Sex assault conviction | A society that nurtures secrets | Graphic: house of horrors | Health implications | Blog reaction | Factfile

The human body is remarkably adaptable. Given food and water, and protected from disease, people can survive physically in the most appalling circumstances.

Being locked up in a cellar for 24 years – if indeed this extraordinary story turns out to be true – is certainly not good for physical health but the damage is largely psychological.

Sunlight, for example, is desirable rather than absolutely necessary. It provides a source of vitamin D created in the skin, but diet can also provide this vitamin.

A lack of sunshine, especially for the children who are alleged to have been born and raised in the prison below the house in Amstetten, would increase the risk of diseases linked to vitamin D deficiency. Rickets, the scourge of Victorian slums, is the most obvious.

It causes softening of the bones, making deformities and broken bones more likely. Vitamin D deficiency also increases the risk of several cancers, including colon cancer.

Lack of opportunity for exercise also carries serious risks to health, including obesity, heart disease and diabetes. Anybody restricted to a room or a few rooms for so long is likely to be in poor shape physically.

Other physiological effects are harder to measure. One study – ironically, among long-term residents of an Austrian prison – found that decline in brain function was strongly linked to the length of time served.

Much depends on how the mother and children lived in the underground dungeon, and how well they were fed. The circumstances are so unlike any normal experience of imprisonment that scientific studies of prisoners have little to tell us.

It is possible that if the mother and children formed a close bond, the physical damage may be less than one might expect. Normal life would prove difficult, but that would be from psychological rather than physical causes.

The greatest health problems for the children are likely to come not from their environment, but from their inheritance. The children of incestuous relationships have a far greater risk of genetic abnormalities. Some die young while others suffer from disabling problems.

Most of the evidence comes from cousin marriages, which are common in some cultures. Less work has been done on brother-sister and father-daughter relationships, but one study looked at 21 children and found that 12 had abnormalities, severe in 9 of them.

Another study looked at 18 children of similar relationships, and found 6 who had died or suffered severe defects. The taboo surrounding incest is based on sound biological foundations.

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