LED Lighting Sets the New Standard in HealthcareImproving Sustainability, Performance, and Patient Wellbeing in Hospitals with a Simple Switch

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CURRENT STATE OF HEALTHCARE LIGHTING

For over a century, fluorescent bulbs have been the groundbreaking technology in lighting. Since the 1940s, we have been treating patients under fluorescent lights in our healthcare facilities, worked under them

in offices, exercised under them in gymnasiums, and educated under them in our schools. With the advent of the compact fluorescent bulb, we even brought them into our homes.1

Fluorescent lights are gas-filled tubes with a coating on the inner surface. Electricity, regulated by a ballast, ignites a filament and vaporizes small amounts of mercury within the tube, causing them to emit ultra-violet (UV) light. The inner surface coating absorbs the UV light and converts it to visible light, producing a ‘white-ish’ glow.1

Lighting is a necessity in our lives. Fluorescent lights have become essential due to the lack of competitive-ly-priced technology with comparable light output and efficiency.

The Hospital Environment

We all use healthcare facilities, and thankfully, we can always rely on them to be open and functioning. The rotation of workers, from cleaning crews to doc-tors, run on a 24/7 basis through these facilities, making sure hospitals and treatment clinics are always in working order for our times of emergency and moments of healing.

The rate of running a facility on the scale of a large hospital is astounding. Electricity, air quality, ventilation and temperature control all contribute to the costs of keeping these buildings oper-ational. Although healthcare facilities only account for <1% of all commercial buildings in the US, they consume 4.3% of the total delivered energy used by the commercial sector.2 As hospitals grow to accommodate more patients, their costs rise concurrently.

Current Impact of Fluorescent Lighting on Patients

Fluorescent tubes create silent com-peting elements in hospitals that are harmful to patients’ health and wellness both from a physical and physiological perspective. Fluorescent tubes contain a mixture of mercury and other gases, and a broken fluorescent tube carries the risk of mercury entering the body through the lungs (via breathing in the gas) or the skin (from coming in contact with mer-cury residue on the inner glass surface).3 Mercury is a hazardous material and in the unforeseen event that a fluorescent light bulb shatters, anyone in the vicinity will be exposed its dangers, making it an instant safety hazard in any facility that actively uses them.

Fluorescent bulbs produce UV light, which is partially, but not completely,

converted to visible light. UV radiation, unseen, is emitted from the fluorescent bulbs and penetrates our skin and eyes. UV radiation has more energy than visible light and is able to degrade many materials, causing damage to materials such as plastics, skin tissues, and eye lenses and retinas. Prolonged exposure can result in a clouding of the lens, com-monly known as Cataract formation, and is a contributing factor to Age-related Macular Degeneration (damage to the retina) - the leading

cause of blindness.4 Young people are es-pecially at risk to the hazards of UV light, as a protective layer of yellow pigments in the eyes occurs with age, slowing the amount of radiation reaching the retina in older adults.5

In addition to invisible UV light, the visible light emitted by fluorescent sources consists of three inconsistent color spikes (magenta, yellow-green, and orange), with negligible other colors contributing to the output.6 The human visual system transmits those light sig-nals to the brain, which must ‘fill in the gaps’ to process the picture. Patients be-ing treated in poor-spectrum fluorescent lighting environments often do not have the ideal conditions for proper emotional and psychological healing due to these constant flash of color spikes. In the case of patients with extremely sensitive vi-sion, particularly in the scotopic (low-lit) range, low-spectrum lighting can trigger similar visual responses. Patients can be subjected to dizziness, headaches and nausea caused by the spikes and gaps in fluorescent light output.7 Patients with special needs are particularly sensitive to visual fluctuations. As light flickers out of the fixture, the bright spikes and missing gaps from fluorescent lights appear as a strobe light to them, which can range from distracting to painful.13,14 Leading companies in LED lighting technology are going the extra mile and spending the extra dollars on the engi-neering of their LED lighting products to omit flicker altogether.15

Cost Savings and Earth-Friendly Behavior

By executing small changes, both in existing facilities and new building development, we can effectively create a sustainable environment, allowing the healthcare industry to put their sole fo-cus on caring for patients. These changes can start with something as simple as changing the lightbulbs.

Hospitals in the US spend, on average, $1.67 on electricity per square foot. Lighting alone accounts for 15% of a hospital’s electricity budget.8 For an average sized hospital building (75,000 square feet) that’s $18,000.00 for light-ing alone. For a large hospital building (650,000 square feet), that’s $160,000.00 going towards keeping the lights on.

White LEDs require less energy to pro-duce more light than other systems.9 Moreover, high quality LED lighting products can last at least 5 years at 24/7 hour operation.9 As the technology im-proves, so will the efficiency and lifespan.

Not only do LEDs diminish electricity, maintenance, and replacement costs, but the superior quality and efficiency reflect in a healthier environment. LEDs do not contain hazardous Mercury, and their higher efficiency results in a decrease in CO2 emissions and an overall lesser impact on the energy grid- de-creasing the need for fossil fuels.10,11 Furthermore, the light output of LEDs is the closest spectral and an overall lesser impact on the energy grid- decreasing the need for fossil fuels.10,11 Furthermore, the light output of LEDs is the closest spectral match to sunlight, providing the safest, whitest, easiest light to see.12

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The LED Lighting Technology Alternative

Light Emitting Diodes (LED) are a cutting-edge solid-state technology that are predicted by the US Depart-ment of Energy to replace almost all artificial lighting in the United States by 2030. While the basic technology has been available for years, recent developments have driven down cost and made LEDs more widely-available to the general public. Available as al-ternatives to everything from industri-al and landscaping feature lighting, to residential settings, to the ubiquitous fluorescent tubes in schools and offic-es, LEDs provide a number of benefits over their predecessors. Known primarily for their energy efficiency, LED bulbs produce more lu-mens per watt, resulting in less power needed to produce more light output. LEDs are also superior when it comes to quality of light output, as white tubular LED lamps provide the closest color match to sunlight (Graph 1), with no spikes or gaps in color output. And unlike their fluorescent counterparts, LEDs are 100% visually efficient; that is, they only produce radiation in the visible range, with virtually no harmful UV or wasted infrared. Additionally, LED bulbs contain no mercury or hazardous waste, and are 100% recyclable. High-quality LED products can last up to 20x longer than any other artificial light source, reducing the time, cost, and effort of maintenance.8 These factors combine to make LED lights the clear choice over fluorescents.

Graph 1. 13

environment possible enhances their ability to diagnose correctly, identify reactions, prevent secondary infections and overall, minimize readmissions.

In a patient’s room and in the ICU, spaces are required to be bright enough for medical examinations but comfortable enough for patients to rest and recover. With the current mainstream use of fluorescent lighting, patient rooms typically end up looking too bright in the daytime and too dark at night. This inadequate lighting can directly affect the physical and emotional wellbeing of the patient. While all humans have a daily routine defined by the regularity of sunlight, this regimen is particularly important for patients in need of physical recovery. Proper lighting can provide normal and longer sleep duration for patients, giving their body time to fully recuperate, and can enhance the mood of patients, as derived from the Hospital Anxiety and Depression Scale (HADS) depression scores. By providing LED lighting, hospitals are providing the right conditions for better moods and better rest which directly correlates to faster recovery time.

Physical Utility

The even distribution of colors provided by LED result in more saturated, vivid, discriminable color rendering and effortless visual acuity. Fully directional down-lighting also provides more illumination on working surfaces, rather than the diffuse glow produced by the gas-filled fluorescent tubes. The color temperature, color rendering, and efficiency of LED lights combine to improve visibility to create a better

Readmission Rate and Patient Recovery Time

The value of improvements LED lighting can provide in quality of care is priceless to the healthcare industry. Some of the biggest issues facing hospitals today are readmission rates and patient recovery time, leading symptoms of costly and uncoordinated facilities. The fundamentals of LED lighting provide one of the best, most affordable solutions to these concerns. The color rendering and accurate, bright light provided by LED lighting has been shown to reduce the amount of not only caregiver procedural errors during hospital visits but also the error rate of prescription-dispensing across healthcare facilities. Providing caregivers with the best lighting and visual

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Benefits of LED Lighting for PatientsGood lighting aids treatment in many ways. This is especially important in the case of children and elderly or disabled patients as well the healthcare providers who are able to see more clearly to provide care.

environment as vision is a major contributing factor to an individual’s ability to receive and respond to treatments.

Cognitive Utility

Not only does LED provide higher quality lighting for patients’ emotional wellbeing, studies have also shown LED lighting can enhance surgical, procedure and diagnostic settings as well.

Most healthcare providers encourage patients to get a full eight hours of sleep to help their recovery. A healthy sleep/wake cycle (or Circadian Rhythm) is crucial to mental cognition and physical wellbeing. Our bodies’ roughly 24-hour cycle is governed by hormonal responses that are triggered by full-spectrum light - light provided by sunlight and LED, but not fluorescent.14

We have all experienced the relief of leaving a fluorescent-lit hospital room and stepping outside back out into the natural sunlight. The spectral output of fluorescent lights is to blame. In the bleak winter months, many people are diagnosed with Seasonal Affective Disorder (SAD), while many more self-diagnose their yearly “winter blues.” LED lighting is used in the treatment of SAD, and also has been shown to improve mood, decrease stress, and create a generally healthier and happier environment – all because the lighting spectrum mimics that of natural sunlight.15

Patient seating area

Conclusion

LED lighting is the best choice for healthcare facilities that want to foster a safe, healthy, comfortable, and “green” environment for patients and staff. The benefits range from monetary savings – lessened electricity costs – to increased sustainability, improved patient health, and ocular safety for all. These lights best eliminate lighting-related competing elements in hospitals that physically affect the vision while physiologically affecting our ability to give and receive proper treatment. Just like the societal revolution, LEDs are no longer the future of the lighting industry. They are the present, and should be the source illuminating our healthcare facilities.

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ENLIGHTENING & INSPIRING LED LIGHTING SOLUTIONS

Sources:

1. Edison Tech Center. “The Fluorescent Lamp” http://www.edisontechcenter.org/Fluorescent.html.

2. U.S. Energy Information Administration. “Energy Characteristics and Energy Consumed in Large Hospital Buildings in the United States in 2007”

http://www.eia.gov/consumption/commercial/reports/2007/large-hospital.cfm 2012

3. United States Environmental Protection Agency “Health Effects of Mercury Exposure” http://www.atsdr.cdc.gov/mercury/docs/

HealthEffectsMercury.pdf.

4. Roberts, Joan E. “Ultraviolet Radiation as a Risk Factor for Cataract and Macular Degeneration” Eye & Contact Lens Vol 37 No 4. 2011.

5. Pokorny et al. “Aging of the human lens” Applied Optics Vol 26 No 8. 1987.

6. Ellis et al. “Auto-tuning daylight with LEDs: sustainable lighting for health and wellbeing” Drexel University and Philadelphia University.

7. Irlen Institute. “What is Irlen Syndrome?” http://irlen.com/what-is-irlen-syndrome/.

8. E Source Companies LLC. “Managing Energy Costs in Hospitals” http://www.nationalgridus.com/non_html/shared_energyeff_hospitals.pdf

9. US Department of Energy “Solid-State R&D Plan” May 2015.

10. United States Environmental Protection Agency “Health Effects of Mercury Exposure” http://www.atsdr.cdc.gov/mercury/docs/

HealthEffectsMercury.pdf

11. U.S. Environmental Protection Agency. “Global Greenhouse Gas Emissions Data” http://www3.epa.gov/climatechange/ghgemissions/global.html

12. Popular Mechanics: The Ultimate Light Bulb Test http://www.popularmechanics.com/technology/gadgets/reviews/g164/incandescent-vs-

compact-fluorescent-vs-led-ultimate-light-bulb-test/

13. Graph 1: Popular Mechanics: The Ultimate Light Bulb Test

14. Lucas, Robert J et al. “Measuring and using light in the melanopsin age” Trends in Neurosciences Vol 37 No 1. 2014.

15. Meesters, Ybe et al. “Low-intensity blue-enriched white light (750 lux) and standard bright light (10000 lux) are equally effective in treating SAD.

ENLIGHTENING & INSPIRING LED LIGHTING SOLUTIONS