Implementing Circadian Rhythm Lighting – Two Health-Care Case Studies

The studies derive from two larger Danish cases, which evaluated the application of circadian rhythm lighting in sensitive health care environments and highlights the difficulties that can be experienced in the implementation of entraining, or shifting of the timing, of the biological clock through lighting design. The paper focuses on the effects of introducing new 24-hour light and dark patterns on patients and residents in the two institutions, a home for the aged with dementia and a psychiatric facility for eating disorder patients. Data was gathered through ethnographic interviews, questionnaires, mappings, and structured observations. While positive benefits for health were an intended effect of implementing 24-hour biologically attuned lighting into these two environments, its introduction was also experienced negatively by staff and patients, particularly in the early stages of implementation, by affecting the patients’ everyday routines and feeling of ownership. The paper lays out the foundation for current research projects by the author, by comparing the perceived comfort and experiences of the patients with the documented laboratory effects of the design of circadian lighting system. The paper concludes with preliminary recommendations for future implementations of circadian lighting designs, including the consideration of the context, the users’ adaptation of the technology, communication with staff, usability and personal control.publishedVersio

Formaldehyde-releasers: Relationship to formaldehyde contact allergy, Part 2: Metalworking fluids and remainder

We have reviewed formaldehyde-releasers used in metalworking fluids (MWFs) in this and a previous part of a two-part article. These biocides do not appear to be frequent or important sensitizers. Even in highly selected patient groups of metalworkers, mean prevalence rates of sensitivity are low: 0.2% for Tris(hydroxymethyl)nitromethane, 1.6% for tris(N-hydroxyethyl)hexahydrotriazine, 1.9% for Bioban (R) P-1487 and Bioban (R) CS-1246, and 2.8% for Bioban (R) CS-1135. In the case of the Biobans, many reactions may have been irritant. Only N,N'-methylenebis(5-methyloxazolidine) has a fairly high mean score of 4.0% in metalworkers. With the exception of Bioban (R) P-1487, there is a clear relationship between positive patch test reactions to the releasers and formaldehyde sensitivity: 40-70% of reactions to releasers occur in patients sensitive to formaldehyde and may therefore be caused by formaldehyde allergy. There is a lack of reliable data on the clinical relevance of contact allergy to the formaldehyde releasers in MWF. In most studies, no data on relevance were provided and in those that did, relevance was often found for a (very small) minority of the reactions only. Also discussed here are the formaldehyde-releasers MDM hydantoin, methenamine, N-methylolchloracetamide, paraformaldehyde, and Preventol (R) D2

Formaldehyde-releasers: relationship to formaldehyde contact allergy. Metalworking fluids and remainder. Part 1

In Part 2 of the article, the relationship between formaldehyde-releasers used in MWF and formaldehyde contact allergy is discussed as are data on miscellaneous releasers not previously presented, followed by a discussion of Parts 1 and 2 of the article