Working your fingers to the bone

Working your fingers to the bone

HomeConference Keynote SpeakersConference ProgrammeWorkshop - New Coimbra Method


Working your fingers to the bone. An interdisciplinary conference on identifying occupation from the skeleton

6th – 8th of July, 2016. Department of Life Sciences, University of Coimbra.

The aim of this interdisciplinary conference is to bring together researchers interested in disease, injury and other effects of occupations (in the broadest sense) on the human skeleton to improve the interpretation of these changes in archaeological and forensic contexts. 

Why Occupational Health?

Identifying occupation, task division and activity-patterns from skeletal remains past populations and using this to assist forensic identification, has been an alluring prospect in bioarchaeology from its earliest inceptions. Some occupation identification can be made by pathognomonic changes, e.g. “phossy jaw” which was characteristic of those working with white phosphorous in the matchstick industry, however, the majority of skeletal changes cannot be ascribed to a single task or occupation, e.g. entheseal changes or cross-sectional geometry. Recent research has highlighted that the multifactorial aetiology of many skeletal changes previously used to identify activity-patterns cannot be applied simplistically.

Conference Content

This conference will build on recent advances in related fields to provide a direction for future research on using skeletal changes to identify occupations (and activity-patterns) based on what is currently known. Abstracts are invited on a diverse range of approaches including: palaeopathology, biomechanics, ethnography, modern medicine, forensic science, archaeology, socio-cultural anthropology


The deadline for abstracts is the 13th of March and for early registration, the 25th of April.


Charlotte Henderson, Ana Luisa Santos, Francisca Alves Cardoso, Sandra Assis and Alejandra Acosta.

Scientific committee

The organisers and:

Prof. Eugénia Cunha, Department of Life Sciences, University of Coimbra.

António José Vilar Queirós, MD, Health and Safety Management Department, University of Coimbra Social Services.

Prof. Peter Kirby, Professor of Social History and Leverhulme Research Fellow, Glasgow Caledonian University.

Sébastien Villotte, CNRS Researcher, University of Bordeaux.

Cynthia Wilczak, Associate Professor, San Francisco State University.


Cynthia Wilczak

Associate Professor, San Francisco State University

Title: Methods in Reconstructing Past Activities: Can the new approaches deliver any substantial new insights?

Abstract: The study of “markers of occupational stress” (MOS) in bioarchaeology has its roots in early occupational medicine. In skeletal populations, MOS have been classified as bony changes caused by long-term patterns of activity that result in excessive mechanical forces on the bone, including the formation of flat surfaces (facets) where bone comes in contact with bone; changes at muscle insertions (entheses); patterns of osteoarthritis in joint complexes; cross-sectional geometry of the long bones; as well as stress fractures and other types of traumatic injuries. The pattern of these changes has been used to infer the life history and physical labor of many prehistoric and historic populations yet there are considerable questions surrounding the accuracy and limits of such reconstructions.  Some of the problems are methodological while others stem from an incomplete understanding of how bone responds to strain, complicated by other factors, such as age and pathology, that can also induce bony changes and have the potential to obscure the biomechanical effects, if any, on bone.  Each type of MOS represents a distinct challenge and some of the underlying assumptions about the relationship between activity and skeletal changes have recently received increased scrutiny. After a survey of the history of MOS studies, this presentation will critically examine the clinical and experimental work that might provide support for biomechanical stress as a factor in the etiology of the skeletal changes currently used in activity studies and will then review the most recent advances in methodological approaches in bioarchaeological studies. Finally the limitations of what we can reasonably infer about activity patterns in past populations in light of the most recent advances in skeletal biology and suggestions for future research studies will be presented.

Biography: Cynthia Wilczak received her Ph.D. from Cornell University in 1998. She has worked on the development of both quantitative and qualitative methods for recording entheseal changes and coauthored “Atlas of Occupational Markers on Human Remains” with Luigi Capasso and the late Kenneth AR Kennedy. As a member of a methodology working group established at the 2009 workshop on Musculoskeletal Stress Markers held at the University of Coimbra, Portugal, she has collaborated with her colleagues in developing and testing the Coimbra method for recording entheseal changes.  Her other research interests are in paleopathology, particularly disease processes that are associated with bone formation. Dr. Wilczak formerly worked in the Repatriation Laboratory at the National Museum of Natural History, Washington D.C. and is currently an associate professor in the Department of Anthropology at San Francisco State University.


Peter Kirby (withdrawn due to unforeseen circumstances)

Professor of Social History and Leverhulme Research Fellow, Glasgow Caledonian University

Title:  The Body and the Industrial Workplace in Britain, 1780-1850

Abstract: Before the mid-nineteenth century, ideas about the relationship between the human body and the industrial workplace were rooted largely in theoretical medical opinions and rarely informed by empirical observation. Most early medical commentaries on the ailments of industrial occupations were influenced by the theories of early authorities such as Ramazzini who ascribed workplace ailments variously to influences such as harmful vapours, raw materials and unfavourable ergonomics. Medical witnesses to early industrial inquiries seized upon ergonomics in particular to explain skeletal deformities amongst child workers in factories. It was argued that unusual postures and long periods of standing in factories led to widespread skeletal distortion and disabilities. In coalmining, meanwhile, widespread short stature and distinctive body shapes were ascribed to constrained working positions and heredity. This lecture examines how industrial influences upon physical growth and development were reported in the early nineteenth century and suggests that the high profile given to medical diagnoses at the early industrial inquiries into child health tended to divert attention from more tangible causes of industrial ill-health and injury.

Biography: Professor Kirby is an elected Fellow of the Academy of Social Sciences (2014) and an elected Fellow of the Royal Historical Society (2010). He was honoured in 2014 to be an invited Visiting Professor at the School of Advanced Studies in Social  Sciences (EHESS, Paris) as a guest of the French Government. Prof Kirby sits on the Executive Committee of the Economic History Society and is Chair of the Information Technology Committee. He has held academic posts in the universities of Sheffield, Sunderland and Manchester and before joining Glasgow Caledonian University he was an elected Research Associate at St John’s College, Oxford. He was appointed Professor of Social History at GCU in April 2012 and spent three years as Director of the Social History of Health and Healthcare. His main research interests are in the historic labour market and especially the health and working conditions of child workers in the past. Prof Kirby’s most recent book, Child Workers and Industrial Health, 1780-1850 (2013) discusses the illnesses, disabilities and ill-treatment of child labourers in textiles and mining. He has also published widely on the labour market in journals including Past and Present, Economic History Review and Continuity and Change and recently published an article in the Economic History Review on the attendance patterns and productivity of men in the coalmining industry.


Sébastien Villotte

CNRS Researcher, UMR 5199 PACEA.

Title: Division of Labour in European Prehistory

Abstract: Cultural anthropologists have long recognised that the age and sex of individuals determine the level of participation in activities among human groups cross-culturally. On this basis, it seems legitimate to formulate the hypothesis of a division of tasks within prehistoric European societies as well. In the absence of writing the number of possible approaches to test this hypothesis, however, is quite limited. On can analyse art manifestations depicting everyday activities, artefacts (mostly to discuss  the level of experience or specialisation needed for their realisation), grave goods, or human remains  themselves. None of these kinds of study is without limitations, but the bioanthropological approach  seems the most promising. Based on examples of studies of human remains dated from the Upper Palaeolithic, Mesolithic, and Neolithic, I will attempt to illustrate how to address independently (and thus avoiding circular reasoning so commonly seen in this field) task divisions in European Prehistory. The purpose of this kind of research is twofold: on the one hand it can allow to better understand the structure of these societies; on the other hand it may highlight cultural universals.

Biography: Sébastien Villotte is involved in interdisciplinary projects that focus on biological characteristics and burial practices of European Upper Palaeolithic and Mesolithic populations. One strand of his research focuses on the behaviour of past human populations; the main issues addressed being division of labour and workload, human-environment interactions and group mobility.


Duarte Nuno Vieira

Director and professor at the Faculty of Medicine, University of Coimbra

Title: Work, skeletal changes and identification

Biography: Duarte Nuno Vieira is visiting professor in several Portuguese, European and South American universities. He is President of the European Council of Legal Medicine, of the Ibero-American Network of Forensic Medicine and Forensic Science Institutions and of the Portuguese Association for Bodily Injury Assessment and Vice-President of the European Confederation of Experts on Evaluation and Repair of Bodily Injury. He is also Chairman of the Forensic Advisory Board of the Prosecutor of the International Criminal. He has been President of the International Academy of Legal Medicine, of the International Association of Forensic Sciences, of the World Association of Police Medical Officers, of the Mediterranean Academy of Forensic Sciences, and of the Latin American Association of Medical Law. He also had been Director of the Institute of Legal Medicine of Coimbra, President of the Portuguese National Institute of Legal Medicine and Forensic Sciences and of the Portuguese Medico-Legal Council and President of the Portuguese Superior Council of Legal Medicine and the College of Forensic Medicine of the Portuguese Medical Association. He is Chairman of the Thematic Federation on Legal and Forensic Medicine of the European Union of Medical Specialists. Coordinator of the Competence in evaluation of Bodily Injury group of the Medical Association. Member of the Executive Committee of the Working Group on Pathology and Forensic Anthropology of Interpol Standing Committee on Identifying Mass Disaster Victims. He works on regular basis as Temporary Forensic Consultant for the United Nations High Commissioner for Human Rights, and he is Member of the Forensic Advisory Board of the International Committee of the Red Cross, Member of the Forensic Expert Group of the International Rehabilitation Council for Torture Victims, among many other functions.


Helena Canhão

Invited Full Professor, Head EpiDoC Unit, NOVA, Universidade Nova de Lisboa

Title: Diseases of the bones and joints: what do they tell us?

Abstract:  Osteoarthritis is a joint disease characterized by subchondral bone and cartilage failure. It has been reported in humans since Paleolithic times. The disease prevalence increases with age and also with intense physical exercise. The prevalence was very high in the British Isles, documented in remains from Romano-British and Saxon burials suggesting that, whatever genetic factors there may have been, there was an extremely high level of physical activity (WJ MacLennan). The prevalence of the condition has been decreasing in late Medieval times through the 18th and 19th centuries. Currently it is a bit higher than in 19th century not only associated to ageing as well to the promotion of physical activity in modern societies.

By opposite, osteoporosis is characterized by bone fragility and increased risk of fractures. Inactivity and sedentary life habits increase the prevalence of osteoporosis. This justified the reduction in bone density with the change from hunter to agriculture, with lower physical activity. Severe cases of osteoporosis have been identified from individual skeletons dated to the Bronze Age. Osteoporosis is much more frequent in women. But the pattern changed over time. In the Early Medieval period osteoporosis frequency started to raise. Contributing factors were bad nutrition, pregnancies and prolonged lactation (WJ MacLennan). With the increasing of life survival the prevalence of post menopausal osteoporosis has been progressively increasing through the high levels we are experiencing today.


Geneviève Perréard Lopreno

External collaborator, Laboratory of Prehistoric Archaeology and Anthropology, University of Geneva

Title: Bone geometry and strength : anthropological and medical approaches to assess the influence of occupational activities on the skeleton

Abstract: Repeated loading influences bone mass, geometry and/or microstructure. Contributing factors are extensively studied in biomechanics and in the medical field, but in studies without longitudinal design in populations with specific characteristics, e.g. age, sex, disease, sports activities. Whether chronic loading in the frame of professional activity in a life course impacts bone, particularly cortical bone that markedly contributes to bone strength, is poorly documented. This lecture will present results from two original studies, one in the field of anthropology, the other in a medical context (carried out by Dr. E. Biver, Department of Bone Deseases, University of Geneva Hospitals). Based on the same corpus (men from the SIMON collection of identified skeletons with known professions), on identical variables (cross-sectional properties on several sections from humerus, radius and clavicle) as well as similar occupational groups categorisation, each study had a specific aim of research. In an osteoporosis/bone disease context the issue is to understand if occupational activities in a life course contribute positively to bone geometry and strength, so lowering the risk of fracture in old ages. In an anthropological approach, the main question is to know if daily occupational activities influence, in a distinctive way, the bone geometry allowing discrimination of unilateral versus bilateral activities. Results, enhanced by in vivo data (GERICO cohort), demonstrate that repeated loading may positively influence cortical bone strength by two mechanisms: an increase of cross-sectional area in young adulthood followed by slowdown of the age-related endosteal bone loss. It appears further, that agricultural activity, mainly bimanual, led to a gain of symmetry, since both the non-active and specialists groups show a higher asymmetry on the upper limb. Besides these statistical results, some more qualitative results, concerning bilateral asymmetry, handedness, and overall characteristics of bone geometry at an individual as well as population level will also be presented. Finally these findings will briefly be discussed in the context of current research.


Lecturer in prehistoric archeology and anthropology laboratory of the University of Geneva from 2000 to 2012, currently external collaborator of this institution and independent archaeological anthropologist.

Research topics: identified skeletons collections (construction, testing and creation of methodological standards), functional adaptation of the skeleton, palaeodemography, bio- cultural environment of medieval and modern regional populations (growth and stature).

Member of the working group on the categorization of occupations, resulting from the workshop of Coimbra, 2009.

President of the Swiss Society of Anthropology (2010-2015).

Link to abstract book and conference programme

List of presentations

Type Authors Title
Oral Acosta, MA; Henderson, CY Analysing uniqueness and symmetricality of entheses: an approach to identifying individuals in mass burials.
Poster Alves-Cardoso, F Exploring “wear and tear” of joints and “muscle function” assumptions in skeletons with known occupation at death.
Oral Berthon, W; Tihanyi, B; Pálfi, Gy; Dutour, O; Coqueugniot, H Could microCT help to grasp the nature of entheseal changes? Early insight from radial tuberosity exploration
Oral Boston, C Suffering a sea change- trauma in the late th to early th century British Royal Navy
Poster Caldas, IM; Pereira, ML; Teixeira, A; Pérez-Mongiovi, D Occupational-related changes in oral structures
Poster Curate, F; Cunha, E; Ferreira, I; Albuquerque, A Occupational activity and bone mineral density in men: a study from the Coimbra Identified Skeletal Collection
Poster Ferreira, MT; Coelho, C; Cunha, E; Wasterlain, SN Evidences of trauma in an enslaved African individual from Lagos, Portugal (th-th centuries)
Poster Henderson, CY Enthesis size: the relationship with occupation and entheseal changes
Oral Henderson, CY; Mariotti, V; Wilczak, CA; Villotte, S The “new Coimbra method” and the effect of age.
Poster Inskip, S; Palmer, J; Schats, R Diachronic Analysis of ‘Squatting Facets’ in Rural and Urban Dutch populations
Oral Klingner, S; Schultz M Respiratory health in past populations:
Bony changes and risk factors for respiratory diseases observed in the Linear Pottery Culture ( – BC) Population from Wandersleben, Central Germany
Oral Magalhães, BM; Mays, S; Santos, AL Is occupation a risk factor for respiratory disease? An essay in the Coimbra International Exchange Skull Collection”
Oral Matos, VMJ Was occupation a risk factor for the development of bone lesions in leprosy patients before the “antibiotic era”? Evidence from the archives of the last Portuguese leprosarium
Oral Maximiano, AF; Santos, AL; Henderson, CY Physical stress and repetitive movement in sewing: the use of clinical literature to infer activity in skeletal remains from late th to early th century
Oral Mendes, A; Soares, S; Cardoso, FA Confronting Markers of Occupational Stress with Known Occupational Data: Cases from Portuguese Human Identified Collections
Oral Milella, M; Alves-Cardoso, F; Assis, S; Speith, N (Mis)informed? Identified skeletal collections, occupation, age-at-death and the reconstruction of physical activity.
Oral Mulder, B; Van Rietbergen, B; Waters-Rist, AL Comparing microarchitecture with macromorphology: is entheseal change a marker of activity?
Oral Niinimäki, S; Narra, N; Härkönen, L; Abe, S; Nikander, R; Hyttinen, J; Knüsel, C; Sievänen, H Activity history consisting multidirectional loading affects strength but not shape of the femur shaft
Oral Nikita, E; Radini, A Mahalanobis distances as a means of exploring inter-population differences in entheseal changes
Poster Palmer, JLA; Waters-Rist, AL; Hoogland, MLP A re-assessment of sex-differences in EC using the Coimbra method
Oral Ríos, L; Cardoso, HF Appearance of endplate defects in the thoraco lumbar spine: an ontogenetic study
Oral Rodrigues, AC; Silva, AM; Matias, A; Santos, AL Atypical dental wear and oral pathology in a skeletal sample exhumed from one maqbara of Shantarîn (Portugal).
Oral Rufino, AL; Ferreira, MT; Wasterlain, SN Orofacial dysfunction and dental wear: analysing biomechanics in an individual from the archaeological collection of slaves from Lagos (Portugal)
Poster Ryan, J; Desideri, J; Besse M Musculoskeletal Stress Markers and the Search for Specialised Archers:
A Look into Bell Beaker Burials
Poster Salega, MS; Silva, AM; Henderson, CY A diachronic study of activity in Portugal using entheseal changes
Oral Simonit, F; Cavalli, F; Giudici, F; Innocenti, D; Lusnig, L Moments of inertia in the evaluation of bone functional adaptation of the lower limbs: a study on historical and modern populations
Oral Spekker, O; Molnár, E; Marcsik, A; Lovász, G; Masson, M; Maczel, M; Pósa, A; Neparáczki, E; Váradi, O; Schultz, M; Nerlich, A; Minnikin, D; Donoghue, H; Maixner, F; Zink, A; Dutour, O; Bereczki, Z; Paja, L; Pálfi, G. On the traces of ancient tuberculosis: possibilities of the macromorphological diagnosis of tuberculosis in prehistoric and historic osteological series – Skeletal tuberculosis cases from the Szeged Anthropological Collection
Oral Stevens, E “Sticks, stones, and broken bones: Traumatic injuries and how they contribute to a life course of entheseal changes and activity patterns”
Poster Syrogianni A Enthesopathies on individuals from a cemetery in Piraeus (Greece) of the 4th century B.C
Oral Teßmann, B External auditory exostoses (EAE) – an activity indicator for activities in the or on the water?
Oral Tihanyi, B; Révész, L; Berthon, W; Dutour, O; Nepper, I; Spekker, O; Bereczki, Z; Molnár, E; Pálfi, Gy The Hungarian Conquest Period archery and activity-induced stress markers – anthropological and archaeometrical studies of a th c. AD Hungarian series
Poster Toussaint, MP; Włodarczak, P Habitus, Entheseal Development, and Gender: A Bioarchaeological Investigation of Embodiment in an Early Bronze Age Community in Southeastern Poland
Oral Üstündağ, H Gendered division of labour in a Hellenistic-Roman population from Boğazköy, Turkey: Consideration of traumatic, degenerative and musculoskeletal effects
Oral Van Cant, MPJ Dyed-in-the-wool: the impact of occupational behaviour and the environment on small urban and rural communities in Flanders, c. – AD.
Poster Wasterlain, S Tooth wear and extra-masticatory behaviour: a particular case of a fisherman from the Identified Skeletal Collections of the University of Coimbra
Oral Yonemoto, S Reconstruction of hierarchy society from entheseal changes in Edo period, Japan.

Workshop – New Coimbra Method

Workshop - New Coimbra Method

A workshop teaching the new Coimbra method (Henderson et al. 2015) for recording entheseal changes will be run the afternoon of the 8th. This will be limited to 25 people per session and more than one session will be arranged if there is sufficient interest, in which case another session will be opened the morning of the 6th of July.

This is a hands-on workshop with limited spaces; therefore registration must be done during the early registration period ending 3rd of Apriland selecting the day on your choice.

Registration fee for workshop (in addition to conference fee and also non-refundable): 8 euros for students/unemployed (proof of status is required) and 12 for non-students. 

All workshops are in Sala 1.2.

Please go to the conference registration desk before the start of the conference to sign in and get your name badge. The registration desk opens 08:00 on the 6th of July on the 1st floor (up one flight of steps) in the Colégio de São Bento.