Mandatory wearing of facemasks was an unprecedented Public Health restriction during COVID-19.
Few studies have explored the impact of face coverings on the interpretation of emotions from
facial expressions which can negatively impact communicative exchange.
Aims: This study investigated if face coverings affect the ability to recognise facial
expressions/emotions; pertinence of the location of face coverings (upper versus lower face), and, if
face coverings are considered to impact communication.
Method: An online survey was completed by 573 participants (aged 18-75+) who matched
photographic facial expressions with emotions (happy, sad, anger, surprise, fear, disgust) under
three conditions (upper face covered, lower face covered, uncovered). Accuracy of facial expression
identification was analysed. One-way ANOVA compared within/between conditions. Potential
association with occupation type was analysed using Chi-square. Participants’ reflections on
experiences of wearing face masks and impacts on communication were examined using a
qualitative descriptive approach.
Findings: ‘Happy’ was the most accurately identified emotion for all conditions with ‘fear’ and
‘disgust’ more challenging to recognise, particularly with lower face covering. There was no
association with facial expression/emotion identification and gender, age or occupation.
Participants (85%) agreed that face coverings negatively impact communication. Three themes were
identified - Visual Aspect of Communication; Understanding Verbal Communication and
Interpreting Emotional Expressions.
Conclusion: Face coverings negatively affect facial expression/emotion recognition with lower face
coverings posing greater challenges than upper. Participants reported misunderstandings and breakdowns in verbal communication exchanges and highlighted the importance of seeing the full face to more successfully interpret communicative exchanges.