An investigation of skeletal indicators of vitamin D deficiency in adults: Effective markers for interpreting past living conditions and pollution levels in 18th and 19th century Birmingham, England

Vitamin D deficiency in adults is referred to as osteomalacia, and this condition has multiple causes related to factors such as environment, living conditions and cultural practices. Therefore, understanding the types and range of expression of osteomalacia in archaeological bone, using a number of investigative techniques, will have significant implications for interpretations made about past communities. This study aimed to understand the expression of vitamin D deficiency in the skeletons of adults through detailed analysis of human bone from the late 18th and 19th century churchyard of St. Martin's, Birmingham, England, at a gross, radiological and histological level. The collection from St. Martin's is unusual for the period as this central burial ground in Birmingham was used by a wide cross section of society rather than a narrow socio-economic group as at other sites of this date. Macroscopic and radiological analysis of 291 adults identified seven individuals with osteomalacia, and histological analysis using back-scattered scanning electron microscopy confirmed the findings. Detailed description of the range of pathological alterations observed in the archaeological skeletons are presented, and possible interpretations of the patterns seen considered. The results of this investigation will enable clear diagnosis and interpretation of this vitamin D deficiency disease, an important socio-economic indicator, to take place in the future.