Josef Fritzl, the Austrian man who imprisoned his daughter in a cellar for 24 years and fathered seven children with her, is facing prosecution for rape, abduction, incest, and possibly murder. One of the seven kids died (hence the possible murder charge), three were raised by their grandmother aboveground, and three others spent their entire lives in a windowless, 60-square-meter hellhole. Is living in a dungeon bad for your health?
Yes, but not as bad as you might think. From a medical standpoint, there's one major problem with underground living: the absence of natural light. Lack of exposure to sunshine increases the risk of vitamin D deficiency, which causes rickets and other bone diseases including osteoporosis. Vitamin D malnutrition may also lead to chronic diseases such as high blood pressure. Unless you eat huge amounts of fish—cod liver oil every day for lunch, for example—it's difficult to obtain sufficient vitamin D from natural food sources alone. It's possible, however, to get the vitamin through dietary supplements.
Another health hazard for the forcibly homebound is lack of exercise. Sixty square meters isn't much space for a cardiovascular workout. If the Fritzls weren't getting their heart rates up regularly, then they're all at risk for heart disease and obesity.
While fresh air isn't a health requirement per se, poor ventilation can lead to a host of medical problems. Humidity encourages the growth of mold, which can trigger allergies and asthma attacks. If one person gets sick, it's dangerous for others to breathe the same air. Of course, the subterranean family never had direct contact with the outside world, but they were exposed to bacteria via contact with Josef, so they weren't entirely cut off from diseases, airborne or otherwise.
Scientific studies on the physical effects of long-term confinement in prison aren't especially pertinent here since prisoners generally have more space to roam around and more access to fresh air than the Fritzls did. But another famous Austrian kidnapping case might shed some light. Natascha Kampusch was abducted at the age of 10 in 1998 and held captive in a small, windowless cellar. After the first several months, she had access to the upstairs house and, occasionally, to the garden, but she spent nights in the basement. When she finally escaped in 2006, she was thin (just a little more than 100 pounds) and hadn't grown much (about 6 inches), but otherwise, she was in good health.
Explainer thanks Mark Schattner of the Memorial Sloan-Kettering Cancer Centerand Slate contributor Sydney Spiesel of the Yale University School of Medicine.