Objective

The development of tuberculosis is classically associated with the rise of the Industrial Revolution. Our objective is to test this epidemiological hypothesis for populations in France between the 18th and 20th centuries using osteoarchaeological and historical sources.

Materials

Osteoarchaeological sources include two skeletal collections from plague epidemics in Provence (1590 and 1722) representing a total of 349 individuals and medical archives dating 1750–1930 from Paris, Lyon, Marseille, Montpellier.

Methods

Paleoepidemiological analysis (crude prevalence rate) of the archeological data, and epidemiological analysis of historical data included the proportional mortality rate of tuberculosis (PMR-TB) and the mortality rate by tuberculosis (MR-TB).

Results

Mean prevalence of TB before the 19th century was approximately 30 %, according to osteoarchaeological data. Historical sources showed that pulmonary TB was responsible for 33 % of total deaths in the city of Marseille during the second half of the 18th century and represented about 20 % of deaths in the four French cities during the 19th century. The mortality rate was 6.5 per thousand inhabitants in the 18th century (Marseille) and stable at 4–5 ‰ during the 19th century before, during, and after the Industrial Revolution period, with the exception of years 1870–1871 (French-Prussian war), when it increased.

Conclusions

Population increase contemporary to the industrialization process did not increase the mortality rate by tuberculosis in France.

Significance

The epidemiological assertion that tuberculosis increased with the Industrial Revolution in cities must be reevaluated. In France, and perhaps in other cities, it was an endemic disease at least a century before, and associated with a higher mortality rate.

Limitations

Reliability and biases inherent to archaeological and historical data prior and during the Industrial Revolution must be taken into account.

Suggestions for further research

Extension of research to all the French territories (rural and urban areas) is advised.

中文翻译：

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结核病的兴起是否与工业革命同时发生？从骨考古和历史档案推断法国结核病的流行病学演变（17-20 世纪）

客观的

结核病的发展通常与工业革命的兴起有关。我们的目标是使用骨考古学和历史资料来检验 18 至 20 世纪法国人口的这一流行病学假设。

材料

骨考古学来源包括普罗旺斯瘟疫流行（1590 年和 1722 年）的两个骨骼收藏品，共代表 349 个人和可追溯至 1750-1930 年的巴黎、里昂、马赛、蒙彼利埃的医学档案。

方法

考古数据的古流行病学分析（粗患病率）和历史数据的流行病学分析包括结核病的比例死亡率（PMR-TB）和结核病的死亡率（MR-TB）。

结果

根据骨考古数据，19 世纪之前结核病的平均患病率约为 30%。历史资料表明，肺结核占 18 世纪下半叶马赛市总死亡人数的 33%，占 19 世纪法国四个城市死亡人数的 20% 左右。18 世纪（马赛）死亡率为 6.5‰，在 19 世纪工业革命之前、期间和之后稳定在 4-5‰，除了 1870-1871 年（普法战争） )，当它增加时。

结论

与工业化进程同时期的人口增长并未增加法国肺结核的死亡率。

意义

必须重新评估结核病随着城市工业革命而增加的流行病学断言。在法国，也许在其他城市，至少在一个世纪之前，它是一种地方病，并且与更高的死亡率有关。

限制

必须考虑工业革命之前和期间考古和历史数据固有的可靠性和偏见。

进一步研究的建议

建议将研究扩展到所有法国领土（农村和城市地区）。