Artificial night light and thyroid cancer

BACKGROUND

The occurrence of thyroid cancer (TC) has increased in recent decades. Exposure to outdoor artificial light at night (ALN) is associated with an increased risk of cancer.

AIM

To investigated the impact of ALN, as a significant environmental pollutant, on TC incidence worldwide.

METHODS

The assessment involved analyzing satellite ALN data in conjunction with TC incidence data [adjusted standardized rate (ASR)], while considering the quality of cancer registries (QCR), gross domestic product (GDP) per person, and health expenditure per person (HEP) for each country.

RESULTS

Results indicated a correlation between higher ASR and ALN exposure percentages, particularly in countries with higher GDP or HEP quartiles (all P< 0.05). Significant differences in ASR were observed across QCR levels, both high and low quality (all P < 0.05), but not in countries without registry activity. However, when evaluating ASR against ALN exposure percentages while considering GDP/HEP quartiles or QCR levels, no significant associations were found (all P > 0.10).

CONCLUSION

The findings suggest a potential link between higher GDP and adverse health conditions, serving as possible risk factors for TC, rather than a direct association with ALN. Limitations include the use of cross-sectional data, temporal misalignment, and reliance on ALN as a socioeconomic proxy. It is proposed that light pollution might be connected to a lifestyle conducive to carcinogenesis. Additionally, the presence of higher GDP/HEP could enhance access to diagnostic resources, potentially facilitating TC diagnosis and inclusion in cancer registries.

Shedding light on the ART laboratory

This commentary examines the impact of light conditions in the assisted reproductive technology (ART) laboratory, specifically considering gametes and embryo culture. While these processes traditionally occur in the absence of light within the female reproductive tract, laboratory conditions often involve exposure to varying wavelengths, intensities and light sources. Although literature reports describe potential detrimental effects of certain wavelengths of light on biological material, these findings are often based on experiments that might not reflect actual laboratory conditions. Current ART laboratory practices aim to minimize light exposure; however, some procedures necessitate light exposure, typically involving microscopy. Results from the authors' cross-sectional survey on light-intensity practices in ART laboratories revealed the frequent use of inadequate lighting, leading to errors and impacting staff well-being. A failure mode and effects analysis was used to identify potential failure modes and their impacts due to poor lighting. Overall, this manuscript stresses the importance of maintaining proper ambient lighting in the ART laboratory, balancing the potentially detrimental effects of light on gametes and embryos against the need for proper lighting for accurate procedures and staff well-being. Adequate lighting not only ensures the safety of reproductive cells, but also improves process management and the operators' psychological conditions.

Prioritising quality: investigating the influence of image quality on forensic facial comparison

Morphological analysis in forensic facial comparison was recently validated for judicial use. However, no image quality assurance systems exist for this purpose, despite image triage being considered the best practice approach. Hence, this study aimed at testing a semi-quantitative scoring method to assess image quality and investigated facial image resolution and lighting quality quantitatively in a context of forensic facial comparison. For this purpose, 400 facial comparison photographic and CCTV image pools developed from the Wits Face Database were used. These facial images were analysed in prior studies that investigated the validity of morphological analysis. A semi-quantitative image quality scoring system was adapted and tested on the above sample and compared across correct and incorrect matches obtained as part of previous studies using a logistic regression model. In addition, facial images were cropped to the closest pixel comprising the face, head and neck areas; then, a face-to-image pixel proportion was calculated as an estimator of resolution quality; and pixel exposure qualities were obtained to be compared to facial comparison outcomes. Ideal and high image quality scores were related to correctness of matches, while low-quality scores were related to incorrect matches. High pixel proportions were related to true matches and low exposure was related to false positives, while high exposure was related to false negatives. These results suggest that an easy method for image triage could be employed by scoring image quality. Quantitative measures should be investigated further for thresholding quality suitability for confidence of facial comparisons.

Smart humancentric lighting system improves sleep efficiency of nursing home residents

The global phenomenon of population aging presents a significant challenge, affecting both the increasing number of older individuals and their duration of living with disability. Tailored care services are crucial for improving the quality of life of older adults, particularly those with disabilities residing in nursing homes. However, ensuring personalized care and mitigating the risks associated with institutionalization are essential in optimizing care quality. One particular challenge in nursing homes is maintaining residents' personal routines and addressing sleep disturbances linked to neurodegenerative disorders. Non-pharmacological interventions are increasingly recognized as preventive and management strategies for behavioral and psychiatric symptoms in nursing home residents. Sleep disruptions, such as reduced duration and increased nocturnal awakenings, are prevalent among nursing home residents. Excessive nocturnal lighting and frequent caregiver interventions contribute to these disturbances. This study aimed to investigate the impact of implementing smart humancentric lighting on the sleep efficiency of nursing home residents. Data from pressure sensors embedded in mattresses were collected to assess sleep efficiency. The findings suggest that smart humancentric lighting can significantly reduce sleep disturbances and improve sleep quality in nursing home residents. Future research should delve into specific symptoms, care burden, and psychotropic agent utilization to validate the effectiveness of this intervention.

Emotional responses of college students to filtered fluorescent lighting in a classroom (v3)

Background

Classroom lighting, usually bright fluorescent light, can significantly influence the learning environment and emotions of students.

Objective

To assess the emotional impact of classroom lighting on students during an academic year.

Methods

This study used an ABAB withdrawal research design in the following manner: in phase A, the baseline condition, classroom lighting was provided by conventional overhead white fluorescent classroom lights; in phase B, the intervention condition, the conventional overhead white fluorescent classroom lights were covered with fabric filters (thin, translucent, creamy-colored plastic sheets) that were attached to the lighting fixture frame with magnetic discs. The filters produced softer light in the classroom than the fluorescent lights. Each phase lasted for at least 2 weeks. During each phase, students rated 18 pairs of words from the Mehrabian and Russell pleasure, arousal, and dominance semantic differential scale at least four times to assess the emotional impact of the lighting conditions.

Results

For all three emotional behaviors, the mean score of the filtered fluorescent light phase was significantly greater than the mean score of the baseline unfiltered fluorescent lighting phase, indicating more positive emotional responses. Students also noted they experienced fewer headaches and found it easier to see the whiteboard at the front of the classroom when the light filters were in place.

Conclusion

The light filters exerted a positive impact on the students' emotions. Students preferred the filtered lighting to fluorescent lighting. This study supports the installation of filters over fluorescent lights in a college classroom.

Outdoor light at night and risk of endometrial cancer in the NIH-AARP diet and health study

PURPOSE

Outdoor light at night (LAN) can result in circadian disruption and hormone dysregulation and is a suspected risk factor for some cancers. Our study is the first to evaluate the association between LAN and risk of endometrial cancer, a malignancy with known relationship to circulating estrogen levels.

METHODS

We linked enrollment addresses (1996) for 97,677 postmenopausal women in the prospective NIH-AARP cohort to satellite imagery of nighttime radiance to estimate LAN exposure. Multivariable Cox models estimated hazard ratios (HR) and 95% confidence intervals (95% CI) for LAN quintiles and incident endometrial cancer overall (1,669 cases) and endometrioid adenocarcinomas (991 cases) through follow-up (2011). We tested for interaction with established endometrial cancer risk factors.

RESULTS

We observed no association for endometrial cancer overall (HR_Q1vsQ5 0.92; 95% CI 0.78-1.08; p trend = 0.67) or endometrioid adenocarcinoma (HR_Q1vsQ5 1.01; 95% CI 0.82-1.24; p trend = 0.36). Although body mass index and menopause hormone therapy were both associated with risk, there was no evidence of interaction with LAN (p interactions = 0.52 and 0.50, respectively).

CONCLUSION

Our study did not find an association between outdoor LAN and endometrial cancer risk, but was limited by the inability to account for individual-level exposure determinants. Future studies should consider approaches to improve characterization of personal exposures to light.

Circadian phase advances in children during camping life according to the natural light-dark cycle

BACKGROUND

It is known that the circadian rhythm phase in adults can be advanced in a natural light-dark cycle without electrical lighting. However, the effect of advanced sleep-wake timing according to the natural light-dark cycle on children's circadian phase is unclear. We investigated the effects of approximately 2 weeks of camping life with little access to artificial lighting on children's circadian phases. We also conducted an exploratory examination on the effects of wake time according to natural sunrise time on the manner of the advance of their circadian phases.

METHODS

Twenty-one healthy children (mean ± SD age, 10.6 ± 1.4 years) participated in a camping program with wake time (4:00) being earlier than sunrise time (EW condition), and 21 healthy children (10.4 ± 1.1 years) participated in a camping program with wake time (5:00) being almost matched to sunrise time (SW condition). Salivary dim light melatonin onset (DLMO) before the camping program and that after approximately 2 weeks of camping were compared.

RESULTS

DLMO was advanced by approximately 2 h after the camping program compared with the circadian phase in daily life in both conditions. In addition, the advances in DLMO were significantly correlated with mid-sleep points before the camp in both conditions (EW: r = 0.72, p < 0.01, SW: r = 0.70, p < 0.01). These correlations mean that the phase advance was greater for the children with delayed sleep habits in daily life. Furthermore, in the EW condition, mean DLMO after the camp (18:09 ± 0:33 h) was earlier than natural sunset time and there was no significant decrease in interindividual variability in DLMO. On the other hand, in the SW condition, mean DLMO after the camp (18:43 ± 0:20 h) matched natural sunset time and interindividual variability in DLMO was significantly lower than that before the camp.

CONCLUSIONS

Camping with advanced sleep and wake timing under natural sunlight advances children's circadian phases. However, DLMO earlier than sunset in an early waking condition may lead to large interindividual variability in the circadian rhythm phase.

An easy-to-apply method for determining permissible exposure limit of retina to light

Long exposure to intensive artificial light imposes threats to the retina. It is crucial to know the permissible exposure time to prevent photoretinitis. One complicated quantification method is available, which, however, also requires instrumentally measured spectrum and illuminance. We present herein an easy-to-apply formula and a ready-to-use table derived therefrom to determine the permissible exposure limit for any given desk lamp at any viewing distance. One only needs to acquire its color temperature and luminous flux labeled on the product. The method can be used to assist the general public in quickly assessing the potential hazardous status of their desk lamps, if any, and guide the field experts in designing human-eye-friendly lighting.

The effect of monochromatic, combined, and mixed light-emitting diode light regimes on growth traits, fear responses, and slaughter-carcass characteristics in broiler chickens

This study aims to determine the effects of blue and green monochromatic, blue-green combination, and blue-green mixed led lighting systems on growth, fear, and carcass characteristics of broilers reared in an extensive indoor system. Experimental groups were formed as follows; 1-conventional (incandescent), 2-blue, 3-green, 4-blue-green combined (blue for the first 10 days, then green), 5-green-blue combined (green for the first 10 days, then blue), and 6-blue-green intermittent (alternating every 5 min) monochromatic lightings. It was detected that the average values of the body weight of chickens at 42 and 56 days of age in the green-blue group were higher than those of the other treatment groups (both P < 0.05). It was determined that the broilers in the green and green-blue groups had higher means of the β₀ parameter of Gompertz model. The tonic immobility, emergence test, home cage avoidance test, a looming human test, and box plus experimenter test were applied to determine the fear responses. It was determined that the worst results for fear responses of broilers were in the intermittent lighting group and green-blue combined group. As a result, it was determined that the application of green monochromatic lighting in the first 10 days of the fattening period and blue monochromatic lighting in the following period positively affected growth and slaughter-carcass characteristics. However, it was found that broilers reared under green-blue combined lighting had high fear levels.

Impact of Upgraded Lighting on Falls in Care Home Residents

OBJECTIVES

Falls in care home residents have major health and economic implications. Given the impact of lighting on visual acuity, alertness, and sleep and their potential influence on falls, we aimed to assess the impact of upgraded lighting on the rate of falls in long-term care home residents.

DESIGN

An observational study of 2 pairs of care homes (4 sites total). One site from each pair was selected for solid-state lighting upgrade, and the other site served as a control.

SETTING AND PARTICIPANTS

Two pairs of care homes with 758 residents (126,479 resident-days; mean age (±SD) 81.0 ± 11.7 years; 57% female; 31% with dementia).

METHODS

One "experimental" site from each pair had solid-state lighting installed throughout the facility that changed in intensity and spectrum to increase short-wavelength (blue light) exposure during the day (6 am-6 pm) and decrease it overnight (6 pm-6 am). The control sites retained standard lighting with no change in intensity or spectrum throughout the day. The number of falls aggregated from medical records were assessed over an approximately 24-month interval. The primary comparison between the sites was the rate of falls per 1000 resident-days.

RESULTS

Before the lighting upgrade, the rate of falls was similar between experimental and control sites (6.94 vs 6.62 falls per 1000 resident-days, respectively; rate ratio [RR] 1.05; 95% CI 0.70-1.58; P = .82). Following the upgrade, falls were reduced by 43% at experimental sites compared with control sites (4.82 vs 8.44 falls per 1000 resident-days, respectively; RR 0.57; 95% CI 0.39-0.84; P = .004).

CONCLUSIONS AND IMPLICATIONS

Upgrading ambient lighting to incorporate higher intensity blue-enriched white light during the daytime and lower intensity overnight represents an effective, passive, low-cost, low-burden addition to current preventive strategies to reduce fall risk in long-term care settings.

Influence of thermal and lighting factors on human perception and work performance in simulated underground environment

The utilization of underground working space in the rapidly developing global economy has broadened the scope of human activities. However, it has also brought new challenges to existing environmental construction strategies. The comfort and performance of the people inside a building are influenced by multiple factors. This study investigates the main factors affecting personnel perception and work performance, such as humidity, heat, and light, to guide the construction of underground working environments. Therefore, an experiment was designed and carried out in an artificial climate chamber to explore the differences in subjective evaluation, physiological parameters, and working performance of personnel under different thermal and lighting environments. The results show that air temperature has a significant effect on most subjective and objective parameters, while lighting has a weak effect. Air temperature and illumination are the two main environmental factors that affect comfort. Regression analysis shows that the recommended air temperature and illumination ranges are 22.0-27.3 °C and 545-1000 lx, respectively. This study also found that the interaction between color temperature and air temperature had significant effects on several evaluation parameters.

Broiler behavior differs from males to females when under different light wavelengths

It is well established that different light wavelengths affect broiler behavior. The present study aims to evaluate the effect of four light wavelengths on broiler behavior from 1 to 42 days of age. Birds were housed at a stocking density of 13 birds/m2, in 32 boxes of 1.56 m2. The experimental design was a completely randomized factorial of 4 × 2 (four colors × two sexes), with four replicates. Behavioral variables were accessed through cameras and observed in person thrice a week for 30 min per day in three different periods. Data were organized according to age groups and analyzed by a data mining approach with the different light wavelengths as the classes. Natural behavior defined by stretch, dust bath of male broilers reared in environments with green and blue light was more relevant to the classification of male broilers' behavior (96.9 and 96.9% accuracy and 0.8 and 1.0 of class precision of behavior classification, respectively). Blue and green lights affected the behavior of male broilers starting at 7 days of age, increasing the presence at the bird feeder, and reducing the idle period.

Making lighting adjustments to establish new behavioral patterns in a child with autism: A follow-up study

Acknowledging the importance of lighting adjustment (a less-studied aspect of the environmental modification), this study showed novel effects of black light conditions, where white objects became part of the foreground of a blackened environment to train a child with autism to master a series of self-care tasks. This follow-up study provided details about how training progressed under black light conditions to teach the child a second task called self-feeding. The process of training self-feeding for this child was undergone after the child mastered the self-care task of toothbrushing. Healthcare practitioners may want to illuminate overlooked aspects of the non-human environment, which may be ignored by children with autism, to stimulate interest in objects following lighting adjustments.

Effects of Light on Attention and Reaction Time: A Systematic Review

BACKGROUND

Accuracy, speed, efficiency, and applicability of activities in the workplace are among the most important effective factors on people's productivity, which is in turn affected by environmental factors, such as light. Therefore, the present research aimed to review the studies performed about the effects of light on attention and reaction time.

METHODS

This review study systematically searched articles from 2000-2019 in databases of Google Scholar, ISC, SID, Magiran, Web of Science, Science Direct, PubMed, and Scopus using keywords of light, lighting, attention, and reaction time. The titles and abstracts of articles containing relevant results over the past 20 years were extracted. Thereafter, they were categorized and analyzed according to the title, author name, publication year, study method, study type, and evaluation results.

RESULTS

Based on the results, the light with shorter wavelengths, higher intensity, and higher color temperature led to suppressed melatonin, higher consciousness, less somnolence, increased attention, and faster reaction time. Simultaneous exposure to harmful levels of environmental factors affects cognitive and physiological parameters, acting independently with a separate mechanism or synergistically with a similar mechanism. The best light in the regulation of psychological, biological, and cognitive processes is bright daylight in the morning with a short wavelength, high intensity, and more lasting effects.

CONCLUSION

As evidenced by the obtained results,  light is a powerful modulator of non-visual performance in cognitive tasks. The wavelength, color temperature, and light intensity modulate brain responses to cognitive tasks, including attention and reaction time. Therefore, these parameters, along with personal and environmental factors, should be considered in designing and using light.

Light at night and risk of breast cancer: a systematic review and dose-response meta-analysis

Breast cancer is the most common malignancy in women and the second leading cause of cancer death overall. Besides genetic, reproductive, and hormonal factors involved in disease onset and progression, greater attention has focused recently on the etiologic role of environmental factors, including exposure to artificial lighting such as light-at-night (LAN). We investigated the extent to which LAN, including outdoor and indoor exposure, affects breast cancer risk. We performed a systematic review of epidemiological evidence on the association between LAN exposure and breast cancer risk, using a dose–response meta-analysis to examine the shape of the relation. We retrieved 17 eligible studies through September 13, 2021, including ten cohort and seven case–control studies. In the analysis comparing highest versus lowest LAN exposure, we found a positive association between exposure and disease risk (risk ratio [RR] 1.11, 95% confidence interval-CI 1.07–1.15), with comparable associations in case–control studies (RR 1.14, 95% CI 0.98–1.34) and cohort studies (RR 1.10, 95% CI 1.06–1.15). In stratified analyses, risk was similar for outdoor and indoor LAN exposure, while slightly stronger risks were observed for premenopausal women (premenopausal: RR 1.16, 95% CI 1.04–1.28; postmenopausal: 1.07, 95% CI 1.02–1.13) and for women with estrogen receptor (ER) positive breast cancer (ER + : RR 1.09, 95% CI 1.02–1.17; ER–: RR 1.07, 95% CI 0.92–1.23). The dose–response meta-analysis, performed only in studies investigating outdoor LAN using comparable exposure assessment, showed a linear relation up to 40 nW/cm²/sr after which the curve flattened, especially among premenopausal women. This first assessment of the dose–response relation between LAN and breast cancer supports a positive association in selected subgroups, particularly in premenopausal women.

Subconscious influences on perceived cleanliness in hospitality settings

Due to the COVID-19 pandemic, now and for years to come, guests at hospitality venues will have heightened awareness with regard to formulating their perceptions of cleanliness. While perceived cleanliness has received attention in our existing body of literature, this conceptual paper integrates potential subconscious influencers on cleanliness perceptions into our understanding. Specifically, findings contained in various streams of research suggest that a number of factors can have subconscious influences on individuals' perceptions of cleanliness in service environments. Such factors include the degree of lighting, the presence of plants / greenery, the shininess of surfaces, the use of ambient scents, the use of white bedding, and the presence of cleaning staff. Evidently, the sooner hospitality venues (particularly airlines, lodging operations, restaurants, and cruise ships) are perceived as clean and safe, the faster they will recover from the pandemic. As such, this paper is rich with both practical and research implications.

Changing color and intensity of LED lighting across the day impacts on circadian melatonin rhythms and sleep in healthy men

We examined whether dynamically changing light across a scheduled 16-h waking day influences sleepiness, cognitive performance, visual comfort, melatonin secretion, and sleep under controlled laboratory conditions in healthy men. Fourteen participants underwent a 49-h laboratory protocol in a repeated-measures study design. They spent the first 5 hours in the evening under standard lighting, followed by an 8-h nocturnal sleep episode at habitual bedtimes. Thereafter, volunteers either woke up to static light or to a dynamic light that changed spectrum and intensity across the scheduled 16-h waking day. Following an 8-h nocturnal sleep episode, the volunteers spent another 11 hours either under static or dynamic light. Static light attenuated the evening rise in melatonin levels more compared to dynamic light as indexed by a significant reduction in the melatonin AUC prior to bedtime during static light only. Participants felt less vigilant in the evening during dynamic light. After dynamic light, sleep latency was significantly shorter in both the baseline and treatment night while sleep structure, sleep quality, cognitive performance, and visual comfort did not significantly differ. The study shows that dynamic changes in spectrum and intensity of light promote melatonin secretion and sleep initiation in healthy men.

Is the pink ball still under review? Cricket umpires' perceptions of the pink ball for day/night matches

OBJECTIVES

The visibility of the pink ball used in day/night Test cricket has been under scrutiny, with recent research suggesting cricketers find the pink ball less visible at dusk under floodlights. With increasing interest in this match format, this study sought to investigate elite umpires' opinions pertaining to the visibility of the pink cricket ball during day/night matches.

DESIGN

Purposeful sampling of a cross-section of elite umpires with experience adjudicating matches played using a pink cricket ball.

METHODS

Twenty-seven international/first-class umpires completed a questionnaire consisting of Likert scale and free text responses covering perceptions of the pink cricket ball, with a particular emphasis on visibility.

RESULTS

The pink ball when viewed at night under floodlights was rated as being significantly more visible than the red ball during natural lighting (ps<0.050). Umpires who actively participated in training reported a significantly higher rating of the visibility of the pink ball (mean -3.14) at night under floodlights compared to those who didn't (mean p=0.010). No significant difference was reported in visibility in natural light or dusk under floodlights. Free text responses (n=10) revealed the following themes: use of eyewear (coverage 0.30), and adjustment to positioning (coverage 0.20) to improve visibility of the pink ball.

CONCLUSIONS

Umpires report the visibility of the pink ball is equal to the red in natural light and at dusk but is significantly better at night. Preference for the pink ball is likely due to the predominantly perceptual nature of visual tasks performed by umpires.

A comparison of white/red and white/blue LED light fixtures on Pekin duck production, stress and behaviour

1. The objective of this study was to determine the effects of two mixed LED light spectra on duck production, stress and fear responses. Pekin ducks were reared under either white/red (WR) or white/blue (WB) LED light.2. No differences were observed in feed conversion ratio (P = 0.690) or d 35 body weight (P = 0.919). Furthermore, no differences were observed in plasma interleukin-12 concentrations (P = 0.449), anti-keyhole limpet haemocyanin IgG titre (P = 0.503) or composite physical asymmetry score (P = 0.839). WR caused lower heterophil to lymphocyte ratios (0.40 ± 0.03, P = 0.029) and plasma corticosterone concentrations (4498 ± 534 pg/ml, P = 0.038) than WB (0.58 ± 0.08; 6518 ± 795 pg/ml, respectively). No differences were found in the number of attempts to induce tonic immobility (TI) or in inversion intensity. A shorter latency to first head movement during TI (9.44 ± 1.22 s, P = 0.06) and an overall shorter latency to right from TI (25.66 ± 2.99 s, P < 0.001) was observed for birds under WR compared to WB (20.91 ± 6.01 s; 58.76 ± 8.86 s). The duration of time spent in the second stage of TI, where birds observed their environment using head movements while still remaining immobile on their backs, was shorter in WR (16.23 ± 1.73 s, P = 0.001) compared to WB (37.85 ± 6.38 s).3. The results indicated that rearing ducks under WR caused less stress susceptibility and fear responses compared to ducks under WB. Pekin duck welfare may be compromised by blue LED light exposure, even at supplemental levels utilised in commercial poultry lighting.

Outdoor light at night and breast cancer incidence in the Danish Nurse Cohort

BACKGROUND

Knowledge of the role of melatonin, xenograft experiments, and epidemiological studies suggests that exposure to light at night (LAN) may disturb circadian rhythms, possibly increasing the risk of developing breast cancer.

OBJECTIVES

We examined the association between residential outdoor LAN and the incidence of breast cancer: overall and subtypes classified by estrogen (ER) and progesterone (PR) receptor status.

METHODS

We used data on 16,941 nurses from the Danish Nurse Cohort who were followed-up from the cohort baseline in 1993 or 1999 through 2012 in the Danish Cancer Registry for breast cancer incidence and the Danish Breast Cancer Cooperative Group for breast cancer ER and PR status. LAN exposure data were obtained from the U.S. Defense Meteorological Satellite Program (DMSP) available for 1996, 1999, 2000, 2003, 2004, 2006, and 2010 in nW/cm²/sr unit, and assigned to the study participants' residence addresses during the follow-up. Time-varying Cox regression models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between LAN and breast cancer, adjusting for individual characteristics, road traffic noise, and air pollution.

RESULTS

Of 16,941 nurses, 745 developed breast cancer in total during 320,289 person-years of follow-up. We found no association between exposure to LAN and overall breast cancer. In the fully adjusted models, HRs for the highest (65.8-446.4 nW/cm²/sr) and medium (22.0-65.7 nW/cm²/sr) LAN tertiles were 0.97 (95% CI: 0.77, 1.23) and 1.09 (95% CI: 0.90, 1.31), respectively, compared to the lowest tertile of LAN exposure (0-21.9 nW/cm²/sr). We found a suggestive association between LAN and ER-breast cancer.

CONCLUSION

This large cohort study of Danish female nurses suggests weak evidence of the association between LAN and breast cancer incidence.

Cricketers are not tickled pink by the new coloured ball

OBJECTIVES

Cricket administrators have started scheduling long-form matches which finish at night and are played with a pink as opposed to a red ball. However, there are reports that the pink ball may introduce new dangers and alter performance. The aim of this study was to investigate professional cricketers' opinions about the visibility of the pink ball whilst playing in different lighting conditions (afternoon, dusk and night).

DESIGN

Purposeful sampling of a cross-section of elite cricketers with pink ball experiences playing in the United Kingdom.

METHODS

Eighty-eight international or first-class professional cricketers completed a questionnaire consisting of Likert scale and free text responses to questions covering perceptions of the pink ball, with a particular emphasis on visibility.

RESULTS

The pink ball was reported as less visible than the red ball when batting (p<0.001) and fielding (p<0.001). Within the three lighting conditions the pink ball was significantly less visible at dusk under floodlights compared to afternoon and night both when batting and fielding (ps<0.001). Free text comments confirmed that visibility of the pink cricket ball was most challenging at dusk (coverage 0.37), and that players sometimes experienced a blurring sensation with the pink ball leaving a visual 'trail' when viewed under floodlights (coverage 0.24).

CONCLUSIONS

Results advocate that governing bodies should consider the inclusion of a break in play during dusk to enhance player safety and performance. Empirical research is needed to quantify the risks to player safety in different lighting conditions.

Relevance of Electrical Light on Circadian, Neuroendocrine, and Neurobehavioral Regulation in Laboratory Animal Facilities

Light is a key extrinsic factor to be considered in operations and design of animal room facilities. Over the past four decades, many studies on typical laboratory animal populations have demonstrated impacts on neuroendocrine, neurobehavioral, and circadian physiology. These effects are regulated independently from the defined physiology for the visual system. The range of physiological responses that oscillate with the 24 hour rhythm of the day include sleep and wakefulness, body temperature, hormonal secretion, and a wide range of other physiological parameters. Melatonin has been the chief neuroendocrine hormone studied, but acute light-induced effects on corticosterone as well as other hormones have also been observed. Within the last two decades, a new photosensory system in the mammalian eye has been discovered. A small set of retinal ganglion cells, previously thought to function as a visual output neuron, have been shown to be directly photosensitive and act differently from the classic photoreceptors of the visual system. Understanding the effects of light on mammalian physiology and behavior must take into account how the classical visual photoreceptors and the newly discovered ipRGC photoreceptor systems interact. Scientists and facility managers need to appreciate lighting impacts on circadian, neuroendocrine, and neurobehavioral regulation in order to improve lighting of laboratory facilities to foster optimum health and well-being of animals.

Study of the variations in the Schumann resonances parameters measured in a southern Mediterranean environment

Schumann resonances (SRs) provide a unique tool for exploring continuous and long-term monitoring of global environmental parameters, although their detection and study is a very complex task. This paper presents diurnal and seasonal variations of principal parameters, namely the resonance frequency, the Q-factor, and the power of SRs, in the North-South (NS) magnetic field component for the first five modes from Extra Low Frequency (ELF) measurements. These were acquired at the observation site located at Doliana, Kalpaki, in the Region of Epirus, North West Greece. These variations are the first ones reported for the principal parameters in the South Eastern Mediterranean area and correspond to the one-year measurement period from 2016 to 2017. The comparison with variations at several observations sites is also discussed. Moreover, correlation with global lighting centers, as well as local lightning activity, and SRs parameters variation is attempted.

Orb-weaving spiders are fewer but larger and catch more prey in lit bridge panels from a natural artificial light experiment

Artificial light at night is rapidly changing the sensory world. While evidence is accumulating for how insects are affected, it is not clear how this impacts higher trophic levels that feed on insect communities. Spiders are important insect predators that have recently been shown to have increased abundance in urban areas, but have shown mixed responses to artificial light. On a single bridge with alternating artificially lit and unlit sections, I measured changes in the orb-weaving spider Larinioides sclopetarius (Araneidae) web abundance, web-building behavior, prey-capture, and body condition. In artificially lit conditions, spiders caught more prey with smaller webs, and had higher body conditions. However, there were fewer spiders with active webs in those lit areas. This suggests that either spiders were not taking advantage of an ecological insect trap, perhaps due to an increased risk of becoming prey themselves, or were satiated, and thus not as active within these habitats. The results from this natural experiment may have important consequences for both insects and spiders in urban areas under artificial lighting conditions.

Dynamic LED light versus static LED light for depressed inpatients: results from a randomized feasibility trial

Background

Retrospective studies conducted in psychiatric wards have indicated a shorter duration of stay for depressed inpatients in bright compared to dim daylight-exposed rooms, pointing to a possible antidepressant effect of daylight conditions. Dynamic LED lighting, aiming to mimic daylight conditions, are currently been installed in several hospitals, but their feasibility is poorly investigated.

Methods

To investigate the feasibility of these systems, we developed and installed a LED-lighting system in four rooms in a psychiatric inpatient ward. The system could function statically or dynamically regarding light intensity and colour temperature. The system consisted of (A) a large LED luminaire built into the window jamb mimicking sunlight reflections, (B) two LED light luminaires in the ceiling and (C) a LED reading luminaire. In the static mode, the systems provided constant light from A and B. In the dynamic mode, the system changed light intensity and colour temperature using A, B and C. Patients with unipolar or bipolar depression were randomised to dynamic or static LED lighting for 4 weeks, in addition to standard treatment. Primary outcome was the rate of patients discontinuing the trial due to discomfort from the lighting condition. Secondary outcomes were recruitment and dropout rates, visual comfort, depressive symptoms and suicidal ideation.

Results

No participants discontinued due to discomfort from the LED lighting. Recruitment rate was 39.8%, dropout from treatment rates were 56.3% in the dynamic group and 33.3% in the static group. 78.1% in the dynamic group were satisfied with the lighting compared with 71.8% in the static group. Discomfort from the light (glare) was reported by 11.5% in the dynamic group compared to 5.1% in the static group. Endpoint suicidal scores were 16.8 (10.4) in the dynamic and 16.3 (14.9) in the static group. The lighting system was 100% functional. The light sensor system proved unstable.

Conclusion

Dropout from treatment was high primarily due to early discharge and with a lack of endpoint assessments. The feasibility study has influenced an upcoming large-scale dynamic lighting efficacy trial where we will use a shorter study period of 3 weeks and with more emphasis on endpoint assessments. The lighting was well tolerated in both groups, but some found intensity too low in the evening. Thus, we will use higher intensity blue-enriched light in the morning and higher intensity amber (blue-depleted) light in the evening in the upcoming study. The light sensor system needs to be improved

Trial registration

ClinicalTrials.gov: NCT03363529

Estimating the benefits of increasing the recycling rate of lamps from the domestic sector: Methodology, opportunities and case study

The scope of this paper is to identify the benefits of lamp recycling from the domestic sector. Data related to the recycled lamps was obtained from two recycling companies and were compared to those related to the waste lamps from the domestic sector. This was achieved by a new methodology which uses two alternative approaches. The first one is dependent on previous research data in relation to the number of active lamps while the second one elaborates on electricity consumption and sales data, in order to define the corresponding number of active lamps., The wasted amount of glass, metal and plastic is calculated along with the energy savings, the annual emissions of CO₂-eq, the economic benefit from their sale and the potential reduction of hazardous waste, such as mercury to solid waste landfills under various scenarios. The amount of recovered materials collected by the Hellenic recycling companies contributes to a reduction of CO₂-eq by 1298 tonnes, which falls significantly short of the CO₂-eq that could have been saved 3108-5463tonnes if all the lamps were recycled. Furthermore, the recycling companies have an annual economic benefit of €32,251 which could be increased by €122,725 if all lamps were recycled together with the proper recycling of 3.4 kg of mercury, which was disposed in the environment. Finally, a future scenario was examined, in which all lamps in the domestic sector were assumed to be LEDs, an issue that can affect the viability of the recycling factories and it was proved that these might be affected.

Technological Advances in Herpetoculture

Technology plays a vital role in herpetoculture because ectothermic animals rely on their environment to carry out basic physiologic functions. Controlling the environment appropriately ensures the health and welfare of captive reptiles and amphibians. This article summarizes some of the technological advances and products currently available, including lighting, climate control, and recordkeeping.

Changes in Lighting Source Can Produce Inaccurate Assessment of Visual Poultry Doneness and Induce Consumers To Eat Undercooked Ground Turkey Patties

Undercooked poultry is a potential source of foodborne pathogens, such as Salmonella and Campylobacter. The best way to avoid eating undercooked poultry is to use a food thermometer during cooking. However, consumers who cook poultry often use visual appearance for determining doneness, which relies on extrinsic factors, including lighting conditions. Because the United States recently mandated changes in lighting to promote energy conservation, this study evaluated the effect of lighting sources on consumer perceptions of doneness and willingness to eat cooked poultry patties. Consumers ( n = 104) evaluated validated photographs of turkey patties cooked to different end point temperatures (57 to 79°C) and rated the level of perceived doneness and willingness to eat each sample. Evaluations were conducted under different lighting sources: incandescent (60 W, soft white), halogen (43 W, soft white), compact fluorescent lamp (13 W, soft white), light-emitting diode (LED; 10.5 W, soft white), and daylight LED (14 W). Lighting changed perception of doneness and willingness to eat the patties, with some of the energy-efficient options, such as LED and halogen making samples appear more done than they actually were, increasing the willingness to eat undercooked samples. This poses a risk of consuming meat that could contain bacteria not killed by heat treatment. Recent changes in lighting regulations can affect lighting in homes that affects perceptions of poultry doneness, requiring that educators place extra emphasis on the message that properly using a meat thermometer is the only way to ensure meat is cooked to a safe end point temperature.

The effect of supplementary ultraviolet wavelengths on broiler chicken welfare indicators

Qualities of the light environment are important for good welfare in a number of species. In chickens, UVA light is visible and may facilitate flock interactions. UVB wavelengths promote endogenous vitamin D synthesis, which could support the rapid skeletal development of broiler chickens. The aim of the study was to investigate the impacts of Ultraviolet wavelengths (UV) on welfare indicators in broiler chickens. Day-old Ross 308 birds reared under commercially representative conditions were randomly assigned to one of three lighting treatments: A) White Light Emitting Diode (LED) and supplementary UVA LED lighting (18-hour photoperiod); B) White LED with supplementary UVA and UVB fluorescent lighting providing 30 micro watts/cm2 UVB at bird level (on for 8 h of the total photoperiod to avoid over-exposure of UVB); C) White LED control group, representative of farm conditions (18-hour photoperiod). Welfare indicators measured were; feather condition (day 24, n = 546), tonic immobility duration (day 29, n = 302), and gait quality, using the Bristol Gait Score (day 31, n = 293). Feather condition was improved in male broilers in the UVA treatment (A), compared to the control treatment (C). Birds in the UVA treatment had shorter tonic immobility durations compared to the control treatment (C), suggesting lower fearfulness. Broilers reared in UVA (A) and UVA + UVB (B) had better Bristol Gait Scores compared to the control (C). Together these results suggest UV may be beneficial for broiler chicken welfare. While treatment A and B both provided UVA, the improvements in welfare indicators were not consistent, which may be due to exposure time-dependent beneficial effects of UVA. The modification of commercial lighting regimes to incorporate UVA wavelengths for indoor-reared broiler chickens would be an achievable change with significant positive impacts on bird welfare.

The impact of cookstove operation on PM2.5 and CO emissions: A comparison of laboratory and field measurements

Inefficient biomass combustion in traditional cookstoves generates high levels of household air pollution (HAP) that is associated with numerous adverse environmental and human health conditions. Many cookstoves have been evaluated using laboratory tests, but past studies revealed discrepancies between laboratory and field measurements. Fuel re-loading, a common operation in actual use but not required in the laboratory test, might be a contributing factor to this laboratory-field gap. In this study, we evaluated the pollutant emissions performance of a semi-gasifier cooking stove using both laboratory and field measurements. Emission factors and real-time properties of CO and PM_2.5 were separately measured during the following 4 phases of a typical cooking event: lighting, stable combustion, fuel re-loading and post fuel re-loading. We quantified the CO and PM_2.5 contributions to total cooking event emissions in each phase. We found over 70% lower PM_2.5 emissions and 60% lower CO emissions during 3 no re-loading laboratory tests compared with all 16 field tests. Lighting generated 83.8% ± 15.6% of the total PM_2.5 and 39.1% ± 7.8% of the total CO in laboratory tests without fuel re-loading, and 57.8% ± 33.5% and 37.9% ± 21.2% of the total PM_2.5 and CO in field tests, respectively. On average, fuel re-loading led to 29.1% ± 30.8% of PM_2.5 emissions and 24.9% ± 22.6% of CO emissions in 16 field tests, which also contributed to significant discrepancies between laboratory and field-based emissions. According to the ISO IWA tiered stove ratings for emissions, fuel re-loading led to at least one tier lower ranking in both laboratory and field cookstove tests. Fuel re-loading could be an important factor causing laboratory-field discrepancy of emissions, thus it could be considered in future cookstove selection and intervention projects.

Foveal amplitudes of multifocal electroretinograms are larger following full-field electroretinograms

PURPOSE

The clinical standards for multifocal electroretinograms (mfERG) call for adaption to normal room lighting before the mfERG begins. They specify that any assessments where bright lights are used, should be done after the mfERG to prevent excess stimulation of retinal cells. However, full-field electroretinograms (FFERG) are performed prior to mfERGs in some clinical settings. It is unclear from the literature whether the FFERG has an impact on the mfERG. This study seeks to examine the effect of the FFERG on the mfERG when performed sequentially.

METHODS

Thirty young healthy subjects (age 27.1 ± 3.5 years) were included. Patients reported for two visits and were fully dilated at both visits. At visit one, a FFERG was recorded (VERIS 6.2) using our clinical protocol which includes an ISCEV standard flash sequence; each flash condition was repeated 4-6 times. Following the FFERG, an mfERG was recorded using a 4-min m-sequence at near 100% contrast. At visit two, only the mfERG was recorded. A Burian-Allen contact lens electrode filled with celluvisc was used for all recordings. The two mfERGs were compared for foveal, peripheral, and overall implicit time (IT) and amplitudes (amp). Paired t tests were used to evaluate the data. Coefficient of variation and Bland-Altman analysis was also reported for this patient group.

RESULTS

There was a small but statistically significant difference in foveal amplitudes (amp) (p = 0.004) wherein the amp was larger following the FFERG stimuli. The mean difference was 11.1 nV/deg² (100.9 nV vs 89.8 nV). There was no difference in foveal IT (p = 0.66). There was no difference in overall IT or amp when averaging the entire eye (p = 0.44 amp and p = 0.54 IT) or just evaluating the periphery (p = 0.87 amp and p = 0.051 IT). Bland-Altman analysis found a coefficient of repeatability overall was 1.57 ms (IT) and 10.7 nV/deg² (amp).

CONCLUSIONS

The difference in foveal amplitude is likely the result of a small long-term cone adaptation, but further studies are needed. While it is statistically significant, the small difference is unlikely to be clinically important. These results should help increase clinical confidence in mfERG results when recorded following a FFERG.

Effect of Ambient Light Exposure on Ocular Fatigue during Sleep

BACKGROUND

To investigate the influence of nocturnal ambient light on visual function and ocular fatigue.

METHODS

Sixty healthy subjects (30 men and 30 women) aged 19 through 29 years with no history of ocular disease were recruited. All subjects spent 3 consecutive nights in the sleep laboratory. During the first and second nights, the subjects were not exposed to light during sleep, but during the third night, they were exposed to ambient light, measuring 5 or 10 lux at the eye level, which was randomly allocated with 30 subjects each. The visual function and ocular fatigue were assessed at 7 a.m. on the 3rd and 4th mornings, using best-corrected visual acuity, refractive error, conjunctival hyperemia, tear break-up time, maximal blinking interval, ocular surface temperature, and subjective symptoms reported on a questionnaire.

RESULTS

Three men and three women subjects failed to complete the study (4 in the 5 lux; 2 from the 10 lux). For the entire 54 subjects, tear break-up time and maximal blinking interval decreased (P = 0.015; 0.010, respectively), and nasal and temporal conjunctival hyperemia increased significantly after sleep under any ambient light (P < 0.001; 0.021, respectively). Eye tiredness and soreness also increased (P = 0.004; 0.024, respectively). After sleep under 5 lux light, only nasal conjunctival hyperemia increased significantly (P = 0.008). After sleep under 10 lux light, nasal and temporal conjunctival hyperemia, eye tiredness, soreness, difficulty in focusing, and ocular discomfort increased significantly (P < 0.05).

CONCLUSION

Nocturnal ambient light exposure increases ocular fatigue. Avoiding ambient light during sleep could be recommended to prevent ocular fatigue.

The effect of increasing the illumination on operators' visual performance in the control-room of a combined cycle power plant

BACKGROUND

Lighting is one of the environmental factors affecting the performance of the control room operators. Therefore, the aim of this study was to compare the control room operators' visual performance in two different illumination conditions at a combined cycle power plant through field-work.

METHODS

Sixteen operators in day shift were evaluated with the Freiburg Visual Acuity test (FrACT) software at two lighting systems with different intensities. It includes the first phase with fluorescent illumination system (Power: 40 W, Color Temperature: 4000 Kelvin, Luminous Flux: 2780 Lumen and Model: Pars Shahab) and the second phase with a combined illumination system includes fluorescent and LED (Power: 48 W, Color Temperature: 4000 Kelvin, Luminous Flux: 5400 Lumen and Model: Mazinoor).

RESULTS

Based on the results, visual performance index and visual acuity significantly increased after the intervention (p < 0.001). As to contrast, more lighting significantly reduced the percentage of recognized contrast (p < 0.001) and increased the contrast performance index (p < 0.001).

CONCLUSIONS

The results of this study showed that increasing the intensity of light from the values below the allowable limit to the values above the allowable limit would increase the visual indicators in individuals.

Effect of Different Illumination Sources on Reading and Visual Performance

Purpose:

To investigate visual performance during reading under different illumination sources.

Methods:

This experimental quantitative study included 40 (20 females and 20 males) emmetropic participants with no history of ocular pathology. The participants were randomly assigned to read a near visual task under four different illuminations (400-lux constant): compact fluorescent light (CFL), tungsten light (TUNG), fluorescent tube light (FLUO), and light emitting diode (LED). Subsequently, we evaluated the participants’ experiences of eight symptoms of visual comfort.

Results:

The mean age of the participants was 19.86 ± 1.09 (range: 18–21) years. There was no statistically significant difference between the reading rates of males and females under the different illuminations (P = 0.99); however, the reading rate was fastest among males under CFL, and among females under FLUO. One way analysis of variance (ANOVA) revealed a strong significant difference (P = 0.001) between males and females (P = 0.002) regarding the visual performance and illuminations.

Conclusion:

This study demonstrates the influence of illumination on reading rate; there were no significant differences between males and females under different illuminations, however, males preferred CFL and females preferred FLUO for faster reading and visual comfort. Interestingly, neither preferred LED or TUNG. Although energy-efficient, visual performance under LED is poor; it is uncomfortable for prolonged reading and causes early symptoms of fatigue.

Influence of lighting color temperature on effort-related cardiac response

Higher color temperature refers to a higher proportion of blue spectral components of light, that are known to be associated with higher alertness state in humans. Based on motivational intensity theory (Brehm & Self, 1989), here we predicted that this lighting-induced alertness state should inform about the readiness to perform and this way influence subjective task demand and thus mental effort. To test this, study participants spent 15min under one of four lighting color temperature conditions and then performed a cognitive task. As predicted, effort-related cardiac response, indexed by a shortened cardiac pre-ejection period, decreased with increasing color temperature of light, as indicated by a significant single planned linear contrast. These results demonstrate that spectral properties of light can influence mental effort mobilization.

The effects of treatment room lighting color on time perception and emotion

[Purpose] The purpose of this study was to investigate the perceived treatment times and emotional reactions under different light colors in the treatment room. [Subjects and Methods] Subjects in this study were 20 healthy young students in their 20s. Under each lighting condition (blue, red, white, and yellow) differentiated by color, each subject laid on a therapeutic bed and underwent ultrasound therapy. Subjects were instructed to press a stopwatch every 1 minute, for a total of 5 times, after therapy started according to their perception of time while the stopwatch’s time indicator was blocked. After the experiments, self-administered questionnaires were given to subjects to measure their emotional reactions. [Results] In terms of K-POMS scores, the mood states of depression-dejection, anger-hostility, and confusion-bewilderment were higher scores for blue and red lights compared to yellow light. The mood state of vigor-activity were higher scores for yellow and white lights compared to blue and red lights. [Conclusion] Therefore, it is important to take necessary measures to prevent the negative effects that blue and red light-based therapy can have on patient mood.

[Light sources usable by the plastic surgeon in the absence of photographic studio]

Medical photography is an important part of the medical file and is widely used in medical communication, especially in our discipline. His practice has to be the most standardized and reproducible as possible, which distinguishes it from artistic photography. Photography fix the light reflecting from a subject, so surgeon have to control of the light source in any environment. In the absence of dedicated studio, using external cobra or ring flashes with special diffusers allow the surgeon to have light sources adapted to the different conditions encountered in daily practice.

Small power and lighting load time series data for 27 departments across 8 UK hospitals

The electricity consumption of 27 departments was measured across 8 medium to large General Acute hospitals in England (largely by the authors, some data was donated and authorised for publication by the respective hospitals). The departments fall into 6 different categories which have been selected due to their prevalence in General Acute Hospitals (wards), their high energy intensities (theatres, laboratories, imaging and radiotherapy) or their distinct operating hours (day clinics). This data article provides floor areas and the time series of departmental power loads, mostly encompassing lighting and small power (but excluding central electricity use for ventilation, pumping and medical gas services). Comparative interpretations of the data are published in doi: 10.1016/j.enbuild.2016.02.052 [1].

Small power and lighting load time series data for 27 departments across 8 UK hospitals

The electricity consumption of 27 departments was measured across 8 medium to large General Acute hospitals in England (largely by the authors, some data was donated and authorised for publication by the respective hospitals). The departments fall into 6 different categories which have been selected due to their prevalence in General Acute Hospitals (wards), their high energy intensities (theatres, laboratories, imaging and radiotherapy) or their distinct operating hours (day clinics). This data article provides floor areas and the time series of departmental power loads, mostly encompassing lighting and small power (but excluding central electricity use for ventilation, pumping and medical gas services). Comparative interpretations of the data are published in doi: 10.1016/j.enbuild.2016.02.052 [1].

Neonatal intensive care unit lighting: update and recommendations

Achieving adequate lighting in neonatal intensive care units is a major challenge: in addition to the usual considerations of visual performance, cost, energy and aesthetics, there appear different biological needs of patients, health care providers and family members. Communicational aspects of light, its role as a facilitator of the visual function of doctors and nurses, and its effects on the newborn infant physiology and development were addressed in order to review the effects of light (natural and artificial) within neonatal care with a focus on development. The role of light in regulating the newborn infant circadian cycle in particular and the therapeutic use of light in general were also reviewed. For each aspect, practical recommendations were specified for a proper well-lit environment in neonatal intensive care units.

Evaluating the rollover propensity of trucks--A roundabout example

The rollover propensity of SUVs and trucks has long been recognized as a potential safety issue. The propensity may increase with the growing number of roundabouts that are being built on high-speed roadways designed for 50 mi/h or higher. This paper presents a research methodology developed to evaluate the rollover propensity of trucks on existing roundabouts and other roads with tight curves and high-speed traffic. The research objective was accomplished by developing an advanced 3D model of rollover that is applicable to field observations of the undisturbed behavior of multiple vehicles. This model was supplemented with a nonintrusive method of data collection based on recording video from a remote location and a novel method of extracting the data from the video material and processing it to generate the input required by the rollover model. The method is demonstrated in this paper on an example roundabout by evaluating the rollover propensity of semi-trailers in daytime and nighttime conditions. The results indicate that the drivers observed in nighttime conditions compensated well for the challenging conditions by driving more cautiously, which led to their rollover propensity at night being lower than during the day. The method was found useful for timely detection of the potential rollover problem without waiting for crashes.

Fiat Lux: the effect of illuminance on acuity testing

Purpose

To determine the effect of changing illuminance on visual and stereo acuity.

Methods

Twenty-eight subjects aged 21 to 60 years were assessed. Monocular visual acuity (ETDRS) of emmetropic subjects was assessed under 15 different illuminance levels (50–8000 lux), provided by a computer controlled halogen lighting rig. Three levels of myopia (−0.50DS, −1.00DS & 1.50DS) were induced in each subject using lenses and visual acuity (VA) was retested under the same illuminance conditions. Stereoacuity (TNO) was assessed under the same levels of illuminance.

Results

A one log unit change in illuminance level (lx) results in a significant change of 0.060 LogMAR (p < 0.001), an effect that is exacerbated in the presence of induced myopic refractive error (p < 0.001). Stereoacuity scores demonstrate statistically significant overall differences between illuminance levels (p < 0.001).

Conclusions

The findings of this study demonstrate that changes in illuminance have a statistically significant effect on VA that may contribute to test/retest variability. Increases in illuminance from 50 to 500 lx resulted in an improved VA score of 0.12 LogMAR. Differences like these have significant clinical implications, such as false negatives during vision screening and non-detection of VA deterioration, as the full magnitude of any change may be hidden. In research where VA is a primary outcome measure, differences of 0.12 LogMAR or even less could affect the statistical significance and conclusions of a study. It is recommended that VA assessment always be performed between 400 lx and 600 lx, as this limits any effect of illuminance change to 0.012 LogMAR.

Feasibility of a stepped wedge cluster RCT and concurrent observational sub-study to evaluate the effects of modified ward night lighting on inpatient fall rates and sleep quality: a protocol for a pilot trial

Background

Falls among hospitalised patients impose a considerable burden on health systems globally and prevention is a priority. Some patient-level interventions have been effective in reducing falls, but others have not. An alternative and promising approach to reducing inpatient falls is through the modification of the hospital physical environment and the night lighting of hospital wards is a leading candidate for investigation. In this pilot trial, we will determine the feasibility of conducting a main trial to evaluate the effects of modified night lighting on inpatient ward level fall rates. We will test also the feasibility of collecting novel forms of patient level data through a concurrent observational sub-study.

Methods/design

A stepped wedge, cluster randomised controlled trial will be conducted in six inpatient wards over 14 months in a metropolitan teaching hospital in Brisbane (Australia). The intervention will consist of supplementary night lighting installed across all patient rooms within study wards. The planned placement of luminaires, configurations and spectral characteristics are based on prior published research and pre-trial testing and modification. We will collect data on rates of falls on study wards (falls per 1000 patient days), the proportion of patients who fall once or more, and average length of stay. We will recruit two patients per ward per month to a concurrent observational sub-study aimed at understanding potential impacts on a range of patient sleep and mobility behaviour. The effect on the environment will be monitored with sensors to detect variation in light levels and night-time room activity. We will also collect data on possible patient-level confounders including demographics, pre-admission sleep quality, reported vision, hearing impairment and functional status.

Discussion

This pragmatic pilot trial will assess the feasibility of conducting a main trial to investigate the effects of modified night lighting on inpatient fall rates using several new methods previously untested in the context of environmental modifications and patient safety. Pilot data collected through both parts of the trial will be utilised to inform sample size calculations, trial design and final data collection methods for a subsequent main trial.

Trial registration

Australian New Zealand Clinical Trials Register (ANZCTR): ACTRN12614000615684 (cluster RCT) and ACTRN12614000616673 (observational sub-study).

Date Registered: 10 June 2014 (both studies).

Protocol version: 1.2 (Dated: 01 June 2014)

Anticipated completion: September 2015

Role of Trial Sponsor: The named sponsor for this investigator-initiated trial was the Director of the Royal Brisbane and Women’s Hospital (RBWH) Safety and Quality Unit (Therese Lee, Phone: +61 7 3646 8111). The principal investigators, SC and MA, are employed by the RBWH Safety and Quality Unit. The trial sponsor has no involvement in any aspects of study design, conduct or decision to submit the report for publication. AM and MD are employed by other departments in the same organisation.

The science behind codes and standards for safe pedestrian walkways: lighting and visual cues

BACKGROUND

Walkway codes and standards are created through consensus by committees based on a number of factors, including historical precedence, common practice, cost, and, sometimes, empirical data. The authors maintain that codes and standards that can have an impact on human safety and welfare should give consideration in their formulation to the results of pertinent scientific research.

PURPOSE

This article extends a companion one in examining many elements of common walkway codes and standards related specifically to lighting, warnings and markings. It indicates which elements are based on or supported by empirical data; and which elements could benefit from additional scientific research.

PRACTICAL APPLICATIONS

This article identifies areas in which additional research leading toward scientific based codes and standards may be beneficial in enhancing the safety of pedestrian walkway surfaces.

Effects of Different Viewing Conditions on Radiographic Interpretation

OBJECTIVES

Optimum viewing conditions facilitate identification of radiographic details and decrease the need for retakes, patients' costs and radiation dose. This study sought to evaluate the effects of different viewing conditions on radiographic interpretation.

MATERIALS AND METHODS

This diagnostic study was performed by evaluating radiograph of a 7mm-thick aluminum block, in which 10 holes with 2mm diameters were randomly drilled with depths ranging from 0.05 mm to 0.50mm. The radiograph was viewed by four oral radiologists independently under four viewing conditions, including a white light viewing light box in a lit room, yellow light viewing light box in a lit room, white light viewing light box in a dark room and yellow light viewing light box in a dark room. Number of circular shadows observed on the film was recorded. The data were analyzed by two-way ANOVA.

RESULTS

The mean number of detected circular shadows was 6.75, 7.5, 7.25 and 7.75 in white light viewing light box in a lit room, white light viewing light box in a dark room, yellow light viewing light box in a lit room and yellow light viewing light box in a dark room, respectively. Although the surrounding illumination had statistically significant effect on the radiographic details (P≤0.03), the light color of the viewing light box had no significant effect on visibility of the radiographic details.

CONCLUSION

White and yellow light of the viewing light box had no significant effect on visibility of the radiographic details but more information was obtained in a dark room.

Lighting, sleep and circadian rhythm: An intervention study in the intensive care unit

Patients in an intensive care unit (ICU) may risk disruption of their circadian rhythm. In an intervention research project a cycled lighting system was set up in an ICU room to support patients' circadian rhythm. Part I aimed to compare experiences of the lighting environment in two rooms with different lighting environments by lighting experiences questionnaire. The results indicated differences in advantage for the patients in the intervention room (n=48), in perception of daytime brightness (p=0.004). In nighttime, greater lighting variation (p=0.005) was found in the ordinary room (n=52). Part II aimed to describe experiences of lighting in the room equipped with the cycled lighting environment. Patients (n=19) were interviewed and the results were presented in categories: "A dynamic lighting environment", "Impact of lighting on patients' sleep", "The impact of lighting/lights on circadian rhythm" and "The lighting calms". Most had experiences from sleep disorders and half had nightmares/sights and circadian rhythm disruption. Nearly all were pleased with the cycled lighting environment, which together with daylight supported their circadian rhythm. In night's actual lighting levels helped patients and staff to connect which engendered feelings of calm.

Propensity scores-potential outcomes framework to incorporate severity probabilities in the highway safety manual crash prediction algorithm

Accurate estimation of the expected number of crashes at different severity levels for entities with and without countermeasures plays a vital role in selecting countermeasures in the framework of the safety management process. The current practice is to use the American Association of State Highway and Transportation Officials' Highway Safety Manual crash prediction algorithms, which combine safety performance functions and crash modification factors, to estimate the effects of safety countermeasures on different highway and street facility types. Many of these crash prediction algorithms are based solely on crash frequency, or assume that severity outcomes are unchanged when planning for, or implementing, safety countermeasures. Failing to account for the uncertainty associated with crash severity outcomes, and assuming crash severity distributions remain unchanged in safety performance evaluations, limits the utility of the Highway Safety Manual crash prediction algorithms in assessing the effect of safety countermeasures on crash severity. This study demonstrates the application of a propensity scores-potential outcomes framework to estimate the probability distribution for the occurrence of different crash severity levels by accounting for the uncertainties associated with them. The probability of fatal and severe injury crash occurrence at lighted and unlighted intersections is estimated in this paper using data from Minnesota. The results show that the expected probability of occurrence of fatal and severe injury crashes at a lighted intersection was 1 in 35 crashes and the estimated risk ratio indicates that the respective probabilities at an unlighted intersection was 1.14 times higher compared to lighted intersections. The results from the potential outcomes-propensity scores framework are compared to results obtained from traditional binary logit models, without application of propensity scores matching. Traditional binary logit analysis suggests that the probability of occurrence of severe injury crashes is higher at lighted intersections compared to unlighted intersections, which contradicts the findings obtained from the propensity scores-potential outcomes framework. This finding underscores the importance of having comparable treated and untreated entities in traffic safety countermeasure evaluations.

Effect of illumination on colour vision testing with Farnsworth-Munsell 100 hue test: customized colour vision booth versus room illumination

Purpose

To evaluate a customized, portable Farnsworth-Munsell 100 (FM 100) hue viewing booth for compliance with colour vision testing standards and to compare it with room illumination in subjects with normal colour vision (trichromats), subjects with acquired colour vision defects (secondary to diabetes mellitus), and subjects with congenital colour vision defects (dichromats).

Methods

Discrete wavelengths of the tube in the customized booth were measured using a spectrometer using the normal incident method and were compared with the spectral distribution of sunlight. Forty-eight subjects were recruited for the study and were divided into 3 groups: Group 1, Normal Trichromats (30 eyes); Group 2, Congenital Colour Vision Defects (16 eyes); and Group 3, Diabetes Mellitus (20 eyes). The FM 100 hue test performance was compared using two illumination conditions, booth illumination and room illumination.

Results

Total error scores of the classical method in Group 2 as mean±SD for room and booth illumination was 243.05±85.96 and 149.85±54.50 respectively (p=0.0001). Group 2 demonstrated lesser correlation (r=0.50, 0.55), lesser reliability (Cronbach's alpha, 0.625, 0.662) and greater variability (Bland & Altman value, 10.5) in total error scores for the classical method and the moment of inertia method between the two illumination conditions when compared to the other two groups.

Conclusions

The customized booth demonstrated illumination meeting CIE standards. The total error scores were overestimated by the classical and moment of inertia methods in all groups for room illumination compared with booth illumination, however overestimation was more significant in the diabetes group.