Circadian lighting in hospital wards was found to significantly reduce falls among patients, by 50%, according to a retrospective observational study published in Healthcare (Basel), in July 2025.
Study Context and Purpose
Falls in hospitalized patients remain a major safety and health concern, often leading to complications, increased length of stay, and greater healthcare costs. The study specifically investigated whether circadian lighting—lighting designed to support the body’s natural circadian rhythm—would reduce the risk of patient falls within a hospital setting.
Study Design and Setting
Researchers conducted a five-month retrospective comparison in a 49-bed subacute and rehabilitation ward in Japan, evaluating two groups:
- Intervention group: Patients admitted following renovation and installation of circadian lighting, defined by delivering at least 275 equivalent melanopic lux between 7 a.m. and 12 p.m.
- Control group: Patients admitted under conventional fluorescent lighting during the preceding five months.
The study measured the rate of patient falls in both periods and performed logistic regression analysis to identify associated risk and protective factors.
Key Findings
The results indicated a substantial decrease in fall incidents with circadian lighting:
- Fall rate: 7.4% in the circadian lighting group vs 15.0% in the control group, a 50% reduction and statistically significant difference (p = 0.0182).
- Adjusted odds ratio (aOR): Circadian lighting was protective, with an aOR of 0.558 (95% CI: 0.351-0.887, p = 0.0137).
- Risk factors: Age ≥ 80 years (aOR = 2.48; 95% CI: 1.18-5.21, p = 0.0167) and anticonvulsant medication use (aOR = 3.68; 95% CI: 1.39-9.72, p = 0.0087) were identified as significant risk factors for falls.
Interpretation
The lower fall risk observed in patients exposed to circadian lighting suggests that environmental interventions can have a direct benefit on hospital safety, likely through improved support of sleep-wake cycles and alertness during the day. The protective effect remained significant even after adjusting for other clinical variables.
Practical Implications
- Fall prevention: Circadian lighting may be a straightforward, nonpharmacological method to enhance patient safety, particularly in wards with higher proportions of elderly or neurologically vulnerable patients.
- Healthcare planning: Lighting systems in healthcare environments should be considered as part of a holistic approach to fall prevention, complementing other clinical risk assessment methods.
- Further research: The study recommends further prospective investigations to validate these findings and to explore specific mechanisms through which circadian lighting influences fall risk.
Limitations
As a retrospective single-center study, results may not generalize to all hospital settings, and causality cannot be conclusively established. Additionally, other confounders in patient care and ward management might exist.
Circadian lighting was associated with a significant reduction in falls (50%) among hospitalized patients. However, advanced age and use of anticonvulsants remain notable risk factors, emphasizing the need for multifaceted fall prevention strategies in clinical practice.
The research paper is available here.
Above image: Healthcare (Basel). 2025 Jul 14;13(14):1692. doi: 10.3390/healthcare13141692
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