Enamel hypoplasia in the Middle Pleistocene hominids from Atapuerca (Spain)

The prevalence and chronology of enamel hypoplasias were studied in a hominid dental sample from the Sima de los Huesos (SH) Middle Pleistocene site at the Sierra de Atapuerca (Burgos, northern Spain). A total of 89 permanent maxillary teeth, 143 permanent mandibular teeth, and one deciduous lower canine, belonging to a minimum of 29 individuals, were examined. Excluding the antimeres (16 maxillary and 37 mandibular cases) from the sample, the prevalence of hypoplasias in the permanent dentition is 12.8% (23/179), whereas the deciduous tooth also showed an enamel defect. No statistically significant differences were found between both arcades and between the anterior and postcanine teeth for the prevalence of hypoplasias. In both the maxilla and the mandible the highest frequency of enamel hypoplasias was recorded in the canines. Only one tooth (a permanent upper canine) showed two different enamel defects, and most of the hypoplasias were expressed as faint linear horizontal defects. Taking into account the limitations that the incompleteness of virtually all permanent dentitions imposes, we have estimated that the frequency by individual in the SH hominid sample was not greater than 40%. Most of the hypoplasias occurred between birth and 7 years (N = 18, X = 3.5, SD = 1.3). Both the prevalence and severity of the hypoplasias of the SH hominid sample are significantly less than those of a large Neandertal sample. Furthermore, prehistoric hunter-gatherers and historic agricultural and industrial populations exhibit a prevalence of hypoplasias generally higher than that of the SH hominids. Implications for the survival strategies and life quality of the SH hominids are also discussed. © 1995 Wiley-Liss, Inc.     

The chronological distribution of enamel hypoplasias from prehistoric Dickson Mounds populations

The chronological distributions of enamel hypoplasias (indicators of nonspecific stress) are assessed for 111 individuals from two prehistoric populations from Dickson Mounds, Lewiston, Illinois. The earlier population (circa A.D. 950-1150) involves a transition from an indigenous gathering-hunting tradition to increasing adoption of Mississippian lifeways. The later population (circa A.D. 1150-1300) is fully Mississippian (MM). Based on the occurrence of hypoplasias on all permanent teeth except third molars, 14 half-year periods from birth to 7.0 years are graded for evidence of hypoplasia-stress. Both populations have a low frequency of hypoplasia which occur before 2 years of age and after 4 years of age. A common peak frequency of hypoplasias between 2.0 and 4.0 years is suggestive of an elevated degree of stress at weaning. The peak frequency of hypoplasias is earlier in the MM (2.5-3.0 years versus 3.0-3.5 years in the pre-Mississippian population). In addition, the rise to and decline from peak frequency occurs approximately 0.5 years earlier in the MM. The earlier and sharper rise to peak frequency suggests earlier and more severe weanling-related stress. Hypoplasias chronologies are undoubtedly influenced by age-related host resistance factors (Sarnat and Schour, 1941). Nevertheless, these data demonstrate that populations may vary in their chronological distribution of hypoplasias and that these variations may provide useful information on age-related patterns of exposure to environmental stressors.     

Factors affecting the distribution of enamel hypoplasias within the human permanent dentition

Frequencies and morphological and chronological distributions of enamel hypoplasias are presented by tooth type (permanent I1 to M2s), based on a sample of 30 prehistoric Amerindians with complete and unworn dentitions. There is nearly a tenfold variation in frequency of defects by tooth, ranging from 0.13 per mandibular second molar to 1.27 per maxillary central incisor. The six anterior teeth average between 0.70 and 1.27 defects/tooth, whereas the eight posterior teeth average between 0.43 and 0.13 defects/tooth. Earlier developing teeth, such as incisors, have earlier peak frequencies of defects (2.0-2.5 years), while later developing teeth, such as second molars, have subsequent peak frequencies (5.0-6.0 years). These variations are relevant when comparing hypoplasia data based on different teeth. Differences in hypoplasia frequencies among teeth are not solely due to variation in time of crown development, as is usually reported. Rather, there is evidence for biological gradients in susceptibility to ameloblastic disruption. Anterior teeth are more hypoplastic than posterior teeth. More developmentally stable "polar" teeth are more hypoplastic than surrounding teeth. Polar teeth may be more susceptible to hypoplasias because their developmental timing is less easily disrupted. In all teeth, hypoplasias are most common in the middle and cervical thirds. Crown development and morphological factors, such as enamel prism length and direction, may influence the development and expression of enamel surface defects.     

Enamel hypoplasia and age at weaning in 19th-century Florence,Italy

A sample representing a population of the Florence district of middle 19th century was studied to determine the age of occurrence of enamel hypoplasias. The age interval most affected was that between 1.5 and 3.5 years. Historical sources on weaning habits of 19th-century Italian populations indicate a weaning period between 12 and 18 months. This is in agreement with the data on enamel defects, showing that children of post-weaning age are more subject to stress. Wide “grooves”, with prolonged duration, are concentrated between 2 and 2.5 years, whereas “lines” occur primarily between 2.5 and 3 years. We suggest that this distribution could reflect the gradual introduction of dietary supplements until weaning is complete. © 1994 Wiley-Liss, Inc.     

Prevalence and age at development of enamel hypoplasias in Mexican children

Enamel hypoplasias, deficiencies in enamel thickness resulting from disturbances during the secretory phase of enamel development, are generally believed to result from nonspecific metabolic and nutritional disruptions. However, data are scare on the prevalence and chronological distributions. of hypoplasias in populations experiencing mild to moderate malnutrition. The purpose of this article is to present baseline data on the prevalences and chronological distributions of enamel hypoplasias, by sex and for all deciduous and permanent anterior teeth, in 300 5 to 15-year-old rural Mexican children. Identification of hypoplasias was aided by comparison to a published standard (Federation Dentaire Internationale: Int. Dent. J. 32(2):159-167, 1982). The location of defects, by transverse sixths of tooth crowns, was used to construct distributions of defects by age at development. One or more hypoplasias were detected in 46.7% (95% CI = 40.9-52.5%) of children. Among the unworn and completely erupted teeth, the highest prevalence of defects was found on the permanent maxillary central incisors (44.4% with one or more hypoplasias), followed by the permanent maxillary canine (28.0%) and the remaining permanent teeth (26.2 to 22.2%) Only 6.1% of the completely erupted and unworn deciduous teeth were hypoplastic. The prevalence of enamel defects on the permanent teeth was up to tenfold greater than that found in studies of less marginal populations that used the FDI method. The prevalence of defects in transverse zones suggests a peak frequency of hypoplasias during the second and third years for the permanent teeth, corresponding to the age at weaning in this group. In the deciduous teeth, a smaller peak occurs between 30 and 40 weeks post gestation. The frequency of defects after three years of age is slightly higher in females than males, suggesting a sex difference in access to critical resources.     

Dental enamel hypoplasias and health changes in the Middle Bronze Age - Early Iron Age transition at Pella in Jordan.

Dental enamel hypoplasias are increasingly being used in epidemiological studies as indicators of health within both modern and prehistoric populations. This symptom of growth disruption is used here to examine possible changes in health occurring at the transition between the Bronze Age and Iron Age in Jordan, through examination of enamel hypoplasias in skeletal remains from two tombs at the archaeological site of Pella. A small but not statistically significant difference in the prevalence and frequency of hypoplastic defects was found between the two time periods. These results suggest that the political and economic changes occurring at this time were not sufficiently stressful to cause a dramatic deterioration in health at the onset of the Early Iron Age.     

Biocultural analysis of sex differences in mortality profiles and stress levels in the late medieval population from Nova Raca, Croatia

Human skeletal remains of 104 individuals from the late medieval (14th-18th century) Nova Raca cemetery, in continental Croatia, are described. Historic data from the parish Book of the Dead, relevant to a period in the early 19th century, suggest that females may have been under greater stress than males. To test this hypothesis, the skeletal material is analyzed for the presence and distribution of enamel hypoplasias and cribra orbitalia. Observations are also made on the presence and pattern of dental disease, skeletal infection, trauma, osteoarthritis, vertebral degenerative changes, and Schmorl's depression frequencies. The mortuary sample, consisting of 36 subadults and 68 adults, exhibits underrepresentation of subadults, and differential adult male/female mortality profiles. Peak female mortality is between 21-25 years, compared to peak male mortality between 31-35 years. Average adult female age at death is 29.9 years, compared to 34.1 years in adult males. Significant sex differences are present in the frequencies of enamel hypoplasia. Adult females have higher frequencies of hypoplastic teeth, and a larger number of defects in the teeth affected than in males. Subadults in the series also exhibit higher frequencies of hypoplastic teeth, and a larger number of defects in the teeth affected than in adults, documenting a relationship between enamel hypoplasia-causing stress events and reduced life expectancy. Significant sex differences are also present in dental pathology frequencies, possibly reflecting differences in resource access. Sex differences in vertebral osteoarthritis and Schmorl's depression frequencies may reflect differential activity patterns.     

Frequency and chronological distribution of linear enamel hypoplasia in a North American colonial skeletal sample

A skeletal sample of 44 individuals born and raised in early 18th century frontier settlements of Northeastern United States is examined for the frequency and chronological distribution of linear enamel hypoplasia (LEH) on the maxillary and mandibular incisors and canines. The prevalence of LEH ranged from 31% on the I² to 66% on the mandibular C and the mean number of defects ranged from .59 on the I² to 1.08 on the mandibular C. These frequencies were generally lower than those reported for two later samples: the Monroe County Poorhouse sample and the Hammon-Todd sample. Individuals in these latter two samples were derived from the lowest socioeconomic stratum of their respective populations. Frequency differences are explained within the context of the changing availability of resources that resulted from the rise of industrialization, urbanization, and wage labor which took place during the 18th and 19th centuries. The frequency of LEH was low prior to 1.5 years of age and may result from attrition and/or decreased susceptibility in the relevant area of the crown or from low morbidity or high mortality. Peak frequencies are observed in all age categories ranging from 2.5 to 3.0 years up to 4.0 to 4.5 years and are too late to result from weaning. Instead, they may reflect the susceptibility of nonimmune children to diseases that were common in colonial North America. As the majority of these diseases were not fatal, most victims who survived may have had one or more LEHs as visible proof of their earlier encounter(s). © 1996 Wiley-Liss, Inc.     

Enamel hypoplasia in ancestral Puebloan populations from southwestern Colorado: I. Permanent dentition

Dental enamel hypoplasias are used to examine metabolic disruption experienced during early childhood by ancestral Puebloan (Anasazi) inhabitants of southwestern Colorado. The hypoplasia sample consists of the permanent anterior dentition from 147 individuals from Montezuma County and Mesa Verde National Park. Using the individual as the basis of analysis, the study compares different time periods of occupation of the region with respect to prevalence and timing of hypoplasia occurrence. The frequency of enamel hypoplasia in the combined regional sample is high, affecting 90% of the individuals and 66% of the anterior teeth. The earliest onset of hypoplasia in individuals occurs most commonly at 2.5–3.0 years, and the peak age for enamel disruption is 3.0–3.5 years. There are no significant differences in hypoplasia frequency or timing between males and females or between adults and subadults. The level of childhood stress appears to have increased significantly with time from the Basketmaker III to the Pueblo I and Pueblo II periods, then decreased slightly during the Pueblo III. The differences between the Pueblo I, II, and III periods are not significant. The Pueblo II sample from Yellow Jacket Canyon sites 5MT1 and 5MT3 and the Dolores Pueblo I sample show the highest levels of childhood stress in comparison to other Puebloan populations inhabiting this region prior to A.D. 1300. Am. J. Phy. Anthropol. 102:351–367, 1997. © 1997 Wiley-Liss, Inc.     

Young adult mortality following severe physiological stress in childhood: Skeletal evidence

Numerous studies report that early childhood biological stress impairs health in later adulthood. Overwhelmingly these studies are based on modern data, when health conditions are quite good by historical standards. Potentially much can be learned by examining the relationship within populations that lived under enormous pressure, enduring life expectancies less than one-half of those found in industrial countries of the late twentieth century. This paper uses the skeletal remains of over 3000 individuals who lived in the Western Hemisphere as long as 6000 years ago to probe the connection between several markers of early childhood stress and survival from approximately age 15 to 30. In a logit model with explanatory variables that control for sex and ethnicity, the probability of survival was systematically 7.6 percentage points less among individuals with two or more hypoplasias, 3.9 percentage points less for those with cribra orbitalia or porotic hyperostosis, and 4.6 percentage points less for individuals stunted by 20 cm in height. The paper compares these findings with those from studies on modern data and concludes with suggestions for research.     

Environmental stress in the Early Mediaeval Slavic population at Borovce (Slovakia)

Several palaeopathological indicators examined in skeletal samples are caused by stress during childhood and remain visible in adults. In this study, dental enamel hypoplasia was observed in 451 individuals from the Early Mediaeval (8th to beginning of 12th c. AD) Slavic skeletal series at Borovce (Slovakia). The presence of enamel hypoplasia was scored in all types of deciduous and permanent teeth. More than one-fourth (27.2%) of the individuals with preserved permanent teeth showed enamel hypoplasia. No significant differences in the occurrence of the enamel lesions were found between males and females. The age at development of hypoplasias was estimated for 74 individuals by measuring the distance of the defect from the cemento-enamel junction. The hypoplastic defects appeared most frequently between 2.5 and 3.0 years. Following the trends observed in the distribution of age at development of the enamel lesions between subadults and adults, individuals stressed earlier in life had a reduced ability to cope with later insults. High prevalence of enamel hypoplasia, especially among 10–14-year-old growing juveniles, has led to the assumption that the Borovce population lived a considerably long period under conditions of high environmental pathogen load, and probably also suffered from some nutritional deficiencies.     

Brief communication: physiological stress in the Florida Archaic-enamel hypoplasia and patterns of developmental insult in early North American hunter-gatherers

We examined the prevalence and developmental timing of linear enamel hypoplasias (LEHs) in an early Archaic Floridian population from Windover (8,120-6,980 (14)C years B.P. uncorrected). Using digital images, mandibular and maxillary canines were analyzed for defect prevalence and timing of insults. Although overall prevalence was very weakly correlated with earlier defect timing, there were significant differences in defect prevalence that varied by sex and tooth type. The mean LEH count in male mandibular canines was far higher than in male maxillary canines or in female mandibular or maxillary canines. We examined defect timing as a possible predictor of the sex differences in LEH prevalence. There were no significant sex differences in the developmental timing of the earliest defects in either tooth class. Developmental timing is not responsible for the sex differences seen in defect prevalence in mandibular canines.     

Dental anthropology and paleodemography of the precolumbian populations of hispaniola from the third millennium B.C. to the Spanish conquest

The demography and dental traits of the skeletal samples from the necropoles of Cueva Roja (IIrd millennium b.C.), El Soco (800 a.D) and Juan Dolio (1400 a.D.) have been analyzed. The preceramic sample from Cueva Roja consists of some 50 individuals, the one from El Soco consists of 158 individuals and the one from Juan Dolio of 108 individuals. The demographic analysis has revealed a slight improvement of life conditions from the pre-contact period to the beginning of the contact period. Dental metrical traits show a marked overlapping of the metrical data for the anterior teeth. A reduction can be noted for the posterior teeth, especially for the first molar, from the preceramic period to the later ceramic period. The analysis of nutritional stresses, through the study of dental enamel hypoplasias, reveals a high incidence of stress in the preceramic population. In the preceramic group, it peaks late in childhood (3.5—3.9 years of age) which could be caused by a delay in weaning. Instead the more recent groups (El Soco and Juan Dolio) show evidence of an earlier occurrence of hypoplasia. Both peak at 3.0–3.4 years of age. The frequencies of hypoplasias calculated by type of tooth are less in the Tainos groups than in the preceramic one. From of the data now available, we can suppose that an amelioration of life conditions occurred from the preceramic period to the later ceramic period. As regards the Tainos groups, a slight improvement in life conditions can be noted from the precontact period to the period immediately before the European colonization. The dental non-metric traits show a strong homogeneity within the Taino groups. However, the preceramic group shows more marked differences when compared to the others. This could be supposed to be due to a different demic background between the Tainos and the group from Cueva Roja.     

Histological enamel indicator of childhood stress in prehistoric skeletal samples.

Although previous paleopathological studies have used disturbances in enamel formation as indicators of childhood stress, the full potential of this technique has not been realized. This paper presents a test case which demonstrates that the frequency of disturbed enamel formation (i.e., Wilson bands) is associated with other stress indicators (i.e., probability of dying and infectious lesions) in three prehistoric skeletal samples representing the Middle Woodland (10.3%), Mississippian Acculturated Late Woodland (21.4%), and the Middle Mississippian (40.0%). Additionally, the mean ages at death of individuals with at least one Wilson band are lower than those without bands.These results suggest that Wilson bands are an indicator of the relative proportion of individuals who are high susceptibles in prehistoric populations. The data also corroborate the hypothesis that the adoption of maize agriculture in the prehistoric American Midwest is associated with increased stress.     

Linear enamel hypoplasias as indicators of systemic physiological stress: evidence from two known age-at-death and sex populations from postmedieval London

Enamel hypoplasias are useful indicators of systemic growth disturbances during childhood, and are routinely used to investigate patterns of morbidity and mortality in past populations. This study examined the pattern of linear enamel hypoplasias in two different burial populations from 18th and 19th Century church crypts in London. Linear enamel hypoplasias on the permanent dentitions of individuals from the crypt of Christ Church, Spitalfields, were compared to enamel defects on the teeth of individuals from St. Bride's. The method used involves the identification of enamel defects at a microscopic level, and systemic perturbations are detected by matching hypoplasias among different tooth classes within each individual. The pattern of linear enamel hypoplasias was contrasted between individuals from the burial sites of Spitalfields and St. Bride's, between males and females, and between those aged less than 20 years of age and those aged over 20 years at death. Six different parameters were examined: frequency of linear enamel hypoplasias, interval between defects, duration of hypoplasias, age at first occurrence of hypoplasia, age at last occurrence of hypoplasia, and the percentage of enamel formation time taken up by growth disturbances. All individuals in the study displayed linear enamel hypoplasias, with up to 33% of total visible enamel formation time affected by growth disruptions. Multiple regression analysis indicated a number of significant differences in the pattern of enamel hypoplasias. Individuals from Spitalfields had shorter intervals between defects and greater percentages of enamel formation time affected by growth disturbances than did individuals from St. Bride's. Females had greater numbers of linear enamel hypoplasias, shorter intervals between defects, and greater percentages of enamel formation time affected by growth disturbances than males. There were also differences in the pattern of enamel hypoplasias and age at death in this study. Individuals who died younger in life had an earlier age at first occurrence of enamel hypoplasia than those who survived to an older age. The pattern of enamel hypoplasias detected in this study was influenced by tooth crown geometry and tooth wear such that most defects were found in the midcrown and cervical regions of the teeth, and greater numbers of defects were identified on the anterior teeth. Differences in sensitivity of the parameters used for the detection of enamel hypoplasias were found in this study. The percentage of visible enamel formation time affected by growth disturbances was the parameter that identified the greatest number of significant differences among the subgroups examined.     

Paradox and promise: Research on the role of recent advances in paleodemography and paleoepidemiology to the study of “health” in Precolumbian societies

Bioarcheology has made tremendous strides since the subdiscipline's inception, subsequent syntheses, the standardization of data collection methods, and analytical advances ranging from molecular analyses through age-estimation and biodistance. Concurrently, health and the adaptive success of past populations have remained primary concerns. However, questions are routinely raised about lesions and whether or not changing frequencies are synonymous with increases or decreases in stress, morbidity, and overall health. These include how and why healed lesions can simultaneously represent stress and survival, demanding that researchers understand how population dynamics influence skeletal sample formation. In this study, methods to analyze age- and sex-specific mortality patterns prior to, and in conjunction with, the analysis of linear enamel hypoplasias are demonstrated. Paleodemographic and paleoepidemiological models are presented for late Pre-Columbian skeletal samples from the Eastern Woodlands. Results of hazard modeling demonstrate that elevated mortality rates were commonplace during the latter half of the Mississippian period (AD 1200–1450) with reproductive-age females experiencing high age-specific risk of death attributed to the development of fortified villages and novel environments for increased pathogen loads. Corollary results are presented for the age-specificity of linear enamel hypoplasias in the central Illinois River valley. The epidemiological models demonstrate that the relationship between adult mortality and early childhood stress varied through space, culture, and time. These findings highlight the need to effectively operationalize measurements related to health and stress in past populations and support the adoption of selective mortality and heterogeneity in frailty as key concepts in bioarcheological research. Am J Phys Anthropol 155:268–280, 2014. © 2014 Wiley Periodicals, Inc.     

Hardships of contact: Enamel hypoplasias in Tupí-Mondé Amerindians from the Brazilian Amazonia

This paper presents an assessment of enamel defects (hypoplasias) in the permanent anterior teeth of three Tupí-Mondé-speaking groups from the Brazilian Amazonia: the Gavião, Suruí, and Zoró. These are native societies that experienced the onset of permanent contact with Brazilian national society in different periods of the 20th century. Tupí-Mondé dentition is highly hypoplastic, which is possibly related to exposure to adverse health and nutritional conditions. Data for the Gavião, Suruí, and Zoró are in agreement with results from other populations that show that certain teeth, the maxillary central incisors and the mandibular canines in particular, tend to be more hypoplastic. Although all types of teeth show hypoplasia concentrations at some enamel zones, there is substantial intertooth variation in the age at which peaks occur. It is argued that hypoplasia concentrations at certain ages are unlikely to be related to postweaning stresses for the Tupí-Mondé. Statistically significant associations between presence of enamel defects and deficits in physical growth (height-for-age) were detected in children 7–11 years of age. Diachronic assessment of enamel defects, which rested upon the potential of enamel as “memory” of past periods of systemic physiological perturbation, allowed us to unravel aspects related to the dynamics of Tupí-Mondé life during the 20th century. Frequencies of enamel zones with defects peaked during the contact years of each of the Tupí-Mondé groups, attesting to the extreme social and biological hardships that characterized the contact experiences of these native societies with Brazilian national society. Am J Phys Anthropol 109:111–127, 1999. © 1999 Wiley-Liss, Inc.     

Stress physiologique et état de santé des plus anciens Hommes anatomiquement modernes du sud-est de l’Europe (données dentaires,couche 6-1, Buran-Kaya III,Crimée)

Buran-Kaya III site, in Crimea, provides an exceptional stratigraphic sequence, extending from Middle Paleolithic to Neolithic. Among the archaeological layers allocated to the Gravettian (sensu lato), more than 170 anthropological remains have been discovered in the layer 6-1. They represent the oldest Upper Paleolithic modern humans from Eastern Europe in a well-documented archaeological context. The aim of this article, based on dental remains and enamel dental hypoplasias in particular, is to evaluate the health of the modern humans, which lived more than 32,000 years BP ago in Crimea. This study puts into the light the low frequency of hypoplasias (occurring in the two youngest individuals). This article complete the rare studies concerning the presence of this physiological stress during the Early Upper Paleolithic and confirm the scarcity of enamel dental hypoplasias and dental pathologies, such as caries, at this period.     

Insights from stable light isotopes on enamel defects and weaning in Pliocene herbivores

A high prevalence of enamel hypoplasia in several herbivores from the early Pliocene Langebaanweg locality, South Africa, indicates general systemic stress during the growing years of life. The presence of several linear enamel hypoplasias per tooth crown in many teeth further suggest that these stress events may be episodic. The δ¹⁸O values along tooth crowns of mandibular second molars ofSivatherium hendeyi (Artiodactyla, Giraffidae) were used to investigate the cause of the stress events in this tooth type. Results show that weaning in this fossil giraffid occurred at a similar ontogenetic age to that in extant giraffes, and that the observed enamel hypoplasia towards the base of this tooth type manifested post-weaning. Further, high-resolution oxygen isotope analyses acrossS. hendeyi third molars suggest that the entire development of defective tooth crowns occurred under conditions of increased aridity in which the cool, rainy part of the seasonal cycle was missing. The high prevalence of this defect in many herbivores suggests that climatic conditions were not favourable. This study reiterates the value of stable isotope analyses in determining both the behaviour of fossil animals and the environmental conditions that prevailed during tooth development.     

Life stresses of slavery

Skeletal evidence exists for life stresses of 120 Black individuals from 25 sites in Maryland, Virginia, and the Carolinas. Periods for statistical comparison are eighteenth century, 1690-1770; Catoctin Furnace, Maryland industrial slaves, 1790-ca.1820; 1800-ca.1860, nineteenth century; and a twentieth-century Black sample compiled from forensic (accidental deaths) cases. From these archaeological sources, skeletal age at death shifts from 36 years, female, and 30 years, male in eighteenth century (N = 29) to 34.8, female, and 36.3, male in nineteenth century (N = 56). Catoctin Furnace slaves' longevity may reflect special conditions for skilled males (34.6 years, female; 41.2 years, male (N = 16). Nutritional stresses are indicated by dental lesions, hypoplasias, stature, and skull base height and pelvic brim index. Occupational stress occurs in some adolescents and in many adults as exaggerated development of lifting muscles (deltoid and pectoral crests) and early vertebral and shoulder breakdown. Lead content of bone may reflect site of occupation. The most common pathology is anemia or sicklemia; parietal depressions and ulna fractures ("parry") indicate violence-related trauma.