Proceedings of the 12th International Conference on Protection and Restoration of the EnvironmentEditors: A. Liakopoulos, A. Kungolos, C. Christodoulatos, A. KoutsopsyrosISBN 978-960-88490-6-8

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Indoor illumination in tertiary sector and human health. A review

N.G.Katsikas1, S.A. Dedegkika2, C.S.Psomopoulos1, K.D.Mardikis1, G.Ch.Ioannidis1

1. T.E.I. Piraeus, Dept. of Electrical Engineering,250 Thivon str & P.Rali Ave,Gr-12244, Egaleo, Greece 2. Attikon University Hospital, 2

ndNeurological Clinic, Rimini 1,Gr-12462, Chaidari, Grrece

Corresponding author’s e-mail: katsikas.n@gmail.com,Tel +30 2109711737, Fax: +30 2109711737

Abstract Illumination is one of the basic parameters affecting indoor environment quality. Effects on human health due to improper illumination have been observed in the tertiary sector. The main observed problems concern perception and behavior issues and changes in the human circadian system, as well as other effects. This work presents a review of a number of studies conducted in the field and summarizes the results from different research groups. Experimental results, investigating the role of the light colors in the behavior of human, will be presented. These results concerns classrooms in schools where it was observed that the lack of proper light quality creates an irrelevant speech, with additional result the improper monitoring and concentration of the students. The effect of poor artificial lighting on hospital staff and patients’ progress, concerning different categories of people in terms of mood and perception, are also presented. Moreover, the effect of blue light in people during sleep and the negative impacts of the applied specified range of light in humans are outlined according to recent studies. Several cases, regarding LEDs illumination, is also presented showing that this type of light affects the employment efficiency since it is commonly used in the typical working environment. This paper is focused mainly on the tertiary sector due to the existence of specific regulations that can be easily checked and applied.

Keywords Indoor illumination and health, LEDs lighting, indoor environment quality, circadian system, quality of lighting, human behavior and light

1. INTRODUCTION

Since the beginning of last century, artificial lighting has started playing a critical role in modern’s world development. Tertiary sector has known a rapid growth in such short time, a 24 hour a day non stopping machine. People working in 24 hour shifts have never thought of the impacts of light on their health. The circadian clock allows a normal Melatonin (MLT) production between 2 and 4 am, a time where a person should be sleeping but also a time that many people is demanded to be awake on night shifts. Night shift workers work under constant high levels of bright lighting with a significant impact on melatonin production. Melatonin is a hormone produced by the human body. It is a protective, oncostatic and antioxidant hormone which under exposure on night time lighting has been proven to be suppressed. Many researches have shown that bright lighting alerts and awakens the human body to work under better and more focused rhythms compared to a more relaxed low temperature lighting [1].

Studies have been performed on lighting’s impacts in education institutes such as schools and colleges, where brighter lighting (>500lx) showed more positive effects on performance and alertness than a low standard lighting (300lx). However, illuminance is not the only factor that impacts on human health and behavior. Correlated Color Temperature (CCT) on different levels (3000K-12000K) also generates positive effects on student’s performance, physical growth and psychological outcomes. On the other hand, if lighting is not installed carefully there is a danger to create pollution, known as lighting pollution. This can be observed at night on gas stations, malls and other commercial places which are using HID lamps. This kind of lighting is based more on

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advertising than helping and guiding people. The light is so bright that trespasses home blinds and creates a sky glow above towns or cities. It has not been a long time since researchers around the world have been attracted in studying the effects of this kind of pollution on human health and behavior [1, 2].

2. METHODS USED IN STUDIES

2.1. Indoor lighting and mood

Knez et.al. [3], performed a research on 80 participants based on previous research results. These results showed that blue-color white lighting, at around 4000K, with a low illuminance level (300lx) preserved the positive mood. This result was also achieved with warm white lighting at 3000K but high illuminance level (1500lx). Their lighting research has addressed the age factor among to the impact of indoor lighting between the male and female participants. Two lighting conditions were used to study the behavior and mood on the participants, aged between 23 and 60 years old. The first lighting scheme used warm white lighting (3000K) while the second one used cool white lighting (4000K). In both of these schemes a 500lx illuminance level were applied. The setting was a neutrally colored and furnished room with false windows. The experiment subjects had to accomplish three tasks contained a self-report of their affective mood, rooms lighting evaluation and cognitive tasks [3, 4].

2.2. Indoor lighting in classrooms

PJC Sleegers et.al. [2], performed an experiment in schools under experimental and control conditions using students as subjects, in order to study the impact of indoor lighting on children's concentration. Their goal was to confirm or scout previous studies in elementary schools which proved that it is not only brighter light (>500lx) that had more positive effects than standard lighting (300lx), on the reading and mathematics solving but also different CCTs (4000K and 17000K). Their main concern on their experiment was the effect of dynamic lighting on students’ performance and concentration. Dynamic light is a scheme where different lighting settings are provided in specific illuminance and CCTs over time to alert or relax the human rhythms. The dynamic lighting scheme consisted of four types of lighting. Energy setting, a 650lx on desk surface with a 12000K (cold-blue, white lighting), Focus setting with a 1000lx at 6500K bright white light, calm setting with a 300lx at 2900K white light with warm red color tone. Fourth and final setting is a standard setting of 300lx at the desk surface and 4000K of CCT with a standard white light. The teacher of the classroom had the ability to choose a setting using a 5 button control unit. A number of 98 students were tested, while students with learning disabilities were excluded [2, 5].

Another study-experiment, to test the lighting effects in a classroom, was performed by Winterbottom and Wilkins [6] influenced by the impact that has been noticed by previous studies regarding fluorescent lamps and their flickering behavior. Ninety classrooms were tested from 11 elementary schools under the effect of glare and flickering randomly selected by the Faculty of Education of Cambridge University. The test was performed during the UK summer holidays when higher ambient lighting occurred. A 100 Hz flicker generated by the fluorescent lights was applied while lux meters used to calculate the illuminance on the desk surface. Four lighting conditions were applied. In the first scheme, the window blinds were kept open while the lights remained on, in the second one the ambient light was only used with the blinds on, in the third one the lights were kept on but with closed blinds and finally, both were switched off. A black line projected on the white board was applied to match the luminance of the classroom. A spot photometer used on all four conditions on the whiteboard (outside the glare spot and within the glare spot of the light

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reflected from the projector to the photometer). The type and number of blinds were recorded [6-17].

2.3. Indoor lighting and bulimic behavior

Kasof [18], performed two studies in order to investigate how lighting schemes promote people towards bulimic behavior. Based on previous studies that confirmed people tend to a relax condition during the evening hours, eating in a more elaborate manner than they do during the daytime. People tend to consume more alcohol in the evening and watch more television, activities leading to food consumption. According to older studies bright lighting schemes create a more resistant behavior than dimmed or dark lighting schemes do. Kasof in third study, attempted to analyze the results obtained by study one and study two (245 and 156 participants) in order to find the relation of indoor dimmed lighting and bulimic behavior. According to the first two studies, 12 participants were diagnosed with bulimic behavior (achieving a Bulimia Test-Revised “BULIT-R” score higher than 98) compared with another 12 participants without bulimic behavior (specific achievements on the tests on the first two studies) [19].

2.4. Indoor lighting effects on human health - circadian clock

Pauley [1], mentions in his research about the effects of artificial light exposure on night shift workers. Data from Harvard Nurses’ Health study on 80,000 women showed that these women appeared higher rates of breast cancer. At a percentage (35%) shift workers who worked a rotating shift for at least three nights per month for fifteen and more years were found with higher incidence of colorectal cancer. A neuroscientist named Berson made a discover showing an unknown function for Retinal Ganglion Cells (RGC). Experiments performed on rats demonstrated that RGC axons are associated with the biological clock center. The rats appear to be more sensitive to blue light, controlling the circadian clock and therefore MLT production and sleep patterns. Schulmeister, used the action spectrum of MLT and calculated time durations where human MLT was suppressed by 50% [20, 68].

3. RESULTS

3.1. Results of indoor lighting and mood In Figures 1 and 2 the results of Knez and Kers [3], present the effects on negative and positive mood mean changes. Female and male subjects were compared based on gender and age. Younger females were more resistant changing their positive mood than the younger males while the opposite is true for older males and females (males more resistant than females). Negative mood changes (Figure 2) revealed that older subjects had a smaller change towards negative mood than younger ones depending on the warm and cool light, being used while the opposite results are valid for the case warm light is used. In Figure 3, the results on the cognitive test shows that younger subjects performed better solving problems than the older while females did it better than the male ones. In every occasion younger participants described the lighting as too bright and cooler than the older subjects. There was a significant change only in the negative mood depending on the lighting applied mostly versus age but not gender. Younger participants preferred and performed better under warm light than the older participants who preferred the use of cool light [3].

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Figure 1: Mean change in positive mood in females and males as a function of age, [3]

Figure 2: Mean change in negative mood in younger and older adults as a function of cool

and warm lighting, [3]

Figure 3: Problem-solving performance in females and males as a function of age, [3]

3.2. Results of Indoor lighting in classroom

PCJ Sleegers et.al.[2[, and his team in their three experiments concerning a control and an experimental school attempted to validate earlier studies. The experimental school had a lighting condition of about 300lx at 4000K CCT at a desk level before the dynamic lighting system was implemented. All the tests performed under the Focus setting as it was described in section 2.2. The control school had an average 600lx 4000K CCT at a desk level. The students were asked to perform concentration tests on the same days in both schools and at the same time [2]. In study 1 the students in the control school performed better than the experimental school. Though, the increase in performance is more significant in the experimental school versus time, an effect of focus lighting setting. As for the errors made by the students, they were decreased versus time but with a more important effect in the experimental school. Sixth grade students performed better than students in grade fourth but the main result obtained by the first study, was that Focus setting had a positive effect on student Concentration Performance (CP). Although the results indicated that girls performed better than boys, it could not be considered statistically safe for conclusions between gender performances.

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In the case of study two, both classrooms were in the same school compared to study one where they were in different ones. Another difference between the two studies was that the data of their tests were obtained two weeks after the dynamic lighting installation in study two while in study one the data were collected one month after the installation. The control classroom had an average illuminance level of about 350lx at 3000K while the experimental classroom had a constant Focus setting with an average illuminance 750lx at 3000K CCT. In comparison to study one, 44 students were tested with an average age of ten years. Students in the experimental classroom performed better than the students in the control classroom. Focus lighting setting had a positive effect on student concentration performance in the experimental classroom. In addition, student in the experimental classroom made fewer errors compare to the ones in the control classroom. Once again gender did not play a dramatic role in the effect of lighting on concentration [2, 4, 21, 22, 23, 34].

Finally in study three, the performance of 55 students was examined in a windowless lecture room where a dynamic lighting schemes was installed in University of Twente. The students were asked to gather early in the morning to avoid the effect of the exposure to natural light before exposure to artificial light. The students were not aware of which lighting scheme was applied each time. Standard and Focus setting were randomly assigned for the experiment. Once again students under Focus setting performed better on the CP than the ones under Standard setting, while errors made in the Focus setting were less than in Standard setting. However, the differences between the two groups, showed that the Focus setting did not have a large impact on the concentration than the normal lighting setting [2, 5].

Whinterbottom and Wilkins [6], study showed that both students and teachers preferred daylight than artificial fluorescent lighting [6]. The dominance of imperceptible 100Hz flicker has a negative impact in health and comfort and visual performance. CIBSE [10], recommends luminaries to be replaced with higher frequency circuits in classrooms where young students spend most of their time and they are more sensitive to the 100Hz flicker. The experiment was applied during the summer months, and this could be one factor to explain why students and teachers preferred the natural light instead of the artificial fluorescent light. When blinds were drawn, excessive light from the luminaries and from the external environment was reported (daylight). User comfort decreases when the ratio between maximum and minimum illuminance exceeds 0.6 according to Slater et.al. [25]. A separate control of the artificial lighting in a classroom would be beneficial in addition to blind control. Dinsmore and Estes [26, 27], state that high illuminance could be a reason to explain why teachers prefer soft lighting and improved behavior under dim lighting. Excessive lighting may produce discomfort and annoying glare on white boards [9, 14, 16, 17, 25-39].

3.3. Results of indoor and bulimic behavior

Kasof [28], found from his experiment that dimmed light while eating was related with bulimic behavior on the subjects under high dietary restraint, while lighting preference was unrelated among participants under low dietary restraint. This argument was enhanced based on past studies, where bulimic behavior was significantly high during evening hours and where night lasts longer (winter months). Therefore, it probably is not connected with just the time but with the fact that dimmer light produces a high-risk environment for bulimic behavior to be expressed. The author addresses the limitations applied on this experiment (eg. Lighting preferences were not examined in different kind of meals such as breakfast, dinner, etc.). MLT suppression was not considered a plausible argument for expressing bulimic behavior. Another explanation could be that frequent binge eater usually prefer dimmed light while eating as a module to cover their anonymity which would be revealed under bright light. Bulimic people are aware of their act hence lower levels of light, is an umbrella of their act [18,40-55].

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Old --- ---- --Young ---- - ----Old ----- ---- -

Young - - -----Old --- - --

Young ---- --- ----Old ----- - -

Young - --- -----Female

Male

Female ++Male +

Female ---Male ---

Female + -Male + -

++++

W&W - - -Dinsmore

&Estes + + + +Kasof -

300lx 4000K

1000lx 6500KExp 3

PCJ Sleegers

et .al

100Hz flicker

Dimmed lighting in class

Dimmed light ing while eat ing

Exp 1

300lx 4000K

600lx4000K

dynamic

Exp 2

350lx3000K

control class750lx 3000K

exp class

500lx 3000K

500lx 4000K

Knez & Kers

Male

Female

Male

Female

Positive mood

Negat ive mood

Probleme solving

Perf. concentration

(CP)

Improve behavior

Bulimic behavior

Errors sequence Health Comfort Visual

(-) negative impact, (+) positive impact Table 1: cumulative experimental results

3.4. Results of indoor effects on human Health – circadian clock

Experiments on rats conducted by Blask et.al. [56], and their team showed that light at night exposure suppressed MLT levels and increased liver cancer levels. A 300lx white light, a typical level of an office building, showed the same results as the dim light. Humans, on the other hand, are more resistant than rats but according to Brainard [57], who performed experiments on humans, MLT was suppressed by a 90min exposure to 0.1lx of 464nm blue light, which is equal of the illumination created on earth from a full moon. According to the same experiment, when total darkness was interrupted by a 300lx white light, rats with implanted human breast cancer and lower MLT levels, achieved a 70% improvement when melatonin was added and reduced the light exposure. Hatonen, however demonstrated that two out of eight people exposed under 2000lx of white light for 60 minutes during the MLT production time (2-3 am) showed lowered melatonin levels with their eyes closed. On the other hand in industrialized world, many people wake up during that time and are exposed to television screens, tablets, and other artificial light sources with their eyes open. Results reported by Schulmeiste showed that monochromatic red light at 100lx would take 403h of exposure to suppress MLT by 50%, while a 60W old incandescent lamp would need 39 minutes and a 58W fluorescent deluxe daylight lamp, approximately 15 minutes. The new in the market LED take about 13 minutes to suppress the MLT by 50% [1, 57-60].

Holick proposes that the best way to daily entrain our circadian clocks is a simple 15 minute exposure of natural sunlight every morning while total darkness during sleeping time is critical. Studies have shown that a good way to entrain our circadian clock during daylight is the use of bright full spectrum white light, while at night, non-blue lights both indoor and outdoor should be used. In office buildings where windows are not available to provide natural daylight, non-glare bright full spectrum light should be provided [1, 61-67].

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Conclusions

Light plays a very important role in our everyday life. Natural or artificial, lighting has been chosen to improve the visual and working comfort for hundreds of years. Careless lighting may cause irreversible implications on human health. Lighting pollution, trespassing windows at night might occur causing sleep disorders with a direct effect on the circadian clock and melatonin production. Studies have shown that cool white light alerts human behavior and achieves better concentration on students or workers. Lighting for decorating purposes in tertiary sector should not be preferred. Most of the researchers state that further analysis and investigation should be conducted on the effects of light in human health and behavior. Students performed better on higher illuminance than CIBSE proposes (500lx) and around the zone of 3000-4000K. If fluorescent lighting is not carefully placed may cause visual discomfort especially if the luminaries are not corrected to work under high frequency. While dim light is associated with bulimic behavior, it is preferred in many occasions so that it does not suppress MLT production. The best lighting condition in tertiary sector is allowing daylight, controlled by blinds in order to create a natural lighting condition. In cases where windows are not present, cool white with an absence of blue component is preferred. Luminaries should be designed in such way that glare does not appear on working surfaces as it has been found to create discomfort.

Many of the studies have not validated their results about the relation between levels of light on human health and behavior but, there are clear indications that it plays a significant role. An important question to be answered is: whether light is a cover for abnormal behavior (bulimic patients). It definitely is an important performance factor of human alertness in working environment or schools. Aimless luminary installation and lighting levels may cause serious health problems or decrease the performance of workers in the tertiary sector.

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