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Our aim was to investigate how different risk factors impacted childhood upper respiratory health throughout the Dutch medieval and Post\u2010medieval periods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>We selected 13 sites representative of different time periods (475\u20131866\u2009<jats:sc>CE<\/jats:sc>), living environments (i.e., rural and urban), and socioeconomic status to provide an in\u2010depth overview of past Dutch societies. We macroscopically and endoscopically analyzed the maxillary sinuses of 227 pre\u2010adult individuals to identify paleopathological signs of sinusitis. Adult data on chronic maxillary sinusitis from 11 of these populations were available for comparison.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Statistical analysis revealed that time period had the most noteworthy impact on sinusitis prevalence. Post\u2010medieval pre\u2010adults were nearly three times more likely to develop sinusitis than their early\u2010medieval counterparts, while post\u2010medieval adolescents faced an eightfold increase in risk compared to adolescents from earlier periods. Neither living environment nor socioeconomic status showed a statistically significant effect on sinusitis prevalence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Our findings highlight the interplay of risk factors affecting respiratory health in pre\u2010adults, contributing to a more comprehensive understanding of the historical burden of respiratory diseases in past populations. Factors such as increased population densities, limited access to resources (e.g., healthcare, nutritious food, and drinking water), and the institutionalization of child labor in the Dutch post\u2010medieval period likely had negative impacts on the respiratory health of pre\u2010adults.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ajpa.70050","type":"journal-article","created":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T10:44:19Z","timestamp":1744281859000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Historical Trends and Risk Factors in Chronic Maxillary Sinusitis Among Dutch Pre\u2010Adults (475\u20131866\u2009CE)"],"prefix":"10.1002","volume":"186","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4209-7889","authenticated-orcid":false,"given":"Maia","family":"Casna","sequence":"first","affiliation":[{"name":"Faculty of Archaeology Leiden University  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0424-6748","authenticated-orcid":false,"given":"Sarah A.","family":"Schrader","sequence":"additional","affiliation":[{"name":"Faculty of Archaeology Leiden University  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajpa.21258"},{"key":"e_1_2_10_3_1","first-page":"13","volume-title":"De Doden Vertellen. 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