Age Estimation in the Living

The Practitioner's Guide

Sue Black, Anil Aggrawal, Jason Payne-James

• Publisher: Wiley
• Year: 2011
• ISBN:
  9781119957256
• Edition: 1
• Topic: Social Sciences
• Subtopic: Physical Anthropology
• Index: Social Sciences

This book summarizes and explains the main approaches to age estimation in the living, defining when a parameter may be of use and raising awareness of its limitations. This text ensures that practitioners recognize when an assessment is beyond their area of expertise or beyond verification depending upon the clinical data available. Each key approach to age evaluation has been allotted a single chapter, written by an international leader in the particular field. The book also includes summary chapters that relay readily accessible data for use by the practitioner, and includes important "ageing milestones."

This book is indispensable where problems of immigration and legal standing, juvenile vs. adult criminal status, and responsibilities of law enforcement to protect vulnerable persons are key issues on a daily basis. Medical practitioners, forensic practitioners such as pathology, odontology, anthropology andnursing, lawyers, and police would find this book incredibly useful.

1

AN INTRODUCTION TO THE HISTORY OF AGE ESTIMATION IN THE LIVING

Andreas Schmeling¹ and Sue Black²

¹Universitätsklinikum Münster, Institut für Rechtsmedizin, Röntgenstraße 23, 48149 Münster, Germany

²Centre for Anatomy and Human Identification, University of Dundee, Dundee DD1 5EH, UK

1.1 Introduction

Despite the alleged use of the eruption of second molars by the ancient Romans to evaluate readiness for military service (Müller, 1990), age estimation (sometimes known as age evaluation, age determination, age diagnostics or age assessment) in living individuals is a relatively recent area of applied research within the forensic sciences. Its value and importance as an assessment tool has risen exponentially as the needs for an informed opinion on the age of an individual have assumed increasing importance for the assessment of both criminal culpability and legal/social categorization. Age is an important classifier in most cultural and judicial hierarchies, and the absence of credible legal documentation often demands that authorities must seek the expertise of the scientist and the clinician for guidance and assistance in this regard.

There are many areas in which the evaluation of age in the living has become relevant but the most prevalent concern issues pertaining to refugee and asylum seekers, criminals and their victims, human trafficking and child pornography (UNHCR, 2004; Lee, 2007; O’Donnell and Milner, 2007; Cattaneo et al., 2009). Age evaluation is also required for adoptive children from countries without birth registration (Crossner and Mansfeld, 1983; Melsen et al., 1986; Fleischer-Peters, 1987). An additional category is age evaluation in competitive sports to ensure that athletes are competing within an age appropriate banding for the sake of both fairness and health protection (Braude, Henning and Lambert, 2007; Dvorak et al., 2007a, 2007b; Houlihan, 2007). Parents have also been known to falsify the ages of their children, particularly of their sons, to obtain preferential educational opportunities (Chagula, 1960). While it is undeniable that the majority of issues raised concerning age evaluation are predominantly within the juvenile aspect of the human age range, there are issues of legality in relation to the elderly, for example those which relate to matters of eligibility for state-funded pension support or retirement law (Ritz-Timme et al., 2002).

The assignment of age to address appropriate and fair processing of asylum and refugee seekers is influenced heavily by issues pertaining to international human rights. These issues are largely governed by the UN Convention on the Rights of the Child (1989) and the UNHCR Guidelines on Policies and Procedures in Dealing with Unaccompanied Children Seeking Asylum (1997). Both documents follow the guiding principles that the best interests of the child take precedence and that the child should be given the benefit of the doubt if their chronological age remains uncertain (UNHCR, 1997). For most countries that recognize the 1989 United Nations Convention on the Rights of the Child, the legal age of maturity is accepted as 18 years of age and this is largely supported by the modern legal framework of most nations. If an individual claims to be younger than 18 years of age, and there is some doubt, then there may be a statutory obligation that the receiving nation is required to offer asylum and support to that minor until age is established to the satisfaction of the authorities. Therefore, the demarcation between 17 and 18 years is a key milestone with regards to both legal and social responsibility – from the perspective of both the state and the individual.

Human trafficking is concerned with the recruitment, movement and sale of people for exploitative purposes. Trafficking has been recognized and in some respects tolerated if not indeed condoned by many countries throughout history. While slave labour, prostitution and organized crime are the trademarks of human trafficking, it shares a blurred boundary with the crime of human smuggling, which seeks to extort money from criminalizing migrants (UN, 2000). Each of these crimes trespasses into the juvenile age spectrum and does so particularly boldly in the areas of slave labour and prostitution, as witnessed by the increasing prevalence of juvenile sex tourism, particularly in the Far East (Singh, 2002; Lindstrom, 2004).

The introduction of the Internet has unquestionably played a significant role in the incidence of child pornography and the sharing of illegal images by increasingly large and sophisticated paedophile rings (Lanning and Burgess, 1989; Jones and Skogrand, 2005; O’Donnell and Milner, 2007). In addition to the taking, holding and sharing of illegal images, is the nature of the content of those images and whether there is any degree of physical sexual interaction with the child as this will impact significantly on the severity of the criminal sentence. Under Irish statute, the Child Trafficking and Pornography Act 1998, child pornography is defined in relation to images as ‘the depiction for a sexual purpose, of the genital or anal region of a child’. The definition of that ‘child’ or ‘minor’ is important for prosecutorial purposes as it is not illegal to take, hold or share indecent images of consenting adults as long as they do not include a minor. Irish law reverses the burden of proof, which is placed on the accused to prove that the image is not that of an underage individual – as this is accepted as being almost impossible to enforce, this poses a potential human rights issue in its own regard. As if to openly challenge the legal boundary, there is an active Internet ‘barely legal’ teen genre which purports to take pornographic photographs of individuals within hours of their eighteenth birthday and therefore exploits the sexual frisson of the now ‘technically’ legal images which would have been illegal only hours previously (Lane, 2001).

A description of the (relatively short) history of forensic age estimation in living individuals must take full cognizance of the early research undertaken in age evaluation (frequently not on the living) and must therefore concentrate on the three major components of this process:

1. assessment of dental development,

2. evaluation of skeletal maturation and

3. expression of secondary sexual characteristics.

Emphasis will obviously be given to those methods that are directly relevant and applicable to forensic age estimation in living individuals. It is recognized that there are other techniques that are not directly relevant to the subject matter of this chapter and these will not be discussed in this text.

1.2 Dental Development

Teeth are the only hard tissue structures of the human body that are visible to the naked eye and so it is not surprising that the study of tooth development was linked to the chronological age of the individual from early times (Scheuer and Black, 2000). One of the first documented uses of teeth as an indicator of age for legal requirements dates to the first half of the nineteenth century. The British Factory Act of 1833 attempted to improve the working environment of the child and prevent exploitation. Clauses included:

• Outlawing the employment of children younger than 9 years of age in the textile industry.
• Children aged between 9 and 13 years could not work for more than 8 hours and were required to have a 1 hour lunch break.
• Children aged between 9 and 13 years had to receive 2 hours of education per day.
• Children aged between 14 and 18 years could not work for more than 12 hours a day and had to have a 1 hour lunch break.
• Children under 18 years could not work at night.

In 1837, Saunders presented a publication ‘The Teeth, a Test of Age, Considered with Reference to the Factory Children, Addressed to the Members of Both Houses of Parliament’, in which he expounded upon the value of dental emergence for age estimation. His studies were performed on 1000 children and he stated that with the aid of his tables and a little ‘industrious application’, the assessment of age for Factory Act purposes could be conducted by ‘relatively untrained people’. One year earlier, Thomson (1936) reported that ‘if the third molar [first permanent molar] hath not protruded, you can have no hesitation in affirming that the culprit has not passed his seventh year’ and this prevented a significant number of young children from being subjected to the harsh penal code of the time.

Since then, several hundred other studies of dental growth have focused on eruption, which incorporates the entire journey of the tooth from its formation in the alveolar crypts to full occlusion. However, the vast majority of studies which refer to ‘eruption’ actually relate to ‘emergence’, which is restricted to the time when any part of the tooth finally clears the gingival margin and becomes visible in the mouth (Demirjian, 1986; Scheuer and Black, 2000) until the stage when the tooth finally comes into occlusion with its partner tooth from the opposing jaw.

Mineralization has also been addressed in many studies and this refers to the development of both the crown and the root while still confined within the alveolar crypt. Early information on tooth development was established via techniques of dissection, histological sectioning and staining (Schour and Massler, 1941). One of the earliest such studies was performed by Legros and Magitot in 1873 and using their data, Peirce (1877) created one of the first dental mapping schemes, which was reproduced in many textbooks for several decades thereafter. The total number of teeth present in the mouth was first used to assess age by Cattell (1928), but this was a rather crude approach, which received limited scientific support. Very shortly after this date the utilization of radiographs opened up new avenues for visualization of direct dental development in the living and the deceased, and Bustin, Leist and Priesel (1929) and Hess, Lewis and Roman (1932) were among the first to perform dental radiological examinations on children.

The examination most commonly quoted in secondary literature sources was performed by Logan and Kronfeld (1933). These authors used 25 anatomical preparations of children, most of whom had died of tuberculosis, associated diseases or enteritis. In 1940, Schour and Massler created dental mapping schemes based on Logan and Kronfeld’s data. However these studies were all cross-sectional and gave no appreciation of how the dentition developed within an individual in direct relation to chronological age, and it was not until the 1950s that the benefits of longitudinal radiographic studies were to be appreciated, and of course, never again repeated for very justifiable health and safety reasons (Liversidge and Molleson, 1999).

Gleiser and Hunt (1955) examined 25 male and 25 female white children aged 1.5 to 10 years who lived in the Boston area. They restricted their observations to the first mandibular molars, for which they established 15 mineralization stages. Further stage classifications for the determination of dental mineralization were subsequently recommended by others (Nolla, 1960; Haavikko, 1970; Liliequist and Lundberg, 1971; Demirjian, Goldstein and Tanner, 1973; Gustafson and Koch, 1974; van der Linden and Duterloo, 1976; Nortje, 1983; Harris and Nortje, 1984; Kullman, Johanson and Akesson, 1992; Köhler et al., 1994). Frequently used reference studies on the time frame of third molars which are particularly relevant to age estimation in living individuals were published by Anderson, Thompson and Popovich (1976), Kahl and Schwarze (1988), Mincer, Harris and Berryman (1993), Köhler et al. (1994), Gunst et al. (2003) and Olze et al. (2003, 2004).

Such a plethora of scientific reporting and publication does not assist the process of single case evaluation and there is a preference for the use of single source standardized charts or atlases. However, these are dangerous precepts as the methodology of data collection, statistical representation and the data source are unlikely to be either time or group specific and can engender a false sense of security in the application of the results and reliance upon the outcome.

In adults, where all teeth are fully formed, other criteria must be used for estimating the age of the individual. Regressive tooth changes, which progress in severity with the age of the individual, have been described by early authors (Bodecker, 1925). However, a more systematic and statistical approach to dental age estimation was not presented until 1947, when Gustafson published a scoring system with the use of a regression model. Six age-associated parameters (attrition, periodontal recession, cementum apposition, root resorption, secondary dentine formation and root translucency) were evaluated in longitudinal sections of teeth cut through the central area. The small sample size and subsequent statistical shortcomings exposed Gustafson’s method to some criticism (Maples and Rice, 1979). Later investigations by Dalitz (1962), Johanson (1971), Maples (1978) and Solheim (1993), however, resulted in considerable improvements with regards to both material and statistical evaluation. Matsikidis and Schulz (1982) evaluated Gustafson’s criteria with the help of X-ray analysis, making this more applicable for the living. The radiological technique developed by Kvaal et al. (1995) is based on only one of Gustafson’s criteria: the secondary dentine formation. As technology advanced, full use was made of these opportunities, and more recent studies have utilized orthopantomograms (Cameriere, Ferrante and Cingolani, 2004; Paewinsky, Pfeiffer and Brinkmann, 2004; Bosmans et al., 2005; Landa et al., 2009) and cone-beam computerized tomography (CT) (Yang, Jacobs and Willems, 2006). Ever mindful of the need to determine age in the living, other authors, including Solheim (1995), have devised techniques that are non-destructive and based on visually identifiable characteristics including attrition, colour and recession of the periodontal attachment.

The evaluation of cementum annulation (Stott, Sis and Levy, 1981; Condon et al., 1986; Wittwer-Backofen, Gampe and Vaupel, 2004) and the degree of racemization of aspartic acid in the dentine (Ogino, Ogino and Nagy, 1985; Ritz, Schütz and Peper, 1993; Mörnstad, Pfeiffer and Teivens, 1994) are applicable to age estimation in older living individuals. However, these approaches necessitate tooth extraction and this is not a process which is advocated, or indeed permitted, by most countries (Ritz-Timme et al., 2002). Chapter 10 in this text considers the current status of age estimation in the living from dental evidence.

1.3 Skeletal Maturation

Parallel to the establishment of methods for dental age estimation, methods for the evaluation of skeletal maturation were developed. In this context, thanks to the discovery of X-rays, methods that had originally been developed using dry skeletal material could now be applied to living individuals as well.

At a conference of the Munich Medical Society on 1 April 1896, only one year after the discovery of X-rays, von Ranke proposed that the age of children could also be examined with the help of an X-ray of the hand. Around the beginning of the twentieth century, the Polish court pianist Raoul Koczalski, who is said to have already given public concerts when he was only four years old and who had caused a sensation in Munich as a wunderkind, gave a performance in Munich. Von Ranke mistrusted the young court pianist and suspected that he was older than he portrayed. However, it is not known if von Ranke verified his suspicion with an X-ray examination – but it is an interesting potential application of a science occurring at the leading edge of a technology’s development.

In order to establish the chronological age of an individual from their skeletal development, at least one of the three phases of osseous development must be assessed:

• The age of appearance (i.e. ossification) of the different parts of the bone.
• The morphological appearance and/or size of the bone and its constituent parts.
• The timing of fusion of different parts of a bone.

The assessment of these three phases can occur either via direct observance of the bone or via radiographic images of the living individual, and the research literature is rather evenly peppered with this dual origin of source material (Ubelaker, 1978). A significant proportion of the work undertaken on dry bone analysis arises through archaeological sources and much of the material is subsequently not of k...

Table of contents

• Cover
• Title
• Copyright
• Dedication
• Foreword
• Preface
• Glossary of Abbreviations
• 1 AN INTRODUCTION TO THE HISTORY OF AGE ESTIMATION IN THE LIVING
• 2 IMMIGRATION, ASYLUM SEEKERS AND UNDOCUMENTED IDENTITY
• 3 CLINICAL AND LEGAL REQUIREMENTS FOR AGE DETERMINATION IN THE LIVING
• 4 LEGAL IMPLICATIONS OF AGE DETERMINATION: CONSENT AND OTHER ISSUES
• 5 THE CHALLENGES OF PSYCHOLOGICAL ASSESSMENTS OF MATURITY
• 6 PRINCIPLES OF PHYSICAL AGE ESTIMATION
• 7 GROWTH, MATURATION AND AGE
• 8 PRACTICAL IMAGING TECHNIQUES FOR AGE EVALUATION
• 9 EXTERNAL SOFT TISSUE INDICATORS OF AGE FROM BIRTH TO ADULTHOOD
• 10 AGE EVALUATION AND ODONTOLOGY IN THE LIVING
• 11 AGE EVALUATION FROM THE SKELETON
• 12 AGE EVALUATION AFTER GROWTH CESSATION
• 13 THE PRESENTATION OF RESULTS AND STATISTICS FOR LEGAL PURPOSES
• 14 KEY PRACTICAL ELEMENTS FOR AGE ESTIMATION IN THE LIVING
• Index
• Both