Alex Hall / Courtesy Public Lighting Authority of Detroit

During its annual meeting in June 2016, the American Medical Association (AMA) announced its adoption of new guidelines regarding the use of LED technology in outdoor applications due to what it saw as “potential harmful human and environmental effects.” This was described in the organization’s “Guidance to Reduce Harm from High Intensity Street Lights” statement—further detailed by AMA official policy statement H-135.927—which asserted: “Recent large surveys found that brighter residential nighttime lighting is associated with reduced sleep times, dissatisfaction with sleep quality, excessive sleepiness, impaired daytime functioning, and obesity.” Based on conclusions from a 2016 report (2-A-16) titled “Human and Environmental Effects of Light Emitting Diode (LED) Community Lighting,” and produced by the AMA’s Council on Science & Public Health (CSAPH), the AMA’s statement warned that the use of blue-rich LEDs was a cause for alarm in both lighting and healthcare settings, albeit for different reasons.

The resulting story was far-reaching, garnering attention from major news outlets such as CNN and The Washington Post.

The Issue
The AMA’s H-135.927 official policy statement (a result of the CSAPH Report 2-A-16) listed three key points:
Our AMA supports the proper conversion to community-based LED lighting, which reduces energy consumption and decreases the use of fossil fuels.
• Our AMA encourages minimizing and controlling blue-rich environmental lighting by using the lowest emission of blue light possible to reduce glare.
• Our AMA encourages the use of 3000K or lower lighting for outdoor installations such as roadways. All LED lighting should be properly shielded to minimize glare and detrimental human and environmental effects, and consideration should be given to utilize the ability of LED lighting to be dimmed for off-peak time periods.

While the AMA acknowledges that LED lighting reduces energy consumption and reliance on fossil fuels, the organization, in it’s “Guidance to Reduce Harm from High Intensity Street Lights” (Policy H-135.927) statement, called for member physicians to “stand against light pollution and [promote] public awareness of the adverse health and environmental effects of pervasive nighttime lighting.” Policy statement H-135.927, however, did not include the input of experts and researchers in the lighting community who have scientific knowledge and application experience in this area. The AMA’s position statement was generated using research articles “published between 2005 and 2016 … [from] PubMed and Google Scholar databases using the terms ‘light,’ ‘lighting methods,’ ‘color,’ ‘photic stimulation,’ and ‘adverse effects,’ in combination with ‘circadian rhythm/physiology/radiation effects,’ ‘radiation dosage/effects,’ ‘sleep/physiology,’ ‘ecosystem,’ ‘environment,’ and ‘environmental monitoring,’ ” as described in the methods of the report. Although the report does note that “additional information and perspective were supplied by recognized experts in the field,” the expertise of the lighting community’s professional associations, the Illuminating Engineering Society (IES) and the International Association of Lighting Designers (IALD), was not solicited.

John Cates / Courtesy Public Lighting Authority of Detroit

The Controversy
While the lighting industry as a whole has come to embrace LEDs—as of 2014, LEDs comprised 10 percent of outdoor lighting applications with calculated energy cost savings of $1.4 billion, according to the U.S. Department of Energy—speculation and insufficient research has left the public, and even some professionals, in the dark. This has led to misleading coverage in mainstream news outlets. For instance, following the AMA’s announcement, CNN reporter Richard Stevens, in his article “Doctors Issue Warning About LED Streetlights,” asked, “Can communities have more efficient lighting without causing health and safety problems?” The September 2016 Washington Post article “Some Cities Are Taking Another Look at LED Lighting After AMA Warning” by Michael Ollove suggested that the AMA’s policy statement adds “credence to the issue and is likely to prompt cities and states to reevaluate the intensity of LED lights they install.” While articles that call attention to the challenges posed by new LED streetlighting and the public’s unfamiliarity and consequential dissatisfaction with the technology’s illumination are not new, those two articles further demonstrate the impact of incomplete or inaccurate information for the public and the confusion it creates.

Following the AMA’s 2-A-16 report, the IES released a statement promising to “respond to this through a proper analysis.” On June 28, 2017, a little more than a year into discussions with the AMA—but no closer to resolution—the IES published position statement PS-09-17. The IALD endorsed the IES’s statement.

The Response
Adding to the complexity of the debate is its multifaceted nature. While the IES concurs with some aspects of the AMA’s statement, it completely disagrees with the AMA on others. For example, the IES acknowledges that it concurs with the AMA’s understanding of the efficiency and environmental savings of LEDs. But the IES continues and points out that the AMA’s findings lack sufficient evidence: “Given the state of current knowledge, it is not possible to weigh the probabilities of health care concerns regarding light-at-night and its effect on sleep disruption from outdoor and roadway lighting against the needs of nighttime driver and pedestrian safety, but such deliberations should precede any policy statement that affects both concerns.”

The other point of contention is on the subject of color temperature. The IES does not agree with the AMA’s color temperature recommendations. Rather, the IES asserts that melanopic content (which is not correlated to color temperature and can appear at higher levels even at lower color temperatures) has more proven negative effects on circadian rhythms than does correlated color temperature. “Common household incandescent lighting,” wrote the IES in PS-09-17, “could therefore have significantly higher melanopic dosing than 3000K outdoor or roadway lighting at night due to relatively higher melanopic content, higher light levels, and longer durations of exposure.”

The IES concludes its position statement committing to continued work with the AMA and to engage in “collaborative deliberations … to develop Standards for the benefit of public health and safety.” This was an attempt for the organizations to find common ground.

The IALD republished and endorsed the IES response, adding, “While we believe that the scientific research cited by the AMA does not support its policy recommendations, we welcome the AMA’s interest in the impact of light on human beings.”

Haomin Wei / Courtesy Public Lighting Authority of Detroit

What’s Next
The AMA, IES, and IALD all declined architectural lighting’s invitation to comment. In an email response, IES technical director of standards and research Brian Liebel wrote, “In light of our past and ongoing discussions with the AMA, it is not appropriate for me to elaborate at this time.”

The lighting community continues to find ways to work with organizations outside the profession and to promote the need for science-based findings and other critical data for complex lighting issues. Most recently, on Aug. 23, Jim Brodrick, the solid-state lighting technology manager for the U.S. Department of Energy’s Building Technologies Office, Office of Energy Efficiency and Renewable Energy, outlined in the DOE’s SSL Postings newsletter ongoing research initiatives on the subject of sky glow by the Pacific Northwest National Laboratory and Virginia Polytechnic Institute and State University. He also reiterated the sentiment of others in the lighting community criticizing “misperceptions and mischaracterization of the technical information” with regard to sky glow and blue-rich LED lighting, and the disservice imposed on the public when lighting issues are not presented accurately.

Architectural Lighting will continue to monitor discussions between the AMA, IES, and other lighting entities on this topic. The controversy is yet another example of the important need for lighting designers and their input on critical lighting issues, with their distinct skill set and expert knowledge, especially given the impact of this information on public discourse and in policymaking.

This article originally appeared in the 2017 Sept/Oct issue of Architectural Lighting under the title, "Feeling Blue."