From the Archives: Summer 2009 issue of Lupus Now
Lighting the Way
by Emily Wojcik
If you have lupus, chances are you’re familiar with photosensitivity, or abnormal sensitivity to light. Between 40 and 70 percent of people with systemic lupus find their disease is made worse by exposure to ultraviolet (UV) rays, and the lesions of cutaneous lupus are highly photosensitive. The sun is the major source of ultraviolet light, but UV rays also come from indoor lighting, like energy-efficient compact fluorescent light bulbs. Since the Energy Independence and Security Act was enacted in December 2007 -- requiring that all light bulbs in the United States use 30 percent less energy by 2012 and 70 percent less by 2020 -- these bulbs have become a hot trend. But what sort of risk do they pose for people with lupus?
Two types of ultraviolet rays cause photosensitive reactions: type A, commonly known as UVA, which has longer-term effects on aging, and type B, or UVB, which causes sunburns. Richard D. Sontheimer, M.D. (formerly vice chairman of the Department of Dermatology at University of Oklahoma Health Sciences Center, now professor of dermatology at University of Utah Health Sciences Center), conducted a recent study on both types of bulbs and found that the highest amount of UVA leaks from old-fashioned incandescent light bulbs, though they give off very little UVB. The fluorescent bulbs, unfortunately, release both types. His recommendation? Shielded compact fluorescents, which are covered during manufacturing (see sidebar) to prevent leaks of either type.
Sontheimer’s study focused on light sources at close range (up to about 1.5 feet away), roughly the distance from a desk lamp. Although this was a preliminary pilot study involving a small number of light sources, and the results need to be confirmed by a larger study, very little risk of UVA or UVB exposure was seen from fluorescent lights that were farther away, such as overhead fixtures. Other studies, though, have shown that people with lupus can experience photosensitivity even at these distances. So what does this mean for you?
If you’re switching to energy-efficient lighting in your home, ask for shielded compact fluorescents at your local hardware store. If you work at an office that has overhead fluorescent lighting, try to find out what kinds of bulbs are being used to comply with the energy bill. Sontheimer notes that an acrylic plastic diffuser will shield UVB emission from standard fluorescent lights if shielded bulbs are not available. If you experience photosensitivity reactions at work (such as lesions or rashes, joint pain in hands or wrists, fatigue, or other symptoms of systemic lupus), talk to your boss or the human resources department about switching to shielded bulbs or getting acrylic shades for overhead and desk lamps. For more information about workplace accommodations, contact the Equal Employment Opportunity Commission (EEOC) at 800-669-4000 or eeoc.gov.
Acrylic bulb covers and even plain old lampshades can be a lifesaver for people with photo-sensitivity. For more consistent protection, the Health Sciences Center at the University of Oklahoma in Oklahoma City recommends 60-watt shielded compact fluorescent light bulbs, also called “encapsulated” or "double-envelope" bulbs. Your best bet is to ask a home lighting specialist at your local hardware store, but the Philips Marathon or Philips Daylight Energy Saving Bulbs (60-watt) are a good brand to choose. For covers, try North Solar Screen’s bulb jackets, which block up to 99% of ultraviolet light (northsolarscreen.com). NaturaLux (951-735-6285; naturalux.com) offers fluorescent light filters, and discounts to LN readers. Also, the LFA, Winston-Triad Chapter works with a local light shield vendor who offers discounts to LFA members and LN readers. Call 336-768-1493.
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