Lighting for Healthcare

Lighting for Healthcare - Learning Objectives

  1. What makes good healthcare lighting?
  2. What country has standards for healthcare lighting?
  3. What is the wavelength for the color of blood?
    What lighting wavelength is required for detecting sepsis?
  4. For UV Germicidal Light Disinfection please visit my new page.

Healthcare Lighting

Our medical facilities should be designed to provide healthful environments inside and out where staff and patients can have an optimal work and care environment.

A healthy building has lighting designed to do no harm to the occupants nor the environment.
"...Kimmel went on to say that his wife, Molly, gave birth to their second child on April 21, a boy named Billy. Everything seemed normal at first, until a few hours later, when a nurse discovered that he had a heart murmur and noticed his skin was a bit purple...." https://www.washingtonpost.com/news/arts-and-entertainment/wp/2017/05/02/an-emotional-jimmy-kimmel-discusses-newborn-sons-heart-disease-makes-passionate-health-care-plea/
Healthcare Lighting Melanopic Ratio (MR), Circadian Action Factor (CAF), Daylight
Melanopic Ratio (MR), Circadian Action Factor (CAF), Daylight
When selecting lighting sources for healthcare, keep in mind, "You cannot see a color unless the wavelength is present in the light source."  We are used to seeing colors in daylight and this is the ultimate light source; however, many clinical settings are in basements or other windowless environments, and also, services are offered after dark.
​Lighting design for healthcare needs to include specific wavelengths for detecting blood disorders, blood infections, and cyanosis, by observation of lips, gums, skin, nail beds and palm creases. The 660 nm wavelength is often associated with the color of human blood. Look for products complying with Cyanosis Observation Index (COI) 
"The algorithm measures the cyanosis observation index (COI) of a luminaire and is an indication of sufficient energy in the 660-nm red area of the SPD and the presence of cyan."  [1]
Dain, Stephen. (2015). The Visual Recognition of Cyanosis and the Influence of Lighting and Color [2]
Healthcare Lighting - Bridgelux Thrive Spectral Flux Graph showing 660nm output.
Bridgelux Thrive Spectral Flux Graph showing 660nm output for 2700K and 5000K LED lamps.
The bewildering array of light sources and lighting fixture choices is confusing. Understanding how colors appear under different light sources, CRI, CCT, and other metrics for color rendering, and controlling glare are all important lighting challenges.
The Lighting Facts Card describes some qualities of light source. [3] See Color in Light Sources.
Cyanosis is the medical term for a bluish color of the skin
Cyanosis is the medical term for a bluish color of the skin.

Cyanosis Observation Index (COI) Compliant Luminaires

What is cyanosis?www.ecopoint.co.nz/resources/articles/cyanosis-lighting/
Australian Standard - 
https://www.bioshumanlight.com/wp-content/uploads/2019/05/Lighting-for-clinical-observation-of-cyanosis.pdf
​New Zealand Standard - 
www.bentham.co.uk/knowledge/tools-resources/application-guides/method-for-determination-of-cyanosis-observation-index-of-a-light-source-156/
Companies manufacturing 660nm luminaires for healthcare:
Bridgelux - https://bridgelux.com/sites/default/files/resource_media/Bridgelux%20White%20Paper%20-%20Average%20Spectral%20Difference%20051420.pdf
Pathway - https://www.pathwaylighting.com/
Klik - https://kliksystems.com.au/kliktek/cyanosis
Focal Point - https://www.focalpointlights.com/blog/assessing-suitability-light-source-healthcare-environments-using-cyanosis-observation-index-coi
Planet Lighting - Australian Cyanosis compliant -
https://www.planetlighting.com/spotlight-on-cyanosis-observation-led-downlight/, https://www.planetlighting.com/medical-lighting/
​
​NOTE:
SINCE OUR INDUSTRY IS CONSTANTLY CHANGING, BE SURE YOU ARE SPECIFYING CURRENTLY AVAILABLE LIGHT SOURCES THAT INCLUDE 660 NM (NANOMETERS) 

Doctors, Nurses, & Volunteers

In addition to lighting for patients, the staff of healthcare facilities has the need for good quality glare free lighting.  "Many volunteers are retired, but want to continue to be active in the community.  Doctors and nurses are aging and will need appropriate light to carry out their work.  In 2010, 40% of doctors were over the age of 55, and 33% of nurses were over the age of 50." [4] For more information on Glare, please visit our page Lighting for Seniors & Low Vision.

Lighting for Hospitals and Healthcare Facilities | IES

IES RP 29-16 Care Facilities by the Facility Guidelines Institute (FGI).1 Part I of this document addresses the many design considerations important for healthcare facilities, while Part II identifies specific room types that have unique lighting needs. https://www.ies.org/

Visible Light Disinfection

​LRC studies the use of UV-A LED lighting to disinfect hospital room (UPDATED) Feb 22, 2020

 Levels of UV-A radiation that are safe for humans can kill pathogens over time in a hospital room environment, but the radiation can damage other furnishings and equipment. [5]
​https://www.ledsmagazine.com/lighting-health-wellbeing/article/14168377/lrc-studies-the-use-of-uva-led-lighting-to-disinfect-hospital-room
LED Magazine June 2018 issue stated:
"The technology uses violet light, just above the ultraviolet (UV) bands, mixed with white light in luminaires with the violet energy destroying pathogens through continuous exposure while the white light affords functional illumination in a space. The technology targets specific molecules in bacteria cells and results in an overload of oxygen that explodes the cells over time. The company says the technology can kill a variety of bacteria present on surfaces and harmful organisms including MRSA (Methicillin-resistant Staphylococcus aureus),Salmonella, E. coli (Escherichia coli), and C. diff (Clostridium difficile)." [6]

To learn more about Visible Light Disinfection visit these manufacturer's websites.

Acuity - https://vitalvio.com/the-science/
Kenall - https://indigo-clean.com/what-is-it
Hubbell - https://www.hubbell.com/hubbelllightingci/en/spectraclean - Hubbell
GE - https://products.gecurrent.com/sites/products.currentbyge.com/files/documents/document_file/IND557-LBU-Recessed-Luminaire-Disinfection-Series-Spec-Sheet.pdf ​

Introduction to Visible Light Disinfection  
IES Webinar ​January 17, 2019 ​

https://www.ies.org/education/electronic-resources/webinars/

Light and Health Alliances

The Light and Health Alliance is a collaboration among Members (manufacturers, government organizations and NGOs, codes and standards bodies) and practitioners, including architects, specifiers, medical facility managers and physicians, to enable the broad adoption of lighting for human health by producing factual information based on basic and applied research and by visualizing future applications.
http://www.lrc.rpi.edu/programs/lightHealth/alliance.asp

International Well Building Institute

The way that buildings are designed, constructed and maintained impacts the way we sleep, what we eat, and how we feel. The WELL Building StandardTM uses innovative, research-backed strategies to advance health, happiness, mindfulness and productivity in our buildings and communities.
https://standard.wellcertified.com/light   &  
https://www.wellcertified.com/your-community

Tuning the Light in Senior Care: Evaluating a Trial LED Lighting System at the ACC Care Center in Sacramento, CA

"Residents whose rooms are located in other corridors at the Care Center are now spending time “hanging out” in Cherry Lane, either wheeling themselves to that area or asking a staff member to take them to Cherry Lane."
At the recent IES Light + Health symposium in Atlanta, Connie Samla presented phase two of her Senior Care lighting retrofit study.  This is an example of a very successful application for circadian friendly lighting systems and controls in elder care and memory units.  Connie Samla's project, in Sacramento, was first published in 2016, funded by the Department of Energy and Sacramento Municipal Utility District She is now on phase two of her study. 
Health-Related Outcomes:
..."​For the 3 months following the LED trial installation, target behaviors such as yelling, agitation, and crying were reduced by an average of 41% for the three residents, relative to the 3 months immediately preceding the installation. Nursing staff noted that all three residents had been consistently sleeping through the night since the installation, and noted that one resident now slept through the night in his bed, although he had previously refused to sleep in his bed and instead slept in his wheelchair. ACC staff also noted that psychotropic and sleep medication use had been significantly reduced for one of the residents whose room was included in the trial installation." [7]

Footnotes

  1. https://www.ledsmagazine.com/articles/print/volume-14/issue-8/features/human-centric-lighting/speakers-cover-circadian-disruption-to-healthcare-assessment-at-new-conference.html
  2. Dain, Stephen. (2015). The Visual Recognition of Cyanosis and the Influence of Lighting and Color Vision. https://www.researchgate.net/publication/267213601_The_Visual_Recognition_of_Cyanosis_and_the_Influence_of_Lighting_and_Color_Vision
  3. http://www.lightingfacts.com/Library/Content/Label
  4. IES RP-28-16 Lighting and the Visual Environment for Seniors and the Low Vision Population  IES.org​
  5. https://www.ledsmagazine.com/lighting-health-wellbeing/article/14168377/lrc-studies-the-use-of-uva-led-lighting-to-disinfect-hospital-room
  6. https://www.ledsmagazine.com/articles/2018/06/lighting-for-health-and-wellbeing-news-vital-vio-lrc-and-more.html​
  7. Senior Care Lighting Retrofit  https://www.energy.gov/sites/prod/files/2016/09/f33/2016_gateway-acc.pdf​​

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