light and health: it is more than tunable white light! by mariana figueiro
TRANSCRIPT
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Designers Light Forum
Light and Health: It is more than tunable white light!
MarianaG.Figueiro,PhDLightingResearchCenter
RensselaerPolytechnicInstituteMarch28,2017
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LightandHealth:Itismorethantunablewhitelight!MarianaG.Figueiro,PhDMarch28,2017
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Credit(s)earnedoncompletionofthiscoursewillbereportedtoAIACESforAIAmembers.CertificatesofCompletionforbothAIAmembersandnon-AIAmembersareavailableuponrequest.
ThiscourseisregisteredwithAIACESforcontinuingprofessionaleducation.Assuch,itdoesnotincludecontentthatmaybedeemedorconstruedtobeanapprovalorendorsementbytheAIAofany
materialofconstructionoranymethodormannerofhandling,using,distributing,ordealinginanymaterialorproduct.___________________________________________Questionsrelatedtospecificmaterials,methods,andserviceswillbeaddressedattheconclusionofthispresentation.
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ThispresentationisprotectedbyUSandInternationalCopyrightlaws.Reproduction,distribution,displayanduseofthepresentationwithoutwrittenpermissionofthe
speakerisprohibited.
©Thenameofyourcompany2012
CopyrightMaterials
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Electriclightingsystemsengineeredtodeliver"healthy"lightingarefloodingthemarket,andsoareclaimsassociatedwithsuchproductsandtheirapplications.
Thistalkwillcoverwhatweknow,whatwedon'tknowandweneedtoknowtodeliverhealthylightingtovariouspopulations,fromprematureinfantstoAlzheimer’sdiseasepatients.
CourseDescription
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LearningObjectives
1. Understandbasicsofcircadiansystem
2.Undestandlightingcharacteristicsaffectingthecircadiansystem
3.Understandhowtocalculatecircadianstimulus
4.Understandwhatpopulationslighthasbeenshowntoaffectsleep,moodandbehavior
Attheendofthethiscourse,participantswillbeableto:
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LightingaffectsthreesystemsVisual+non-visual+message
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Distribution
Appearance Visual System Visual Performance
Performance, Well-being,
Satisfaction, and Comfort
Alerting Effects Non-Visual Systems Phase Shift
Amount Spectrum DurationDistribution Timing
Culture, Experience, Expectations
TimingSpectrum DurationAmount
LightingaffectsthreesystemsVisual
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Appearance Visual System Visual Performance
Performance, Well-being,
Satisfaction, and Comfort
Alerting Effects Non-Visual Systems Phase Shift
Amount Spectrum DurationDistribution Timing
Culture, Experience, Expectations
TimingSpectrum DurationAmount Distribution
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RelativevisualperformanceSize+Contrast+Illuminance+Age
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Luminancecontrast
Retinalilluminance
Visualsize
RVP
IESN
AHa
ndbo
okAppearance/BrightnessPerception
Warm 2700 K Cool 6500 K
Low 100 IxHigh 350 Ix r = 0.7
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Controloverglare,reflectionsandshadows
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Glare
Shadows
Reflection
PhotoResearchers
Encarta
DougM
artin
/PhotoResearchers,Inc
LightingaffectsthreesystemsMessage
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Appearance Visual System Visual Performance
Performance, Well-being,
Satisfaction, and Comfort
Alerting Effects Non-Visual Systems Phase Shift
Amount Spectrum DurationDistribution Timing
Culture, Experience, Expectations
TimingSpectrum DurationAmount Distribution
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Whatisthemessage?
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vs.
Perceptualsystem• Preferenceforview• Biophilia hypothesis
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LightingaffectsthreesystemsNon-Visual
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Appearance Visual System Visual Performance
Performance, Well-being,
Satisfaction, and Comfort
Alerting Effects Non-Visual Systems Phase Shift
Amount Spectrum DurationDistribution Timing
Culture, Experience, Expectations
TimingSpectrum DurationAmount Distribution
Circadiansystem• Plantsandanimalsexhibit
patternsofbehavioralandphysiologicalchangesoveranapproximately24-hourcyclethatrepeatoversuccessivedays—thesearecircadianrhythms
• circa=about;dies=day
• Circadianrhythmsareinfluencedbyexogenousandendogenousrhythms
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Lightistheprimarysynchronizerofcircadianrhythmstolocal
positiononEarth
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Light is the primary synchronizer of circadian rhythms to local position on Earth
The natural, 24-hour, light-dark cycle
light
retina
suprachiasmatic nucleus
hypothalamusthalamus
lateral geniculatenucleus
pineal gland
signals to body
optic nerve
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AdaptedfromNationalLibraryofMedicineimage,2007(publicdomain)
…also the major disruptor
Circadiandisruptionandhealth• Circadian disruption has been associated with:
– Poorsleep,poorperformanceandhighstressEismann,E.A.,Lush,E.,&Sephton,S.E.(2010).Circadianeffectsincancer-relevantpsychoneuroendocrine andimmunepathways.Psychoneuroendocrinology,35(7),963-976.Gumenyuk,V.,Howard,R.,Roth,T.,Korzyukov,O.,Drake,C.L.(2014)Sleeploss,circadianmismatch,andabnormalitiesinreorientingofattentioninnightworkerswithshiftworkdisorder.Sleep.March1;37(3):545–556.
– IncreasedanxietyanddepressionDu-Quiton,J.,Wood,P.A.,Burch,J.B.,Grutsch,J.F.,Gupta,D.,Tyer,K.,...Reynolds,J.L.(2010).Actigraphic assessmentofdailysleep–activitypatternabnormalitiesreflectsself-assesseddepressionandanxietyinoutpatientswithadvancednon-smallcelllungcancer.Psycho-Oncology,19(2),180-189.
– IncreasedsmokingKageyama,T.,Kobayashi,T.,Nishikido,N.,Oga,J.,&Kawashima,M.(2005).AssociationsofsleepproblemsandrecentlifeeventswithsmokingbehaviorsamongfemalestaffnursesinJapanesehospitals.IndustrialHealth,43(1),133-141.
– CardiovasculardiseaseYoung,M.E.,&Bray,M.S.(2007).Potentialroleforperipheralcircadianclockdyssynchrony inthepathogenesisofcardiovasculardysfunction.SleepMedicine,8(6),656-667.Maemura,K.,Takeda,N.,&Nagai,R.(2007).CircadianrhythmsintheCNSandperipheralclockdisorders:roleofthebiologicalclockincardiovasculardiseases.JournalofPharmacologicalSciences,103(2),134-138.
– Type2diabetesKreier,F.,Kalsbeek,A.,Sauerwein,H.P.,Fliers,E.,Romijn,J.A.,&Buijs,R.M.(2007).“Diabetesoftheelderly”andtype2diabetesinyoungerpatients:Possibleroleofthebiologicalclock.ExperimentalGerontology,42(1),22-27.
– HigherincidenceofbreastcancerSchernhammer,E.S.,Laden,F.,Speizer,F.E.,Willett,W.C.,Hunter,D.J.,Kawachi,I.,&Colditz,G.A.(2001).RotatingnightshiftsandriskofbreastcancerinwomenparticipatingintheNurses'HealthStudy.JournaloftheNationalCancerInstitute,93(20),1563-1568.Hansen,J.(2006).Riskofbreastcancerafternight-andshiftwork:currentevidenceandongoingstudiesinDenmark.CancerCauses&Control,17(4),531-537.
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LightingaffectsthreesystemsVisual+non-visual+message
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Distribution
Appearance Visual System Visual Performance
Performance, Well-being,
Satisfaction, and Comfort
Alerting Effects Non-Visual Systems Phase Shift
Amount Spectrum DurationDistribution Timing
Culture, Experience, Expectations
TimingSpectrum DurationAmount
Lighting characteristicsSpectral and absolute sensitivities
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Absolute sensitivity
Rea, M. S., Figueiro, M. G., Bullough, J. D., & Bierman, A. (2005). A model of phototransduction by the human circadian system. Brain Research Reviews, 50(2), 213-228.
Rea, M. S., Figueiro, M. G., Bierman, A., & Hamner, R. (2012). Modelling the spectral sensitivity of the human circadian system. Lighting Research and Technology, 44(4), 386-396.
Spectral sensitivityoutdoors
nightindoorshome
indoorsoffice
outdoors daytime
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LightingcharacteristicsTiming
• Lightcanchangethetimingofsleepandeitherpromoteentrainmentorcausedisruption– Morninglight(afterminimumcore
bodytemperature)willadvancethetimingofsleep
– Eveninglight(beforeminimumcorebodytemperature)willdelaythetimingofsleep
– But,everyphotoncounts!
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Rajaratnam S,ArendtJ.Healthina24-hSociety.TheLancet.2001;358(9286):999-1005.
Figueiro,MG.Delayedsleepphasedisorder:clinicalperspectivewithafocusonlighttherapy. NatureandScienceofSleep2016;8:91-106.
Ourworkinghypothesis• Tailoredlightinginterventiondesignedtopromote
circadianentrainmentcanimprovesleep,mood,andbehaviorinvariouspopulations– SufferersfromSeasonalDepression– Officeworkers– Submariners– Teenagerswithdelayedsleeponset– Olderadultswithearlysleeponset– Alzheimer’sdiseaseandrelateddementiapatients– Cancerpatientsexperiencingfatigueandsleepdisturbances
• Tailoredinterventiondesignedtopromotealertnessindayshiftandnightshiftworkers
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• Circadianstimulus:Metricforquantifyingeffectivenessoflightsourcesforactivatingthecircadiansystem
• CSisequivalenttopercentmelatoninsuppressionafter1-hexposuretothelightsource– Anindicationofhoweffectivethe
lightsourceisforthecircadiansystem– Caveat:doesnottakeintoaccount
durationofexposure,photichistoryandisbasedonacutemelatoninsuppression(notphaseshiftingoftheclock)
• Threshold=0.1CS;halfmax=0.3CS;saturation=0.7CS
Specificationofthelightstimulus
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CalculatingCS• Importantconsiderations:
– VerticalIlluminance(lightattheplaneofthecornea)– Lightlevel– Spectrum– Timinganddurationofexposure– Photichistory
• ExposuretoCSof0.3orgreaterattheeye,foratleast1hourintheearlypartoftheday,iseffectiveforstimulatingthecircadiansystem
• CScalculatorwasdevelopedtoaiddesignersandspecifiersinselectinglightsourcesthathasthepotentialforaffectingthecircadiansystem
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http://www.lrc.rpi.edu/resources/CircadianStimulusCalculator_30Apr2016.xlsx
ImportantConsiderations:Lightatthecornea
• Whendesigningforcircadianhealth,lightattheplaneofthecorneabecomestheprimarytarget
• Theratioofhorizontalilluminancetoverticalilluminancebecomesimportantwhenlookingattheopticofafixture
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ImportantConsiderations:LightlevelandSpectrum
• LowerlightlevelswillachieverelativelylowerCSvaluesunlesscompensatedforbyanSPDwithmorepoweratshorterwavelengths
• Maintainingasinglecorrelatedcolortemperature(CCT)throughoutthedayandachievingchangesinCSvaluesispossiblebysimplyincreasingordecreasinglightlevel
• It’simportanttorequesttheSPDfromthemanufacturerforanyfixturesbeingconsidered.SPDscanvaryforasingleCCT
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ImportantConsiderations:LightlevelandSpectrum
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ImportantConsiderations:Timingandduration
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Exampleofarecommendedscheduleforaseniorcarefacility.
w Carefullyconsiderwhowillbeoccupyingthespace.› Schoolsandnursinghomeswillhaveoccupantsthatrequirecircadianstimulationatdifferenttimes.
w While0.3isagoodminimumCSforstimulatingthecircadiansystem,timingofexposurematters!
Tailoredlightinginterventiondesignedtopromotecircadianentrainment
• Promoteentrainmentinvariouspopulationsby– Deliveringhighcircadianstimulus(CS>0.3)duringtheday,especiallyinthemorning,andlowCS(CS<0.1)intheevening,topromoteentrainmentinAlzheimer’sdiseasepatients,olderadultswithearlysleeponset,adolescents,prematureinfants,cancerpatientsundergoingtreatment)
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Circadianentrainmentinadolescents
• USGBCresearchgrant– Lightimpactsstudents’performanceandwell-beingbypromotingtheircircadianentrainmenttothesolarday
– Performed3fieldstudies• Demonstratedthatlackofmorningcircadianlightdelaysdimlightmelatoninonset,whichcandelaysleeponset
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Sponsor: USGBCFigueiroMGandReaMS.Lackofshort-wavelengthlightduringtheschooldaydelaysdimlightmelatoninonset(DLMO)inmiddleschoolstudents.NeuroEndocrinology Letters.2010;31:4.FigueiroMG,Brons J,Plitnick B,Donlan B,LeslieR,andReaMS.2011.Measuringcircadianlightanditsimpactonadolescents.LightingResearchandTechnology(LR&T)43(2):201-215.FigueiroMGandReaMS.2010.Eveningdaylightmaycauseadolescentstosleeplessinspringthaninwinter.ChronobiologyInternational27(6):1242-58.
CircadianentrainmentinadolescentsImpactofcomputerscreensonmelatoninlevels
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0%
10%
20%
30%
40%
50%
1hour 2hour
Melatoninsuppression
PredictedsuppressionfromDaysimeterdata:10%Actualsuppression:25%
FigueiroandOverington,2015
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Circadianentrainmentinprematureinfants• Prematureinfants
– Increasedweightgainandreduceddaysinventilatorinprematureinfantswhoreceivedcycledlightcomparedtothosewhoreceivedeitherconstantlightorconstantdarkness
– Improvedsleepandcircadianrhythmsafterdischargeinprematureinfantswhoreceivedcycledlightcomparedtothosewhoreceivedeitherconstantlightorconstantdarkness
• LRCisworkingwithneonatologisttodevelopalightblanketthatcanbeplacedontopofincubator– Delivercycledlight– Goodcolorrendering– Examinationlight– Cameraforparentstomonitorinfants
fromafar33
Circadianentrainmentinpersonswithdementia
• Studytestedtheeffectivenessofatailoredlighttreatmentonsleepquality,agitationanddepressionin14patientswithAlzheimer’sdiseaseandrelateddementiaslivinginnursinghomes
• Highcircadianstimulation(CS>0.3)duringdaytime• 300-400luxatthecorneafromwakingto6pm• Bluish-whitelight,CCT>9000K
• Resultsshowedincreaseinsleepefficiency,totalsleeptime,reductioninagitationanddepression
34Sponsor:NationalInstituteonAging(R01AG034157)
Figueiroetal.2014
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Circadianentrainmentinpersonswithdementia• Exposed6subjectstolighttable
(CS>0.4)for4weeks• Resultsshowedasignificant
increaseinsleepefficiencyandduration
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Sponsor:NationalInstituteonAging(R01AG034157)Figueiro M, Plitnick B and Rea M. Research Note: A self-luminous light table for persons with Alzheimer’s disease. Light Res Technol. 2015: 1477153515603881.
Circadianentrainmenttoreducefatigueincancerpatients
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Patients:Breastandgynecologicalcancersurvivorswithclinicallysignificantfatigue
Protocol:30-minexposuretomorninglightatbaseline(aftercompletionofchemo),4weeksafterinterventionand3weeksaftercompletionofthelightintervention
Lightintervention:30mininfrontofalightboxwithin30minofwaking.Comparison:dimredlight
Results:Significantimprovementinfatiguesymptomsinthelightcondition
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Circadianentrainmenttoreducefatigueinbonemarrowtransplantpatients• IncollaborationwithDr.WilliamRedd (OncologicalSciences),weareinvestigatingtheimpactofaCSof0.3duringthemorninghourson:– Circadianmarkers(melatonin)– Fatigue– Depression– Sleep
37 Sponsor:NationalCancerInstitute,PI:Dr.Redd
Otherapplicationstolookoutfor• Usinglighttoreduce
– SleepdisturbancesinVeteranswithPTSD– Postpartumdepressionsymptoms– DeliriuminICUpatients– SleepandfatigueinParkinson’sdiseasepatients
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Tailoredinterventiondesignedtopromotealertnessindayshiftandnightshiftworkers
Promoteacutealertness(e.g.=cupofcoffee)
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.
Sponsor:OfficeofNavalResearch(N00014-11-1-0572)NIOSH/CDC
Lightingfornightshiftworkers
• Studiesshowedthatredlight,whichdoesnotsuppressnocturnalmelatonincan:– Improvesubjectiveandobjectivemeasuresofalertness– Improvecertaintypesofperformance,similartowhitelight
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Sponsor: Office of Naval Research
Figueiro MG, Sahin L, Wood B and Plitnick B. Light at night and measures of alertness and performance: Implications for shift workers. Biological Research for Nursing. 2014; In Press.
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Lightingfordayshiftworkers
• Studiesshowedthatredlightduringpost-lunchdip:– Improvessubjectiveandobjectivemeasuresofalertness– Improvescertaintypesofperformance
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Sponsor:OfficeofNavalResearch(N00014-11-1-0572)
Sahin L, Wood BM, Plinick BA, Figueiro MG. Daytime light exposure: Effects on biomarkers, measures of alertness, and performance. Behavioral Brain Research, 2014, 274:176-185.
Tipsfordesigningforcircadianhealth
• Thinkaboutlayers oflight!– SomedesignersorspecifiersmayhavestrictenergyrestrictionsthatpreventCStargetsfrombeingmet.
• Considerusingsaturatedblue(e.g.,peakwavelength=470nm)LEDsasawaytoboostCSincreativeways.
– Studieshaveshownthatredlightcanhaveanacutealertingeffectwithoutsuppressingmelatonin.
• Considerusingredlightasawaytoboostalertnessforoccupants.
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LightingPatternsforHealthyBuildings
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w TheLRChasdevelopedawebsitedetailinglightingdesignpatternsfor:› 24-hlightingschemeforseniors’facilities
http://lightingpatternsforhealthybuildings.org/
Summary• LightpromotesentrainmenttothelocaltimeonEarth
– Short-wavelength(blue)lightismaximallyeffective;– Whitelightathigherlightlevelsthanneededforvisionis
needed;– Redlightisnoteffective
• Morninglightis“good”buteveninglightshouldbeavoided– Needtokeeptrackoftotallightexposures
• Lighthasanacutealertingeffectonpeople– Brainactivities– Biomarkersotherthanmelatoninlevels– Anycoloroflightiseffective– Mechanismsarenotwelldefined;needtodevelopaspectral
sensitivity
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Thankyou.
www.lrc.rpi.eduhttp://lightingpatternsforhealthybuildings.org/
http://www.lrc.rpi.edu/resources/CircadianStimulusCalculator_30Apr2016.xlsx
ThisconcludesTheAmericanInstituteofArchitectsContinuingEducationSystemsCourse
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Acknowledgmentsv Organizersoftheevent
Ø GaryMannv LightingResearchCenter’sfaculty,staffandstudents
Ø MarkS.Rea,PhDØ BarbaraPlitnick,RNØ SharonLesageØ Kassandra Gonzalez,MSØ RyanBrommØ AndrewBierman,MSØ GeoffJonesØ DennisGuyonØ DavidPedlerØ Rohan NagarØ CharlieRoohanØ RyanKutler
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LightandHealthProjectSponsorsv NationalInstituteonAgingv NationalInstituteonDrugAbusev NationalInstituteofNursingResearchv NationalCancerInstitutev NationalCenterforComplementaryandAlternativeMedicinev EuniceShriverNationalInstituteofChildHealthandDevelopmentv NationalInstituteofOccupationalandSafetyHealth(CDC/NIOSH)v GeneralServicesAdministration(USGSA)v USDepartmentofStatev OfficeofNavalResearchv USNavyv USGreenBuildingCouncilv TheSwedishEnergyAgencyv Boeingv Googlev AcuityBrands
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LightandHealthAllianceSponsorsAcuityBrands,Cree,CurrentPoweredbyGE,Ketra,PhilipsLighting,OSRAM,USAILighting
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The Light and Health Alliance is a collaboration among Members (manufacturers, government organizations and NGOs, codes and standards bodies) and practitioners, including architects, specifi ers, medical facility managers and physicians, to enable the broad adoption of lighting for human health by producing factual information based on basic and applied research and by visualizing future applications.
Goals • Conduct evaluations, demonstrations, and research
projects to develop practical devices and applications.• Institutes to educate key audiences on light and health
with a particular emphasis on developing quantitative lighting specifi cations.
• Presentations at conferences to promote the topic of light and health, and the Light and Health Alliance.
MissionTo bridge the science of light and health to practical applications, and to provide objective information based on basic and applied research.
Member Benefi ts• Meetings to inform Members of our latest research
activities, and discussions that would advance attention to light and health in the public sector.
• Forums to provide an intellectual and physical meeting place — a neutral ground for Members and practitioners to share important insights.
• Infl uence to shape the research agenda.• Early presentations of research results.• Generation of pilot data — an essential requirement
for funding from the National Institutes of Health.• Confi dential research sponsored under separate
contract and IP agreement.
Cost: $30k per year; $20k per year for LRC Partners. A 3-year commitment provides an additional $5,000 discount per year. The LRC will establish and publically announce the alliance after three sponsors join.
21 Union Street, Troy, NY 12180518-687-7100
www.lrc.rpi.eduContact: Mariana G. Figueiro, PhD
www.lrc.rpi.edu/programs/lightHealth/index.asp
Light and Health Alliance
MissionTobridgethescienceoflightandhealthtopracticalapplications,andtoprovideobjectiveinformationbasedonbasicandappliedresearchGoals:• Conductevaluations,demonstrations,and
researchprojectstodeveloppracticaldevicesandapplications
• Institutestoeducatekeyaudiencesonlightandhealthwithaparticularemphasisondevelopingquantitativelightingspecifications
• Presentationsatconferencestopromotethetopicoflightandhealth,andtheLightandHealthAlliance
Projectcollaborators• Mt.SinaiIcahnSchoolofMedicine• BrownUniversity• YaleUniversity• CaseWesternReserveUniversity• UniversityofNorthCarolina,ChapelHill• HarvardUniversitySchoolofPublicHealth• SkidmoreCollege• DukeUniversity• NationalInstituteonDrugAbuseIntramuralResearch• NetherlandsInstituteforNeuroscience• CornellUniversity• NavalSubmarineMedicalResearchLaboratory
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