ARCHITECTURE & DESIGN
A variety of different healthcare ‘spaces’ designed by IBI where ingress of, or access to, ample sunlight was a key design priority.
Day Surgery Facilities, recommend ‘daylight directly from windows or by means of borrowed light’. This is critical for both patients and staff.
Recovery spaces
The largest percentile footprint of any typical hospital is dedicated to this type of accommodation. Essentially, these are recovery spaces, such as medical/ surgical acute wards, as well as other spaces such as Recovery, Therapy, and Rehabilitation spaces, etc. There is substantial and compelling evidence- based research that supports the need for natural daylight in the recovery process – from healing wounds to elevating the body’s immune system. Daylight has proven to ‘fast forward’ healing in both physical and mental aspects of recovery. It is clear that the delivery of daylight and/or full spectrum, artificial forms of lighting are critical to all these three types of clinical space to ensure the very best patient outcomes.
Benefits to body systems and multi-morbidities
There is considerable compelling clinical evidence that, at ‘full spectrum’, daylight has beneficial impacts and outcomes on our body systems, (autonomic, motor state), and multi-morbidities, such as: n Respiratory/pulmonary. n Reduces asthma symptoms, and increases defence against respiratory pathogens, as well as inhibiting pulmonary inflammation.
n Cardiovascular. n Reduces myocardial infarction and other cardiac events. Interestingly, the annual DST (Daylight Saving Time) adjustment prompts a 25%+ increase in stroke risk among cancer patients. Researchers at the Alberta Hospital in Canada discovered that female patients in sun-drenched intensive care unit rooms survived a heart attack much
better than their fellow patients in dark rooms, and they also recovered more quickly.1
n Skeletal orthopaedics. n Increased bone health, calcium homeostasis, and bone density. Reduced Osteoporosis among more senior women, and reduced cases of Rickets among paediatric groups.
One study, published in Psychosomatic Medicine in 2005, ‘The effect of sunlight on postoperative study of patients undergoing spinal surgery’, reveals that ‘Patients housed on the bright side of the hospital consistently used less analgesic medication in all age quantiles’.2 n Dental Care Increased dental growth and density in early stages of childhood.
n Dermatological Daylight reduces Jaundice, Psoriasis, varied forms of Eczemas, Acne, and fungal infections. Interestingly, in December 2016 the Georgetown University Medical Centre researchers discovered that sunlight, through a mechanism separate to Vitamin D production, energised the T cells that play a central role in patient immunity. The findings suggest how the skin, the body’s largest organ, stays alert to many microbes that inhabit the surface.
n Cancer & Oncology There are over 100 types of cancer, and most develop due to absence of daylight. Although excess sunlight can contribute to skin cancers, a moderate amount of sunlight actually has preventive benefits when it comes to cancer. According to researchers, those who live in areas with fewer daylight hours are more likely to have some specific cancers than those who live where there is more sun during the day. These cancers include: colon cancer, Hodgkin lymphoma, Ovarian cancer, Pancreatic cancer, and Prostate cancer.
n Obesity & Increased BMI Increased exposure to daylight is known to loosen body fat and lower cholesterol levels. Reduced absorption of Vitamin D equates to increases in body fat.
The above forms a reduced list of medical conditions showing how daylight can ameliorate the quality of recovery, and indeed increase speed of discharge.
Mental health
Reduced daylight exposure has been associated with drops in serotonin, which can lead to major depression and compound SAD, or Seasonal Affected Disorder, especially during the winter months. Seasonal cycles clearly impact on our mental health. Recent research continues to provide compelling evidence of our inextricable, symbiotic, 24/7 dialogue with daylight, such as the recently discovered ‘photo-sensitive ganglion cells impacting on circadian physiology’, and ‘Calendar Cells producing Winter/Summer hormones’.
There are clinical (day/night) cycles, seasonal cycles, and, importantly, biological clock cycles called Circadian clocks, which are recalibrated daily by exposure to daylight. It is these that predetermine our sleeping and feeding patterns, as well as vital biological controls, such as body temperatures, brainwave activity, hormone production, and cell regeneration.
Research informs us that increased daylight penetration increases mental wellbeing in intensive care units, and reduces post-operative delirium, depression, and indeed hallucination. Indeed, recent research tells us that Bipolar depression can be exacerbated by exposure to a west aspect, whereas exposure to an east-rising sun can accelerate recovery.
October 2019 Health Estate Journal 81
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