Porous skeletal lesions and respiratory infection-related changes in Chalcolithic non-adults: A biocultural approach from Camino del Molino (southeastern Iberia)

OBJECTIVES: This study hypothesizes that the co-occurrence of porous skeletal lesions (PSL) and respiratory infection-related changes influenced non-adult morbidity in prehistoric communities. MATERIALS: All articulated non-adult skeletons (n = 48) from the Chalcolithic (3rd millennium BCE) burial site of Camino del Molino, SE Iberia. METHODS: The presence/absence of PSL (cribra orbitalia, cribra cranii, and cribra femoralis) and infection-related changes (serpens endocrania symmetrica, granular impressions, new bone formation, hypervascularisation of vertebral bodies, ischium, and sacrum) were recorded macroscopically. Lesion co-occurrence was examined in relation to age-at-death and biological sex. RESULTS: Overall, 91.7% of individuals exhibited at least one skeletal alteration. PSL were observed in 89.6% (43/48) of the sample and respiratory infection-related changes in 68.8% (33/48). Co-occurrence of both conditions was identified in 66.7% (32/48) of individuals. Subjects with PSL showed increased risk of respiratory infection-related changes (OR=11.64). Lesions were observed across all age groups, peaking in infants and early adolescents, with no sex-based differences detected. CONCLUSION: The co-occurrence of PSL and respiratory infection-related changes points to prolonged or recurrent infections as a key factor in childhood morbidity. The predominance of lesions in infants and early adolescents aligns with periods of increased vulnerability to respiratory disease. The presence of these lesions suggests that respiratory infections, likely including TB, were already affecting non-adults during the Copper Age. SIGNIFICANCE: This study underscores the complexity of interpreting porous and respiratory infection-related skeletal changes and demonstrates the necessity of holistic, population-level approaches in palaeopathology. SUGGESTIONS FOR FURTHER RESEARCH: Future biomolecular analyses will be essential to verify whether pathogenic agents, particularly those causing tuberculosis or other respiratory diseases, are present in the population.