Do you really need to buy more lights?
Went to my wonderful local surgery last week to check some new lesions on my skin.
Sitting in a small room lit by a standard-issue LED panel, the doctor peered at the blotches, and I wondered how on earth he could see.
I spotted an expensive-looking inspection lamp next to the bed and asked if he’d be willing to turn that on.
All the subtle shifts in skin tone popped to life under the full-spectrum lamp, and he simply said ‘wow’, explaining he’d never noticed it before: he just gets the keys to a room every morning and gets on with his list.
Clearly, someone in the practice had realised the basic overhead lights weren’t good enough for clinical work and spent quite a lot of money on something that would effectively fill the gap. The information just hadn’t reached the people who need to know.
I’m amazed how often that happens in other settings where the user doesn’t own the space – conference suites and classrooms, hot desks and therapy rooms. There’s not enough incentive or information (or it’s just too much hassle) to make the most of what’s already there.
So before you complain about the lights- or spend money on any more – perhaps it’s worth taking a look at what’s already there?
Sunny side up
My GP visit was triggered by concerns about skin cancer – and judging by the bright-yellow stacks of SPF50 in the shops and constant advice to stay out of the sun, I’m not alone.
This fascinating article from a leading dermatologist suggests that I have got it all wrong, noting that there is no link between the six-fold rise in melanoma diagnosis and deaths from skin cancer itself. In his impassioned plea to rethink our troubled relationship with the sun, Professor Richard Weller explains that, paradoxically, outdoor workers have the same or lower risk of death from melanoma than those of us who spend our days indoors. Indeed, higher levels of vitamin D, a reliable marker of sunlight exposure, may even be a protective factor – Risks of sunlight: Melanoma overdiagnosis.
Another recent paper discusses the central role of vitamin D compounds in mental and physical strength over the life course, concluding that deficiency may be a biomarker for chronic inflammatory diseases and a shorter life expectancy. Low levels are also associated with cognitive decline, Alzheimer’s and dementia – Vitamin D, the Sunshine Molecule That Makes Us Strong: What Does Its Current Global Deficiency Imply?
But we get less efficient at producing and using this essential building block with age, with problems with mobility, social isolation or living in a residential care setting, reducing time outside, compounding the problem – Vitamin D in the older population: a consensus statement.
So what’s that got to do with the lights?
There’s been a lot of focus on the value of infra-red recently – with good reason.
But here I’m going to make a pitch for the other end of the spectrum.
Ultraviolet rays, from around 290 to 310 namometers are key to ‘endogenous’ vitamin D production – what happens in the skin – Vitamin D: Production, Metabolism, and Mechanism of Action, with evidence suggesting that the shorter wavelengths pack the biggest punch – an LED emitting at 293nm was and delivered similar effects to sunlight exposure 60 times faster – Ultraviolet B Light Emitting Diodes (LEDs) Are More Efficient and Effective in Producing Vitamin D3 in Human Skin Compared to Natural Sunlight. UV lamps have been used for decades to prevent rickets and jaundice in babies, with growing interest in wearable UV devices like this one – The effect of proto-type wearable light-emitting devices on serum 25-hydroxyvitamin D levels in healthy adults: a 4-week randomized controlled trial.
But from my reading of the literature, it’s broadband rather than narrowband exposure that counts – Solar UVR and Variations in Systemic Immune and Inflammation Markers.
So ideal is to get outside.
According to this excellent blog from the Royal Osteoporosis Society, just 10-15 minutes will do the trick if you get outside when the sun is high enough in the sky, roughly between 11 am and 4 pm here in the UK, between April and October.- Vitamin D: welcome to the ‘sunlight zone’.
And yet most people living in residential healthcare get outside less than once a month, with this excellent paper pointing to the physical and organisational barriers to change – just unlocking doors and making time outside a performance measure will help – Outdoor stays-A basic human need except for older adults in residential care facilities? Researcher-practitioner interaction crosses zones and shows the way out.
For those who can’t get outside, sitting close to the window with the chair positioned to look outside and enjoy the view will help – assuming it’s open, of course: most glazing is engineered to block those wavelengths to improve thermal comfort – ‘low-emissivity’ or low-e glass.
Adding plants will not only have a calming effect and help to reduce light pollution, they’re a living light meter, showing which of the rooms get enough light (and those that don’t) – Reducing CO2 level in the indoor urban built environment: Analysing indoor plants under different light levels.
I came across this ingenious invention – a mirror placed on a balcony angled to bounce the sun back into the room through an open window, linked to a sensor system to optimise the orientation. Exposure for 10-20 minutes three times per day over eight weeks was enough to boost Vitamin D without overheating or sunburn – and without buying another gadget – Harnessing natural sunlight indoors: sensor-regulated therapeutic approach to enhance vitamin D status in humans.