Research Question

This research investigates the range of illumination values needed for safe mobility of a visually impaired person in residential hallways and the relative effectiveness of task versus ambient lighting.

Guidelines

Despite the amount of research conducted on illumination levels for mobility, there is quite a variation in the legislation for the lux level recommended in hallways. Table 1 lists lighting standards recommendations given by the Australian, United Kingdom and the United States authorities.

Table 1: Hallway Illuminance Recommendations

While the literature indicates that a high level of illumination is required to enable safe mobility, no studies have been undertaken to determine a range of illumination levels that would enable the safe and independent mobility of people with vision impairment.

This research review determined that an adequate level of illumination for an ambient lighting system to enable safe movement through a building is 20 – 40 lux provided that the lighting system creates a high contrast with the background environment (Standards Australia, 1990, 1998; Watson, 2002). Adequate illumination for task lighting, such as wayfinding light systems can be 0.05 – 1 lux (Aizlewood & Webber, 1995; M. Wright et al., 1996; M. S. Wright et al., 2002).

Evidence

Lighting in the home can make the difference between seeing and not seeing for individuals with deteriorating vision (Figueiro, 2001b). Recommendations for illumination included in regulatory standards vary widely, despite the amount of existing research on lighting for mobility. While knowledge of the importance of lighting in the home is abundant, this there is a lack of research and information about appropriate residential lighting systems for people who experience vision impairment.

Safe and independent mobility within the home of an individual with visual impairment requires an adequate level of illumination. There is relatively little information on how to provide an increased level of illumination to meet the lighting requirements of people with vision impairment, consequently lighting systems in the home are installed in the absence of critical evidence about their effectiveness.

A systematic review was undertaken to investigate whether wayfinding light systems, positioned in a residential hallway, can provide adequate illumination to enable the safe and independent mobility of people with vision impairment. The review was conducted in accordance with the Home Modification and Maintenance Information Clearinghouse Protocol Guidelines for systematic reviews (Bridge & Phibbs, 2003). It involved searching electronic databases, the World Wide Web, international and national legislation and regulatory documents, and lighting manufacturer specifications. A total of 63 datum sources, including 36 articles, 14 legislative and regulatory documents, and 11 manufacturer specifications were identified that met all the inclusion criteria.

Four key variables relevant to understanding and analyzing lighting for people with vision impairment were investigated:

1. The human visual system is dependent on light. The visual system is vital for obtaining information about the environment and the individual’s position within the environment (Soong & Lovie-Kitchin, 2001), enabling the individual to orientate themselves, scan the environment for potential hazards and navigate their way through a safe pathway of travel (Jansson, 1991). Sight depends on the quality of light in the environment, evident in physiological adaptations that make maximum use of the light available. For example, the iris controls the amount of light entering the eye and the cornea focuses the light onto the retina (Tortora & Grabowski, 2000). Vision impairment is experienced when the eye is unable to process the light effectively (physiological vision impairment) or when light is of a poor quality (environmental vision impairment).

2. The activity of mobility. Vision is the primary sensory modality used for obtaining information about the environment to enable the safe performance of mobility (Patla, 1991). Vision enables the individual to orientate themselves to the environment, preview the environment and visually validate their immediate space (Yablonski, 2000). One of the most significant limitations caused by vision impairment is a loss of ability to travel independently (Golledge, 1991). The activity of mobility enables movement from point A to point B allowing freedom and independence to explore the environment and perform essential daily activities (Jacobsen, 1998). A restriction in mobility can reduce an individual’s independence and they can become more dependent on others to perform their basic day-to-day activities; this can severely reduce their quality of life (Long, Boyette, & Griffin-Shirley, 1996).

3. The environment. The environment can impact the performance of safe mobility, particularly for those who experience vision impairment. A 1990 national study on the mobility problems of people with low vision determined that lighting conditions and adaptation to lighting changes are the highest rated area of difficulty in mobility, with glare as the most frequently reported mobility problem (Geruschat & Smith, 1997).

The function of an area determines the kind of lighting system that will be installed and whether the focus will be on task or ambient lighting (Bean, 2004). Task lighting is using a luminaire that emits a strong bright beam in a relatively confined area to enable an individual to perform a specific activity, for example, a reading lamp or wayfinding light. In contrast, ambient lighting is a wide diffuse beam that brightens the entire space, providing illumination for circulation and non-critical tasks; this is usually a traditional overhead ceiling light (Chartered Institution of Building Services Engineers, 1997).

Lighting enables the safe performance of mobility by illuminating different elements in the environment. Any factor that increases an individual’s ability to detect objects in the environment will assist with safe mobility (Kaufman & Haynes, 1981). The primary function of a hallway and other circulation spaces is to enable safe traffic circulation. While other rooms use small pockets of task lighting to cater for more specific close work tasks, circulation spaces needs to provide a constant level of illumination (De Chiara, Panero, & Zelnik, 1991), particularly as poorly lit areas in a hallway will create dangers such as object collision (Chartered Institution of Building Services Engineers, 1997). The illumination level in circulation spaces also plays an important role as it can assist the individual to adapt to a change in lighting conditions as they move from one level of lighting experienced in one room to another level of lighting in the next (De Chiara et al., 1991).

4. Level of illumination. Illumination is the term used to describe the amount of light arriving on a plane or a surface measured in lumens per square metre (lux) (Bean, 2004). The relationship between illumination level and visual performance has been described by Rea & Ouellette (1991) as a “plateau followed by escarpment” effect. This statement describes how visual performance increases with an increase in illumination. This occurs up to a point where optimum visual performance is attained. The level of visual performance then remains constant even though illumination levels continue to increase (plateau). Eventually the illumination level is so high it begins to cause glare and visual performance declines (escarpment) (Rea & Ouelette, 1998). Adequate illumination can be defined as the range of lux values at which the plateau occurs.

A 1990 study investigating variations in the indoor and outdoor loco-motor mobility of twenty two low vision adults found that low illumination caused two to four times more mobility related incidents across travel environments (Long, Reiser, & Hill, 1990). More recent studies find that in low illumination all subjects experienced a decrease in walking speed and an increase in mobility incidents involving object collision and veering off the pathway of travel (Cornelissen, Bootsma and Kooijman, 1995; Julian, 1983; Kuyk, Elliott, & Fuhr, 1998; Lovie-Kitchin, Woods, & Black, 1997).

Best Practice Examples

[To be added]

Research and Development Needs

The findings of this research review emphasize the need for further research into future applications of wayfinding lighting systems, which, because it is specifically designed to emphasize the pathway of travel, could have a wider range of applications. For example, individuals suffering from cognitive impairments such as dementia may find wayfinding light systems an efficient tool to assist them with orientating and navigating along a pathway of travel. Future studies should investigate whether wayfinding light systems are capable of assisting the broader community, particularly people with cognitive impairment, to move safely through the environment. It would also be useful to compare wayfinding light systems with ambient lighting at the recommended level of illumination of 300 lux and a study assessing the contribution of wayfinding light systems to obstacle detection.

This research investigated lighting systems positioned in a residential hallway, so future studies should focus on determining additional areas of application for wayfinding light systems particularly in public buildings. Most of the datum sources included in this study discussed wayfinding light systems installed in the emergency exits of public buildings. Further investigations should assess other major pathways of travel such as corridors, external pathways such as sidewalks or in public facilities such as a train station.

A major finding of this research was the importance of contrast in the environment. The ability of contrast to enable safe mobility should be explored further in future studies. These studies could investigate different methods of creating contrast using different materials such as colour contrast in the environment design or reflective/bright tape positioned along the major pathway of travel.

The World Health Organisation defines low vision as visual acuity less than 6/18, but equal to or better than 3/60 or corresponding visual field loss to less than 20 degrees (World Health Organization, 2001) . These classifications are used to determine how much government aid and support the individual receives. This research has demonstrated that poor contrast sensitivity results in an inability to detect obstacles or edges within an environment causing the individual to become disorientated and veer off the pathway of travel. An individual with poor contrast sensitivity may have near normal visual field and visual acuity in accordance with the World Health Organisation this would classify them as having perfect vision, preventing them from being able to obtain the resources they need to create a safe home environment. Contrast sensitivity should be tested as part of every vision impairment assessment and national and World Health Organisations Classification of Disease and Injury should support this.

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Links

For the complete copy of this research study, go to the University of Sydney, Australia’s Home Modification Clearinghouse Library Database at this website: http://www.homemods.info/resource/bibliography.

Authors

Michala Pitch and Catherine Bridge, School of Occupation and Leisure Sciences, Faculty of Health Sciences, University of Sydney, Australia.