Exploring Healthcare Illuminance: A Case Study at a Pediatric Hospital

Presented by: Stephanie Braine, Paulette Hebert

There are many studies published which have examined built environments in hospitals and other medical facilities with regards to physical outcomes and perceived satisfaction in adult patients, but research pertaining to the built environment and pediatrics is sparse. Case studies of built environments are generally lacking. It is hypothesized that inadequate electric lighting may adversely affect pediatric patients. Via empirical field examination of existing conditions in a pediatric unit at a large hospital in the southern Mid-West, researchers compared and contrasted current electric lighting levels for visual tasks (i.e., medical examination, reading, and administering medication) with those recommended by the Illuminating Engineering Society (IES). The IES is considered to be the lighting authority in North America and most locally adopted codes are modeled on IES recommendations. The examined pediatric site in the current study was chosen due to the researcher’s prior, personal experiences at the facility. The researcher traveled to the site and conducted an existing conditions survey utilizing a digital camera, a tape measure, a light meter, and a paint chip book. The three areas considered in the pediatric unit were: 1). a typical, private patient room, 2). patient room bathroom, and 3). intensive care waiting room. Furniture floor plans, reflected ceiling plans, lighting plans and interior elevations were produced. These drawings, were sketched on-site and later converted to measured drawings utilizing AutoCAD software. Illuminance measurements were taken on horizontal and vertical work planes (i.e., bed surfaces, tabletops etc.) using a digital, Fisher Science Education light meter, model number S90198, which had been “quality certified and ISO 17025 accredited” by a calibration laboratory. Since room finishes contribute to lighting effects, the existing light reflectance values (LRV) were also estimated by matching wall, ceiling, and floor finishes to a Sherwin Williams’ paint chip book with identified LRV. The current light fixtures’ locations and International Commission on Illumination (CIE) photometric classifications were also documented. A total of twenty four (N=24) measurements were taken. Analysis of the outcomes revealed that the existing lighting was inadequate in all three areas of the pediatric unit. Only one (n=1, 4.2%) measurement complied with IES standards. Researchers found that CIE classified light fixtures varied. They classified two light fixtures as 100% indirect (wall); one light fixture as 100% direct (wall); nine light fixtures as 100% direct (ceiling) and two light fixtures as general diffuse (tabletop). LRV varied from low to high and were estimated as ranging from 22% - 65% (wall), approximately 85% (ceiling) and 65% (floor). The low light level findings are especially of concern considering the light levels with the greatest deficit were found on the patient’s bed, where vitally important tasks, (i.e., medical examination and administering medicine), may be located. The lower LRV absorbed light and resulting areas may appear dark to patients. The variety of light fixture classifications and locations may begin to compensate for the lower light levels. More studies are needed to compare light levels across multiple hospitals.


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