. Although the arthropathies 

 are the most common pathological changes observed in ar- 

 cheological skeletal material, other lesions do occur. While 

 some of these are truly pathological and are a consequence of 

 a disease process, others quite clearly are not. It is common 

 to attribute the term "pathological" to anything that is abnor- 

 mal. Such abnormalities include some of the changes already 

 discussed, such as the enthesopathies, and those due to over- 

 use or activity. Can such abnormal changes be used in the 

 diagnosis of occupationally related paleopathology? 



The Mary Rose 



One of the more serious problems encountered in the analysis 

 and interpretation of archeological human skeletal material is 

 the lack of spatial and temporal controls for a particular site. 

 This problem is part of the wider one already referred to, 

 namely, the general lack of any documentary evidence. Very 

 rarely is a site excavated in which these problems are mini- 

 mized. Such a site is Henry VIII's flagship, the Mary Rose. 

 The Mary Rose was sunk on the morning of 19 July 1545 

 after having emerged from her home port of Portsmouth, 

 England, at the head of the English fleet. The object was to 

 engage the French fleet moored nearby. The ship apparently 

 executed a bad turn to starboard and, in attempting to raise 

 sail, took in water through open gun ports, heeled over and 

 sank rapidly, settling heavily into the soft seabed silts. Of the 

 crew of 415 men all but about 35 drowned, including the 

 captain, the master, and the vice admiral. Most were trapped 

 under the stout antiboarding netting which covered the 

 decks. The ship came to rest on her starboard side and silted 

 up within a matter of months. The exposed port side was 

 eroded by the sea until it collapsed, leaving intact the com- 

 plete starboard half. The wreck was then sealed in the 16th 

 century by a hard, shelly seabed and remained hidden, apart 

 from the occasional severe winter storm, until it was discov- 

 ered in 1968. The rapid silting and sealing provided a perfect 



Zagreb Paleopathology Symp. 1 988 



