Effects of blue-depleted indoor lighting on hospital ward employees

ISRCTN ISRCTN21603406
DOI https://doi.org/10.1186/ISRCTN21603406
Secondary identifying numbers 2018/1516
Submission date
19/12/2018
Registration date
28/12/2018
Last edited
17/08/2022
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Other
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
As humans we have specialized our primary life functions to daylight conditions. As such, our daily bodily rhythms dispose us to be awake and active during the day when it is light outside, and to sleep or rest during the night when it is dark outside. However, the demands of the modern 24-hour society forces some employees to work in the early morning, evening, and during night time. This inevitably leads shift workers to be exposed to artificial light at times that can cause a shift in the daily bodily rhythms. The discovery of a new type of receptor cell in the retina of the eye, which specifically reacts to light of certain wavelengths in the blue spectrum (wavelengths < 530 nanometers, nm), has led to an increased understanding of how light affects the human daily bodily rhythm system. The aim of this study is to investigate how different types of light conditions at the workplace might influence shift workers' health and sleep.

Who can participate?
Nursing staff currently working at the acute ward at St Olavs Hospital, Østmarka in Norway

What does the study involve?
Nursing staff over a 12-week period rotate between two work sites (6-week work period on each work site). The two work sites are structurally and clinically identical, with the exception that one of the sites has evening/nightly (18.30 to 07.00 hours) blue-depleted indoor lighting (lights with wavelengths of less than 530 nm filtered out), whereas the other work site has normal lighting. All nurses work at both work sites over the 12-week period, and they are asked to answer questionnaires in the middle of each 6-week work period, and to keep a work- and sleep diary and wear an activity monitor for 2/3 weeks in each 6-week work period.

What are the possible benefits and risks of participating?
Blue-depleted indoor lighting during evening and night shifts might help shift workers maintain a stable daily bodily rhythm. This can have health-promoting effects for the workers. Furthermore, having evening shifts in blue-depleted lighting might make it easier for the shift workers to fall asleep after the evening shift. Blue-depleted lighting might help maintain a more stable daily bodily rhythm when working during night shifts, as compared to working during nights in normal lighting. In turn, this can lead to a faster re-adaption to a normal day rhythm and better recovery from night work during off-duty periods.
A possible risk of blue-depleted indoor lighting during evening and night shifts is that the light may make the workers sleepier during the shifts. This can potentially increase the risk of accidents during the shifts, or it can increase the risk of car accidents when driving home after an evening/night shift.

Where is the study run from?
This study is run from the Department of Health Promotion, Norwegian Institute of Public Health in Bergen in Norway. The study is carried out in collaboration with the Department of Mental Health at the Norwegian University of Science and Technology and the psychiatric ward at St Olavs Hospital, Østmarka, in Trondheim, Norway. The intervention takes place at the psychiatric ward at St. Olavs Hospital in Norway.

When is the study starting and how long is it expected to run for?
August 2018 to February 2020 (updated 29/08/2019, previously: February 2019)

Who is funding the study?
The study is funded by internal funds at the institutions involved in the project

Who is the main contact?
Dr Øystein Vedaa

Contact information

Dr Øystein Vedaa
Scientific

Department of Health Promotion
Norwegian Institute of Public Health
Zander Kaaes gate 7
Bergen
5015
Norway

Study information

Study designSingle-center non-randomized cross-over study
Primary study designInterventional
Secondary study designNon randomised study
Study setting(s)Hospital
Study typeOther
Scientific titleEffects of blue-depleted indoor lighting during evening and night shifts on psychiatric hospital ward employees
Study objectivesQuestions:
1. What are the effects of blue-depleted indoor lighting during evening and night shifts on nursing staffs job performance, impact on physical and mental wellbeing, symptoms of headache and eyestrain, and satisfaction with their work environment compared to working in normal light conditions?
2. What are the effects of working evening shifts and night shifts in blue-depleted indoor lighting on sleep, mood and the risk of accidents compared to working in normal light conditions?

Hypotheses:
1. The intervention will not influence job performance, impact on physical and mental wellbeing, symptoms of headache and eyestrain, and satisfaction with their work environment compared to working in normal light conditions.
2. The intervention will be associated with improved sleep after evening shifts, and improved re-adaption of sleep timing after spells of night shifts, compared to working in normal light conditions.
Ethics approval(s)Regional Committees for Medical and Health Research Ethics in central Norway, 10/10/2018, ref: 2018/1516/REK Central

Postal address:
NTNU/REK midt, Det medisinske fakultet, Postboks 8905, 7491 Trondheim
Office address:
Øya Helsehus, 2. floor
Mauritz Hansens gate 2, Trondheim
Telephone: 73597511
Email: rek-midt@mh.ntnu.no
Health condition(s) or problem(s) studiedSleep and health of shift working nurses at a psychiatric ward at various light conditions at work
InterventionThe intervention that will be tested in this study is altered light conditions during evening and night shifts for nursing staff at a psychiatric ward at St. Olavs Hospital, Østmarka in Norway. This psychiatric ward has two separate work sites that are structurally identical. One of the work sites will have evening/nightly (18.30 to 07.00 hours) blue-depleted lighting (< 530 nm) in 20 patient rooms and common areas, and normal lighting in the morning/day. The other work site will have normal lighting in 20 patient rooms and common areas. Half of the nursing staff/participants will start on the work site with evening/nightly blue-depleted lighting (< 530 nm), and the other half will start on the work site with normal lighting. All nurses will change work site and light conditions after six weeks.

After three weeks of work in the respective light conditions, the nurses will be asked to complete the questionnaires at work (which can be during day, evening and night shifts depending on their current shift schedule and the nurse’s convenience). All questionnaires specifically instruct participants to answer the questions based on their experience during night- and evening shifts the last two weeks. All nurses will complete the questionnaires twice - once in each light condition.
Intervention typeOther
Primary outcome measureMeasured after 3 weeks of work in the respective light conditions:
1. The nurses' effort, concentration, and estimated performance at work assessed using three items based on the Psychological Variables Questionnaire (Pilcher & Walters, 1997)
2. Nurses' subjective evaluation of the lighting conditions assessed using eight semantic differential adjective items rated on a 7-point scale (Smolders & de Kort, 2014)
3. Symptoms of eye strain assessed using the Headache and Eye Strain Scale (H&ES)
4. Headache related to the altered light conditions assessed with eight self-reported items (Viola, James, Schlangen, & Dijk, 2008)
5. The nurses’ psychological distress assessed using the Kessler Psychological Distress Scale (K10) (Kessler et al., 2003)
6. The nurse’s physical health assessed using the Physical Health Questionnaire (PHQ)(Schat, Kelloway, & Desmarais, 2005)
Secondary outcome measures1. Self-report measures of work and sleep schedules derived from a work- and sleep diary that the nurses will be instructed to keep during the last 2/3 weeks of each light condition. The work diary provides information on the day-to-day shift schedule of the nurses (shift start and end times), level of sleepiness during each shift, and work-related incidents (accidents/near-accidents). The sleep diary provides daily estimates of the nurses sleep episodes, including sleep onset latency, wake after sleep onset, total sleep time, etc.
2. Motor activity in the day and sleep at night measured objectively for 80 nurses with an actigraphy device for the last 2/3 weeks in each light condition. Nighttime data from the actigraph will be used in parallel with the sleep diary for a more accurate assessment of the participants sleep.
Overall study start date05/08/2018
Completion date28/02/2020

Eligibility

Participant type(s)Health professional
Age groupAdult
SexBoth
Target number of participants106
Total final enrolment25
Key inclusion criteriaAll nursing staff currently working at the acute ward at St Olavs Hospital, Østmarka (>= 40% of full time equivalent) will be invited to participate
Key exclusion criteria1. Not working at the acute ward at St Olavs Hospital, Østmarka in Norway
2. Having less than 40% of full time equivalent position at the acute ward at St Olavs Hospital
Date of first enrolment12/11/2018
Date of final enrolment28/02/2020

Locations

Countries of recruitment

  • Norway

Study participating centre

St Olavs Hospital, Østmarka
Østmarkveien 15
Trondheim
7040
Norway

Sponsor information

Norwegian University of Science and Technology
University/education

Department of Mental Health
Olav Kyrres gate 9
Trondheim
7030
Norway

Phone +47 (0)73 59 11 00
Email kontakt@iph.ntnu.no
Website https://www.ntnu.no/
ROR logo "ROR" https://ror.org/05xg72x27
Department of Health Promotion, Norwegian Institute of Public Health
Research organisation

Zander Kaasgate 6
Bergen
5015
Norway

Phone +47 (0)21 07 70 00
Email folkehelseinstituttet@fhi.no
Website https://fhi.no/

Funders

Funder type

University/education

Norges Teknisk-Naturvitenskapelige Universitet
Government organisation / Universities (academic only)
Alternative name(s)
Norwegian University of Science and Technology, The Norwegian University for Technology an Sciences, Universidad Noruega de Ciencia y Tecnología, NTNU
Location
Norway

Results and Publications

Intention to publish date28/02/2021
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planThe study will be described as an ancillary study in a protocol of a randomized controlled treatment trial at the same unit. This will be updated when the protocol has been published. The results from the present study will be published in an international peer reviewed journal during 2019.
IPD sharing planData will not be available outside the core research group until completion of key analyses and relevant manuscripts have been published. However, researchers who are interested in this study can contact the main investigator (Øystein Vedaa) if they have any questions regarding the data. The participants will receive written information about what the study involves and sign a consent form before entering the study.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article 18/07/2022 17/08/2022 Yes No

Editorial Notes

17/08/2022: Publication reference and total final enrolment added.
29/08/2019: The following changes were made to the trial record:
1. The recruitment end date was changed from 17/02/2019 to 28/02/2020.
2. The overall end date was changed from 24/02/2019 to 28/02/2020.
3. The intention to publish date was changed from 01/10/2019 to 28/02/2021.
4. The plain English summary was updated to reflect these changes.