LED lighting provides significant benefits over fluorescent lighting in healthcare facilities. It improves patient health and recovery through better light quality, reduced UV exposure, and support of circadian rhythms. LEDs also provide financial benefits through much longer lifespan, reduced energy and maintenance costs. By switching to LEDs, healthcare facilities can create a healthier environment for patients and staff while reducing environmental impact and saving money.

1. LED Lighting Sets the
New Standard in Healthcare
Improving Sustainability, Performance, and Patient Wellbeing in
Hospitals with a Simple Switch

3. 02
CURRENT STATE
OF HEALTHCARE
LIGHTING
F
or over a century, fluorescent bulbs have
been the groundbreaking technology in
lighting. Since the 1940s, we have been
treating patients under fluorescent lights in
our healthcare facilities, worked under them
in offices, exercised under them in gymnasiums, and
educated under them in our schools. With the advent
of the compact fluorescent bulb, we even brought
them into our homes.1
Fluorescent lights are gas-filled tubes with a coating
on the inner surface. Electricity, regulated by a ballast,
ignites a filament and vaporizes small amounts of
mercury within the tube, causing them to emit ultra-
violet (UV) light. The inner surface coating absorbs the
UV light and converts it to visible light, producing a
‘white-ish’glow.1
Lighting is a necessity in our lives. Fluorescent lights
have become essential due to the lack of competitive-
ly-priced technology with comparable light output
and efficiency.

4. The Hospital Environment
We all use healthcare facilities, and
thankfully, we can always rely on them to
be open and functioning. The rotation of
workers, from cleaning crews to doc-
tors, run on a 24/7 basis through these
facilities, making sure hospitals and
treatment clinics are always in working
order for our times of emergency and
moments of healing.
The rate of running a facility on the
scale of a large hospital is astounding.
Electricity, air quality, ventilation and
temperature control all contribute to the
costs of keeping these buildings oper-
ational. Although healthcare facilities
only account for <1% of all commercial
buildings in the US, they consume 4.3%
of the total delivered energy used by the
commercial sector.2
As hospitals grow to
accommodate more patients, their costs
rise concurrently.
Current Impact of
Fluorescent Lighting
on Patients
Fluorescent tubes create silent com-
peting elements in hospitals that are
harmful to patients’ health and wellness
both from a physical and physiological
perspective. Fluorescent tubes contain a
mixture of mercury and other gases, and
a broken fluorescent tube carries the risk
of mercury entering the body through
the lungs (via breathing in the gas) or the
skin (from coming in contact with mer-
cury residue on the inner glass surface).3
Mercury is a hazardous material and in
the unforeseen event that a fluorescent
light bulb shatters, anyone in the vicinity
will be exposed its dangers, making it an
instant safety hazard in any facility that
actively uses them.
Fluorescent bulbs produce UV light,
which is partially, but not completely,
converted to visible light. UV radiation,
unseen, is emitted from the fluorescent
bulbs and penetrates our skin and eyes.
UV radiation has more energy than
visible light and is able to degrade many
materials, causing damage to materials
such as plastics, skin tissues, and eye
lenses and retinas. Prolonged exposure
can result in a clouding of the lens, com-
monly known as Cataract formation, and
is a contributing factor to Age-related
Macular Degeneration (damage to the
retina) - the leading
cause of blindness.4
Young people are es-
pecially at risk to the hazards of UV light,
as a protective layer of yellow pigments
in the eyes occurs with age, slowing the
amount of radiation reaching the retina
in older adults.5
In addition to invisible UV light, the
visible light emitted by fluorescent
sources consists of three inconsistent
color spikes (magenta, yellow-green,
and orange), with negligible other colors
contributing to the output.6
The human
visual system transmits those light sig-
nals to the brain, which must‘fill in the
gaps’to process the picture. Patients be-
ing treated in poor-spectrum fluorescent
lighting environments often do not have
the ideal conditions for proper emotional
and psychological healing due to these
constant flash of color spikes. In the case
of patients with extremely sensitive vi-
sion, particularly in the scotopic (low-lit)
range, low-spectrum lighting can trigger
similar visual responses. Patients can be
subjected to dizziness, headaches and
nausea caused by the spikes and gaps in
fluorescent light output.7
Patients with
special needs are particularly sensitive
to visual fluctuations. As light flickers
out of the fixture, the bright spikes and
missing gaps from fluorescent lights
appear as a strobe light to them, which
can range from distracting to painful.13,14
Leading companies in LED lighting
technology are going the extra mile and
spending the extra dollars on the engi-
neering of their LED lighting products to
omit flicker altogether.15
Cost Savings and
Earth-Friendly Behavior
By executing small changes, both in
existing facilities and new building
development, we can effectively create
a sustainable environment, allowing the
healthcare industry to put their sole fo-
cus on caring for patients. These changes
can start with something as simple as
changing the lightbulbs.
Hospitals in the US spend, on average,
$1.67 on electricity per square foot.
Lighting alone accounts for 15% of a
hospital’s electricity budget.8
For an
average sized hospital building (75,000
square feet) that’s $18,000.00 for light-
ing alone. For a large hospital building
(650,000 square feet), that’s $160,000.00
going towards keeping the lights on.
White LEDs require less energy to pro-
duce more light than other systems.9
Moreover, high quality LED lighting
products can last at least 5 years at 24/7
hour operation.9
As the technology im-
proves, so will the efficiency and lifespan.
Not only do LEDs diminish electricity,
maintenance, and replacement costs,
but the superior quality and efficiency
reflect in a healthier environment. LEDs
do not contain hazardous Mercury,
and their higher efficiency results in a
decrease in CO2 emissions and an overall
lesser impact on the energy grid- de-
creasing the need for fossil fuels.10,11
Furthermore, the light output of LEDs is
the closest spectral and an overall lesser
impact on the energy grid- decreasing
the need for fossil fuels.10,11
Furthermore,
the light output of LEDs is the closest
spectral match to sunlight, providing the
safest, whitest, easiest light to see.12
4 ENERGY FOCUS

5. ENERGY FOCUS 5
The LED Lighting
Technology Alternative
Light Emitting Diodes (LED) are a
cutting-edge solid-state technology
that are predicted by the US Depart-
ment of Energy to replace almost all
artificial lighting in the United States
by 2030. While the basic technology
has been available for years, recent
developments have driven down cost
and made LEDs more widely-available
to the general public. Available as al-
ternatives to everything from industri-
al and landscaping feature lighting, to
residential settings, to the ubiquitous
fluorescent tubes in schools and offic-
es, LEDs provide a number of benefits
over their predecessors.
Known primarily for their energy
efficiency, LED bulbs produce more lu-
mens per watt, resulting in less power
needed to produce more light output.
LEDs are also superior when it comes
to quality of light output, as white
tubular LED lamps provide the closest
color match to sunlight (Graph 1), with
no spikes or gaps in color output. And
unlike their fluorescent counterparts,
LEDs are 100% visually efficient; that
is, they only produce radiation in the
visible range, with virtually no harmful
UV or wasted infrared.
Additionally, LED bulbs contain no
mercury or hazardous waste, and are
100% recyclable. High-quality LED
products can last up to 20x longer
than any other artificial light source,
reducing the time, cost, and effort of
maintenance.8
These factors combine
to make LED lights the clear choice
over fluorescents.
Graph 1. 13

6. environment possible enhances their
ability to diagnose correctly, identify
reactions, prevent secondary infections
and overall, minimize readmissions.
In a patient’s room and in the ICU, spaces
are required to be bright enough for
medical examinations but comfortable
enough for patients to rest and recover.
With the current mainstream use of
fluorescent lighting, patient rooms
typically end up looking too bright in
the daytime and too dark at night. This
inadequate lighting can directly affect
the physical and emotional wellbeing
of the patient. While all humans have a
daily routine defined by the regularity
of sunlight, this regimen is particularly
important for patients in need of physical
recovery. Proper lighting can provide
normal and longer sleep duration for
patients, giving their body time to fully
recuperate, and can enhance the mood
of patients, as derived from the Hospital
Anxiety and Depression Scale (HADS)
depression scores. By providing LED
lighting, hospitals are providing the right
conditions for better moods and better
rest which directly correlates to faster
recovery time.
Physical Utility
The even distribution of colors provided
by LED result in more saturated, vivid,
discriminable color rendering and
effortless visual acuity. Fully directional
down-lighting also provides more
illumination on working surfaces, rather
than the diffuse glow produced by
the gas-filled fluorescent tubes. The
color temperature, color rendering,
and efficiency of LED lights combine
to improve visibility to create a better
Readmission Rate and
Patient Recovery Time
The value of improvements LED
lighting can provide in quality of care
is priceless to the healthcare industry.
Some of the biggest issues facing
hospitals today are readmission rates
and patient recovery time, leading
symptoms of costly and uncoordinated
facilities. The fundamentals of LED
lighting provide one of the best, most
affordable solutions to these concerns.
The color rendering and accurate,
bright light provided by LED lighting
has been shown to reduce the amount
of not only caregiver procedural errors
during hospital visits but also the error
rate of prescription-dispensing across
healthcare facilities. Providing caregivers
with the best lighting and visual
6 ENERGY FOCUS
Benefits of LED
Lighting for Patients
Good lighting aids treatment in many ways. This is especially important in
the case of children and elderly or disabled patients as well the healthcare
providers who are able to see more clearly to provide care.

7. environment as vision is a major
contributing factor to an individual’s
ability to receive and respond to
treatments.
Cognitive Utility
Not only does LED provide higher
quality lighting for patients’emotional
wellbeing, studies have also shown LED
lighting can enhance surgical, procedure
and diagnostic settings as well.
Most healthcare providers encourage
patients to get a full eight hours of sleep
to help their recovery. A healthy sleep/
wake cycle (or Circadian Rhythm) is
crucial to mental cognition and physical
wellbeing. Our bodies’roughly 24-hour
cycle is governed by hormonal responses
that are triggered by full-spectrum light
- light provided by sunlight and LED, but
not fluorescent.14
We have all experienced the relief of
leaving a fluorescent-lit hospital room
and stepping outside back out into the
natural sunlight. The spectral output
of fluorescent lights is to blame. In the
bleak winter months, many people
are diagnosed with Seasonal Affective
Disorder (SAD), while many more self-
diagnose their yearly“winter blues.”
LED lighting is used in the treatment
of SAD, and also has been shown to
improve mood, decrease stress, and
create a generally healthier and happier
environment – all because the lighting
spectrum mimics that of natural
sunlight.15
Patient seating area
Conclusion
LED lighting is the best choice for healthcare facilities that want to foster a safe, healthy,
comfortable, and“green”environment for patients and staff. The benefits range from
monetary savings – lessened electricity costs – to increased sustainability, improved
patient health, and ocular safety for all. These lights best eliminate lighting-related
competing elements in hospitals that physically affect the vision while physiologically
affecting our ability to give and receive proper treatment. Just like the societal
revolution, LEDs are no longer the future of the lighting industry. They are the present,
and should be the source illuminating our healthcare facilities.
ENERGY FOCUS 7

8. energyfocus.com
tel 440.715.1300 // 800.327.7877
Energy Focus Inc.
2000 Aurora Road, Suite B
Solon, Ohio 44139
ENLIGHTENING
& INSPIRING
LED LIGHTING
SOLUTIONS
Sources:
1. Edison Tech Center. “The Fluorescent Lamp”http://www.edisontechcenter.org/Fluorescent.html.
2. U.S. Energy Information Administration. “Energy Characteristics and Energy Consumed in Large Hospital Buildings in the United States in 2007”
http://www.eia.gov/consumption/commercial/reports/2007/large-hospital.cfm 2012
3. United States Environmental Protection Agency “Health Effects of Mercury Exposure”http://www.atsdr.cdc.gov/mercury/docs/
HealthEffectsMercury.pdf.
4. Roberts, Joan E. “Ultraviolet Radiation as a Risk Factor for Cataract and Macular Degeneration”Eye & Contact Lens Vol 37 No 4. 2011.
5. Pokorny et al. “Aging of the human lens”Applied Optics Vol 26 No 8. 1987.
6. Ellis et al. “Auto-tuning daylight with LEDs: sustainable lighting for health and wellbeing”Drexel University and Philadelphia University.
7. Irlen Institute. “What is Irlen Syndrome?”http://irlen.com/what-is-irlen-syndrome/.
8. E Source Companies LLC. “Managing Energy Costs in Hospitals”http://www.nationalgridus.com/non_html/shared_energyeff_hospitals.pdf
9. US Department of Energy “Solid-State R&D Plan”May 2015.
10. United States Environmental Protection Agency “Health Effects of Mercury Exposure”http://www.atsdr.cdc.gov/mercury/docs/
HealthEffectsMercury.pdf
11. U.S. Environmental Protection Agency.“Global Greenhouse Gas Emissions Data”http://www3.epa.gov/climatechange/ghgemissions/global.html
12. Popular Mechanics: The Ultimate Light Bulb Test http://www.popularmechanics.com/technology/gadgets/reviews/g164/incandescent-vs-
compact-fluorescent-vs-led-ultimate-light-bulb-test/
13. Graph 1: Popular Mechanics: The Ultimate Light Bulb Test
14. Lucas, Robert J et al. “Measuring and using light in the melanopsin age”Trends in Neurosciences Vol 37 No 1. 2014.
15. Meesters, Ybe et al. “Low-intensity blue-enriched white light (750 lux) and standard bright light (10000 lux) are equally effective in treating SAD.