Light Box Therapy: Safety, Effectiveness and Comfort

Light Box Therapy Safety Light Box Therapy Effectiveness Light Box Therapy Comfort

Light Box Therapy Safety

Several safety components should be incorporated into any light therapy device you use:

• The absence of UV wavelengths
• A proper diffusing screen
• UL listing

Ultraviolet (UV) Wavelengths
UV wavelengths are not necessary for the effectiveness of light therapy products. In small amounts (less than 15 minutes of exposure per day) UV can be beneficial. For example, sunlight helps your body produce vitamin D. However, in larger amounts, we know UV rays can be harmful. These wavelengths have been implicated for many years in such conditions as the formation of cataracts, skin cancer, and premature aging of the skin. Most people get enough environmental UV exposure per day just going to and from work, without having to expose themselves to any more of it. For this reason, and because of the known harmful effects of UV, researchers in the field of bright light treatment are unanimous in their recommendation of UV-free light therapy equipment.

The SunBox Company's light boxes have all been tested for UV emissions by an independent laboratory, which has concluded that they are UV-free. We have the reports available upon request.

Diffusing Screen
The acrylic diffuser that is standard in most, but not all, commercially available light boxes spreads the light evenly across the surface of the unit. This makes the light more comfortable for your eyes and protects them from light brighter than 10,000 lux, the highest amount of light that's been tested in clinical studies for safety and efficacy. Using a unit that does not have a diffuser could expose your eyes to "pinpoints" of light that could pose a hazard.

In addition to spreading the light evenly over the light box surface, the diffuser also absorbs the UV wavelengths that are emitted by the bulbs (all bulbs emit UV light to some degree). Without a diffuser you are not protected from the potentially harmful effects of UV rays.

The only case of eye damage with bright light therapy of which we are aware occurred in a man who had built his own light box. Unfortunately, he attempted to save money by omitting the diffusing screen, and suffered retinal damage from using his homemade light box.

UL Listing
Underwriters Laboratories (UL) is an independent group that tests and certifies products for consumer safety in the United States. For an electronic product to be listed by UL, it must undergo stringent testing that ensures that it is electrically safe for home use, and it must be built according to exacting standards.

Some manufacturers state that their products have "UL Listed Components." This is very misleading, since electrical components available to U.S. manufacturers must be UL Listed in order to be available for sale. That is, all electrical components used in U.S. manufacturing are UL Listed. The absence of a UL listing on a light therapy device indicates that either the manufacturer is unwilling to spend the money each year to have their products evaluated, or their product does not pass UL's strict guidelines. In either case, you cannot be assured of the electrical safety of such products.

Light Box Therapy Effectiveness

There are four important factors when considering the effectiveness of a light box:

• Has the product been clinically tested?
• Does it provide 10,000 lux of light?
• Does it deliver the light in a downward angle?
• Is the light diffused evenly over the entire surface of the lamp?

Clinical Testing
The SunBox Company has been supplying light boxes to the National Institute of Mental Health since 1984. Since then, the company has been the exclusive supplier of these devices to NIMH. SunBox light boxes have also been used in clinical studies at research centers worldwide, including: Rush Presbyterian Hospital at St. Luke's Medical Center, Stanford University, Yale University, John's Hopkins University, University of British Columbia (Canada), University of California San Diego, University of Alberta (Canada), Korea University (Korea), University of Wisconsin Hospital and Clinic, SUNY-Syracuse, University of Washington, Northwestern University, Uniformed Health Services, and NASA.

10,000 Lux Brightness
Bright light therapy has come a long way since its discovery in the early 1980s. Initial studies had patients using light boxes that delivered 2,500 lux of light (about 5-10 times brighter than a well-lit office) at a specific distance, approximately 30 inches from the surface of the light box. The patients were instructed to use the light boxes 2-4 hours a day.

In 1990, a study was published which showed that 10,000 lux, a brightness equivalent to being outside on a clear spring day shortly after sunrise, delivered for a much shorter duration produced similar results. Since then, numerous other studies have replicated this finding, and 10,000 lux has become the standard for light therapy equipment. Using this brighter light typically decreases needed treatment time to under 30 minutes per day, which, researchers believe, increases compliance and therefore efficacy...after all, it's much easier for busy people to plan to sit still for 20-30 minutes each day, instead of 2-4 hours!

We are unaware of any research that supports the use of light brighter than 10,000 lux for bright light treatment, either in terms of efficacy or safety.

Downward Angle
The downward angle recommended by researchers and incorporated into most SunBox designs allows more light to enter your eyes, increasing the effectiveness of the light box than upright units. As a bonus, the apparent brightness is decreased, which reduces glare and makes it more comfortable to use.

Diffusion
The acrylic diffuser is an important safety measure, as mentioned above, by filtering out UV rays. It also spreads the light out over the surface of the fixture, creating an even field of light by removing any "bright" and "dark" spots. This increases efficacy, as it won't matter whether your eyes are moved an inch to the left over a dark spot, or an inch down over a bright spot—the light intensity will be the same in front of any part of the light's surface.

Light Box Therapy Comfort

The SunBox Company has incorporated several important features designed to increase user comfort:

• Downward angle
• Full spectrum light
• High quality electronic ballasts

Downward Angle
The downward angle that researchers recommend for increasing light delivery to the eye and improving efficacy also increases user comfort. Rather than shining the light into your eyes from an upright position, much like the lights of oncoming headlights when you're driving at night, the tilted angle allows the light to enter indirectly through your peripheral vision. This does not diminish the light reaching your retina; rather, it spreads it over a larger part of your eye. This reduces the apparent brightness of the unit and decreases glare, which makes it much more comfortable to use. Several SunBox designs incorporate this feature.

Full Spectrum Light
The term "full spectrum" is a loosely defined term in the lighting industry. Generally, it refers to light that has a color temperature of between 5,000-6,500° Kelvin. It may, but does not necessarily, include the UV wavelengths—again, the term is loosely defined and is used differently by different lighting companies. At The SunBox Company, we use the term to mean the visible portion of the spectrum, without the UV wavelengths.

Full spectrum light, regardless of whether it contains UV, appears whiter than other types of artificial light such as cool white, warm white, and broad spectrum, since it contains a greater distribution of colors within the visible spectrum. Cool white bulbs, for example, appear yellow-orange when compared to full spectrum bulbs because they are significantly deficient in the blue-green part of the spectrum.

All SunBox light boxes use bulbs that emit color temperatures of 5,000-5,500° Kelvin. As stated in the Safety section above, the potentially harmful UV wavelengths are eliminated from our light boxes with the acrylic diffuser.

High Quality Electronic Ballasts
We're all familiar with the distinct hum and the annoying flicker of fluorescent fixtures. Generally, fixtures that emit this hum and flicker have older, magnetic ballasts. Higher quality electronic ballasts, such as the ones that have been standard in all SunBox light boxes for several years, greatly reduce the hum and the flicker associated with fluorescent fixtures.

©2002 The SunBox Company

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