Creating protection for an underserved population: children and adolescents

In the Fall of 2021, FaceBase launched a monthly series of “Office Hours” to support researchers and clinicians from the dental, oral and craniofacial (DOC) community - and beyond. These sessions are open to anyone seeking guidance on how to use FaceBase data or contribute to its expanding collection of multi-modal datasets. During our first Office Hours session, Christopher Nemeth, PhD, of Applied Research Associates, Inc. (ARA) contacted us seeking available craniofacial data for children and adolescents.

Dr. Nemeth is the Principal Investigator on an effort funded by the Biomedical Advanced Research and Development Authority (BARDA) to assess the feasibility of designing elastomeric, reusable respirators for children – a critical need that the COVID-19 pandemic made especially evident. While respirators are typically designed for adults. ARA sought to create respirator models that serve children. Dr. Nemeth met with Alejandro Bugacov, FaceBase’s “data guru”, to discuss relevant data resources that could help.

A few datasets immediately came to mind, including the 3D Facial Norms dataset from Seth Weinberg (University of Pittsburgh) and a dataset of facial scans from a Tanzanian cohort from Benedikt Hallgrimsson (University of Calgary). Bugacov facilitated a direct connection between Drs. Nemeth and Hallgrimsson to discuss a potential collaboration. Hallgrimsson was excited to participate in this project for many reasons:

1. This project was a great example of Precision Medicine and how multi-variations can be used to influence the design of respirators, which are greatly affected by facial sizes and shapes.

2. As a member of the Alberta Children’s Hospital Research, he was keenly interested in projects that help underserved populations such as children.

3. This was a practical application of data that no one had considered before. His lab was excited about the prospect of directly helping people with their research!

Over a year of project work, Hallgrimsson’s lab developed a new approach for shape analysis to create the data that are essential for accurate, equitable designs for children age 2 –18. The team has now published its findings in Applied Ergonomics. The paper, Quantitative Analysis of Facial Shape in Children to Support Respirator Design, offers valuable recommendations for designing devices, including respirators, specifically tailored to fit the pediatric population. The hope is that their research will lay the groundwork for the first prototypes of a new generation of reusable respirators for children.

Citation:

Nemeth, C., Hoskens, H., Wilson, G., Jones, M., DiPietrantonio, J., Salami, B., Harnish, D., Claes, P., Weinberg, S. M., Shriver, M. D., & Hallgrímsson, B. (2025). Quantitative analysis of facial shape in children to support respirator design. Applied Ergonomics, 122, 104375. https://doi.org/10.1016/j.apergo.2024.104375

Abstract:

The COVID-19 pandemic demonstrated the need for respiratory protection against airborne pathogens. Respirator options for children are limited, and existing designs do not consider differences in facial shape or size. We created a dataset of children’s facial images from three cohorts, then used geometric morphometric analyses of dense and sparse facial landmark representations to quantify age, sex and ancestry-related variation in shape. We found facial shape and size in children vary significantly with age from ages 2 to 18, particularly in dimensions relevant to respirator design. Sex differences are small throughout most of the age range of our sample. Ancestry is associated with significant facial shape variation in dimensions that may affect respirator fit. We offer guidance on how results can be used for the appropriate design of devices such as respirators for pediatric populations. We also highlight the need to consider ancestry-related variation in facial morphology to promote equitable, inclusive products.

Takeaways:

This collaboration highlights FaceBase’s versatility as a data-sharing platform. Even though our primary focus is to partner with the dental, oral and craniofacial (DOC) community, researchers from other domains can also benefit from this unique collection of high-quality, interoperable multi-modal data of the face and head.

Acknowledgement: The Biomedical Advanced Research and Development Authority (BARDA) had no role in study design; collection, analysis and interpretation of data; writing of the report; or in the decision to submit the article for publication. This project has been funded in whole or in part with Federal funds from the Department of Health and Human Services; Office of the Administration for Strategic Preparedness and Response; Biomedical Advanced Research and Development Authority, under Contract No. HHSO100201700032C