What do you mean I look pale?

by Gina Balestin

March 12, 2019

You know you’ve got your work cut out for you when your industry becomes fodder for a comedian:

The good news is that here at Bridgelux, we are delivering superior lighting for healthcare. We’re trying to tackle the issue on two fronts:

1 – reduce the potential for mistaken diagnoses

2 – help hospital workers, especially those working late shifts, maintain productivity while minimizing risk to their biorhythms

We have a fantastic Solutions team in house that is identifying and addressing the needs of the healthcare industry. Dr. Shiva Rai, Product Development Manager, discusses lighting for healthcare and explains what we’ve learned so far about lighting for hospitals and healthcare facilities.

When it comes to lighting, what do hospitals and doctors care about?

Rai: Hospitals, specifically building managers of those hospitals, generally care about the energy savings ROI of their facility while doctors care about being able to examine the patient accurately.

Doctors are interested in looking at patients’ skin to detect any possible signs of health concerns. Depending on what kind of light they have in their office, a patient’s skin can be perceived improperly. Unfortunately, in hospitals and healthcare facilities, lighting has often been decided by builders or contractors who may tend towards energy efficient lights (based on lm/W), which typically are too rich in blue wavelengths.

When you have blue rich lighting, i.e. red-depleted lighting, the details of a patient’s skin may not be perceived properly. Patients can start to look pale. Veins cannot be seen properly. Patients can be considered unhealthy.

While our LED light sources are efficient, especially compared to most alternative solutions, the industry must balance the need for efficiency with the need for a broader spectrum light source that is richer in red content¹.

It’s a conundrum because hospitals are service facilities, and if the quality of the building infrastructure does not meet the quality of the service, then energy savings ROI really mean nothing. The ROI is not just about energy in the building.

What kind of lighting is needed to ensure that doctors see patients properly?

Rai: Simply looking at lumens per watt should not be the only metric to determine optimal lighting for a hospital or healthcare facility.

Of all the light sources available, the most efficient light sources in terms of lumens per watt are high quality sources such as Bridgelux Class A that includes rich red spectra. But these light sources, and most other commercially available LED light sources, only have peak red content at about 620-630 nanometers.

Hospitals and healthcare facilities need much deeper red content in their light sources. The reflectance of human blood is sensitive to the wavelength of light and also the oxygen levels in the blood. For healthcare practitioners, it is very important to detect the condition of low oxygen levels just by looking at the patient, i.e., early detection! The red peak wavelengths present in high efficiency LED light sources do not create discernable differences in the reflectance between healthy and unhealthy blood. Under these light sources, the practitioners will not be able to differentiate a healthy patient and a patient with low oxygen levels (indicating cyanosis). A red peak deeper than 630nm is required to diagnose patients with low oxygen levels, quickly and easily².

Another way to visualize this is to think about your own hospital visits. Did you ever go to have blood drawn only to have the doctor or nurse tell you that they can’t find a vein? The oxygenation of your blood may be great, but improper lighting can prevent them from find a vein from which to draw blood.

What can happen with the wrong lighting?

Rai: Misdiagnosis.

Proper light sources allow doctors to make early detection diagnoses in patients. Skin carries blood, and blood can be an indicator of what is going on in your body, including severe conditions like cyanosis. Research has shown that visual signs of cyanosis (skin turning blue) are not easily present until the saturated oxygen levels in Hemoglobin drops to 80%, and an immediate intervention is required to avoid getting into severe hypoxia condition. In the absence of proper illumination, detecting this early condition of hypoxia and diagnosing on time becomes difficult for health practitioners².

In addition, productivity and sleep patterns and health for doctors, healthcare practitioners and hospital shift workers can be affected by light. Here, tunable light is a great solution to maintain productivity for doctors and nurses while not interfering with a patient’s recovery.

The health concerns of shift workers in hospitals and healthcare facilities is a significant issue being researched right now. Those working in second and third shifts of the day are seeing their biorhythms disrupted because they see little to no sunlight and spend most, if not all, of their shift under artificial light. In order to address this, we have tunable light platform where light can be tuned for them to get the blue rich content they need at the appropriate time^3,4.

Bottom line, the right quality of light is necessary for those giving and receiving service within a hospital.

How is Bridgelux addressing the needs of hospitals?

Rai: We are coming up with special spectra light sources to target hospitals and healthcare facilities to improve the quality of diagnoses, and at the same time, provide doctors with tunability options depending on the type of examination that they are performing.

We are developing spectra and working closely with research institutions and industry partners to evaluate effectiveness of light sources in hospitals and healthcare facilities with the goal of achieving appropriate certifications. As the feedback from medical practitioners is collected and documented, we will continue to refine the spectra that we are producing.

We have also developed Vesta® Series, a tunable white platform that will be very useful for hospital employees, especially shift workers, to adjust color temperature and intensity of light depending on their shift and their locations within the facility. For example, it is preferred to maintain very low intensity and warm CCT near and around patient rooms during the late evening and nighttime, but nurses would need brighter, cooler CCT light at the nurse stations for them to be efficient and active during their shift.

Finally, we are very excited about a recent announcement around the new Bridgelux color point called Thrive, available now on select V Series™ and SMD products. Thrive is an engineered spectrum that closely mimics the spectral properties of the sun to enhance well-being in a healthy, efficient and economic manner, a human centric lighting solution. The sun is perhaps the most ideal light source, so we are excited to see this product enter the market and believe there is great potential for the healthcare industry.