Masters of Health Magazine September 2018 - Page 30

within the ganglion cell of the retina has opened up new avenues for discovery. Light is modulated by the ipRGC into neural signals for the body’s biological clock regulating body temperature, release of hormones: melatonin and cortisol which are linked to our immunity, tumor growth rates, cognitive function, thyroid function, glucose level and bone density. Some scientists have measured lighting levels in hospitals which would indicate a biological nighttime even during the day which can impact clinical staff performance and possibly patients sleep. Lighting researchers are just beginning to sort how to measure these new non-visual effects so that research results can be compared on a common biological basis rather than on a strictly visual basis for general lighting.

What is the main paradigm shift that solid-state lighting, mainly LEDs, is inducing in the lighting market and industry?

There is a great opportunity for value added to what has become a commodity market. In another in-house study we did at Mount Sinai, standard LED strips were used to create a unique spectrum driven by a computer to enhance the performance of clinicians doing routine surgical tasks within an Emergency Room Simulator setting compared to performance with conventional fluorescent hospital lighting. We are at the tip of a new revolution where lighting will be built into the entire hospital that will respond to the clinical needs of healthcare workers and patients. What is needed is to find the right combination of policies for patient care and lighting technology programmed to enhance that care. Eventually, I believe we will have artificial intelligence systems seamlessly shifting the light spectrum, intensity throughout the day/night. This will take research investment to discover what works and what doesn’t.

How can this affect the delivery of care, for clinicians and patients?

With solid-state lighting we can deliver lighting that will both allow healthcare workers and patients to comfortably do visual tasks, reading, viewing media on various screens and monitors as well as reading a book or working a crossword puzzle. There are competing priorities for lighting specifically at nighttime. It may be possible to have sensors responsive to clinical staff that would lift the light level and eliminate certain blue wavelengths in order to perform clinical care without interrupting the patient’s circadian cycle. If it can be shown that a dynamic lighting system programmed for various times of the day reinforces a near normal sleep cycle, then patients could presumably leave the hospital earlier and have less opportunity to pick up a hospital acquired infection (HAI).

Do you think that adequate lighting at the healthcare facilities may improve the delivery of care and save costs at the same time? If so, this could be a major advance in healthcare.

Many hospitals are late adopters of newer technology such as LED lighting. With careful planning of how LED lighting is rolled out within a hospital, there is an opportunity to both enhance clinical care, safety and alertness of healthcare workers both during the day and the night. A recent study of lighting in a California hospital showed interior lighting at such low levels that it was like nighttime from a biological standpoint. LED lighting can provide higher lighting which can be strategically managed to enhance performance and reduce costs. Employees are one on the highest ongoing costs to hospitals so any improvement in performance can provide a good return on investment.