Lighting It Up

Light-emitting diode (LED) technology offers hospitals many advantages over traditional lighting, such as energy savings, longer life, lower heat output and design flexibility. Little wonder that it can be found everywhere from parking lots to surgical suites.

During the past decade, most health care facil­ities upgraded their lighting to energy-efficient fluorescent technology, industry experts say. During the next five years, however, more hospitals will upgrade to LED technology.

Advantages provided by LED lighting include a uniform, bright white light, reduced heat output, long lamp life and the ability to be dimmed without shifting color.

"Fluorescent fixtures still deliver the best bang for the buck," says Mark Phillips, product manager, Lutron Electronics Co., Coopersburg, Pa. "However, as LED costs drop and color quality improves, we will see LEDs spread into more traditional spaces."

'Millions of colors'

"Red, green and blue LEDs can be mixed to produce millions of colors," says Mark Leggett, senior electrical designer with Smith Seckman Reid Inc., Houston. "Lower wattage means less heat load to HVAC systems and potentially fewer electrical circuits."

The small LED light source allows for a much smaller light fixture, which can fit into tight spaces, Leggett adds. Also, LEDs are less toxic to the environment than fluorescent lamps, which contain mercury.

Experts also agree that LED lighting saves energy and reduces costs.

"LED lighting saves energy by providing more lumens per watt (W) than an incandescent lamp," says Phillips. "For example, a 10W LED lamp can provide enough light to replace a 60W incandescent lamp. Currently, the best LED fixtures are matching and, in some cases, exceeding the efficiency of fluorescent fixtures."

When retrofitting incandescent lighting systems with LED solutions, health care facilities can realize energy savings that approach 85 percent, according to Brian Bernstein, director, product marketing, Philips Color Kinetics, Burlington, Mass.

In addition, fewer lamp replacements can result in a total return on investment (ROI) of less than two years.

"When replacing more efficient systems, such as those that use linear fluorescent T8 and T5 lamps, the savings are less dramatic," Bernstein explains, "but as the cost of LED technology decreases and more local power companies offer rebates and subsidized pricing for LED systems, LED retrofits will begin to make sense across the entire range of lighting applications."

Another advantage of LED technology is the digital nature of the source, which is conducive to the use of lighting controls, says Holly English, director of sales and marketing, Healthcare Lighting, an Acuity Brands Company, Fairview, Pa. Users can turn fixtures on and off manually or via time scheduling.

In addition, lighting controls allow users to adjust lighting levels to their specific needs, and even adjust the levels of electric light when ample sunlight is available.

Heat gain and color rendition are also hot topics in LED lighting circles. LEDs tend to have a higher system efficacy than conventional lamping, industry experts say. In effect, they produce more light with less power and, by extension, produce less heat. Effective use of lighting controls can further reduce resultant heat gain.

"Metal halide lamps change color drastically in less than three years," explains Pat Treadway, director of product marketing at MaxLite, West Caldwell, N.J. "Today's LED manufacturing includes test standards such as LM-80, which establishes a performance level that includes the change of light color over time. Products that use diodes made to this standard exhibit stable color outputs over longer lifetimes."

Typically, an LM-80, LED-equipped fixture will have its color and lumen depreciation decay by less than 30 percent over 10 to 13 years," he says. "This offers a consistent, high-color indexed appearance over the life of the LEDs."

LED sources require proper heat-sinking to ensure this long life, cautions Lou Calvo, director of sales and marketing for Waldmann Lighting Co., Wheeling, Ill.

"Poorly made LED lighting equipment will retain heat inside the luminaire housing, causing premature failure of the circuit board," he says. "The equipment must be properly heat-sinked to allow transfer of heat away from the circuit board."

As for color rendering, high-quality LEDs have approached Color Rendering Index (CRI) levels of fluorescent, but still have a way to go to replicate the 100 CRI found in halogen lighting, Calvo adds.

On the outside

Advances in LED technology provide both the light intensity and optical control to meet the requirements of outdoor applications such as building facades and hospital parking structures, experts agree.

LED luminaires can provide bright, even white light, which is preferable to the light produced by traditional high-pressure sodium fixtures. Also, hospitals may realize a 50 percent reduction in both wattage and energy costs, and virtually eliminate maintenance costs by utilizing LED luminaires.

LED lighting continues to grow in outdoor applications for hospitals, says Mary Gotti, manager of the GE Lighting Institute, Cleveland. "One of the most compelling is outdoor aerial lighting for parking garages, lots and roadways."

LEDs improve safety and security, and save on energy costs in this area, Gotti notes. "Outdoors, savings can be 50 percent or more. For indoor parking garages, the savings can reach 35 percent," she says. "In fact, hospitals can extend the life of their outdoor service systems by a factor of five with the use of LEDs."

Tampa (Fla.) General Hospital recently put this theory to the test. The hospital retro­fitted its seven-story parking garage from high-intensity discharge (HID) lighting to LED; a total of 1,649 luminaires were replaced. As a result, electrical costs have been reduced 40 percent with an estimated return on investment of 2.48 years, according to Oslec Fernandez, facilities director.

"By monitoring maintenance and utility invoices, we know we are on track to hit that mark," Fernandez notes. "Also, we no longer have staff dedicated to constant relamping of parking garage or site luminaires. We can best use that staff inside the hospital to improve visitor, patient and staff satisfaction."

Although hospitals in some cases may see higher initial costs with the installation of LED lighting, when cost is evaluated over time, they can experience tremendous savings, especially as LED technology becomes more efficient, says Gregg Ryberg, sales director, health care, Cree Inc., Durham, N.C. "In general, hospitals are more willing to pay a higher initial cost for general illumination areas with long-term — often 24/7 — lighting needs," he notes. "With dimming capabilities and occupancy sensors, LED lighting also provides additional lighting control and energy savings for total health care lighting management."

If a hospital lighting system has been upgraded over the last five years, the return on an LED retrofit will take longer, cautions Bernstein of Philips Color Kinetics. For example, fluorescent systems recently upgraded from T12 to T8 or T5 systems, or exterior lighting that uses ceramic metal halide sources, are not the best candidates for LED retrofits, since they are already highly efficient and offer reasonably long lifetimes.

Interior applications

LED lighting can change the ambience of a patient room, making it suitable for a wide range of applications, says Colette Fleming, manager, segment marketing, Kenall Manufacturing, Gurnee, Ill.

LED luminaires can be used as bright functional lighting for a patient examination, for example, or they can be dimmed in warm, decorative sconces to create a pleasant atmosphere in which the patient can enjoy a relaxing conversation with visitors.

LED luminaires also are used in wayfinding, projecting low ambient lighting near the patient's bed or in the bathroom. "Studies have found that amber LEDs do not interrupt a patient's circadian rhythms, providing enough illumination for the patient to get up at night without turning on bright fluorescent overhead lights," Fleming adds.

LEDs also are being used successfully for surgical task lighting, according to a study conducted by the Department of Energy's (DOE's) Building Technologies Program.

Completed in January 2011, the study analyzed the energy-saving qualities of LED compared with halogen and HID lighting. It found that LED technology is advancing into new categories of white light applications, including surgical task lighting, and that early indications suggest significant potential for energy savings and reduced maintenance.

"Halogen lamps typically used in surgical task lights suffer from relatively low luminous efficacy (lumens of light output per watt of input power), which is only worsened by filters that must be used to reduce the amount of nonvisible radiation they emit," according to the DOE's "Technical Guidance Document: Surgical Task Lighting" (http://apps1.eere.energy.gov/buildings/publications/pdfs/alliances/surgical_task_fs.pdf). "LED surgical task lights typically do not require such filtering media, and their higher efficacy can allow for reductions in connected load of 50 percent or more, with potential for additional energy savings through constant color dimming and reduced cooling load in the operating room."

Jeff Bisberg, CEO, Albeo Technologies, Boulder, Colo., says his company has successfully fitted several magnetic resonance imaging (MRI) facilities with LED lighting.

"LED fixtures are better suited than incandescent for MRI facilities because incandescent bulbs are nonferrous and inert from magnetic fields," he explains. "In MRI facilities, incandescent bulbs experience shortened lifetimes due to exposure to high-intensity magnetic fields."

According to the website www.myledlightingguide.com, the life of a standard incandescent bulb may be reduced to 700 hours in an MRI suite, he adds. In contrast, LED luminaires are rated to 50,000 hours in many cases. LEDs also are better suited for MRI facilities because they do not generate noise artifacts in scans.

Future applications

"For LED, the possibilities are limitless," says English of Healthcare Lighting. "Many LED luminaires currently in the marketplace look and perform similarly to their traditional counterparts. This constancy has its benefits, but the small size factor of the LED source provides an opportunity for true innovation in form."

In the future, LED luminaires likely will depart from traditional forms and may be smaller, lighter and easier to install within restricted plenum and other structural spaces, she predicts.

Rick Farrell, president of C3 Lighting Solutions, Santa Ana, Calif., says LED lighting is evolving into new areas that connect to building automation systems.

"C3's technology is based on the concept that the LED is simply a diode and functions as just one electrical component in the overall circuitry of a building's lighting system," he explains. "When implementing LED technology, a building's lighting should not be viewed merely as fixtures connected to AC power, but rather as a large integrated circuit." C3 sees LED lighting as a network of fixtures, power supplies, controls and wiring that can be addressed in the same manner as any information technology network, he adds.

Peering further into the future, color-tuning of LEDs could improve the health of patients, according to Joseph Montange, LEED AP, a lighting designer with Candela, a lighting design and consulting company based in Seattle.

"There is talk about the effect of lighting on the human circadian system, which controls the sleep-wake cycle and [growing evidence suggests] plays a large role in our health," Montange says. "The evidence suggests that the color of the light source can impact our well-being and that fine tuning the color over the course of a day could help patients maintain their natural circadian rhythm. This will impact such groups as shift workers, the elderly, and Alzheimer's patients and their caregivers. This is something that only LED lighting will be able to make possible."

Neal Lorenzi is a freelance writer based in Mundelein, Ill., and a regular contributor to Health Facilities Management.