Light Hygiene: Time to make preventive use of insights old and new into the nexus of the drug light, melatonin, clocks, chronodisruption and public health

Light is, clearly, a key to life on Earth and light, equally clearly, determines biological rhythmicity in organisms. Light does the latter by setting internal or endogenous clocks which allow a multitude of species, including man, to adjust their lives to changing external or environmental conditions. Critical changes over time occur from day to night and throughout the year. In this paper, we sum up how visible light provides electromagnetic information about environmental time via the ocular interface of newly discovered photoreceptive cells to a master clock in our brain, viz the suprachiasmatic nuclei [SCN], and how the SCN translate this input, with melatonin as a key biologic intermediary, into endogenous or biological time. We summarize experimental and epidemiological evidence suggesting how chronodisruption, a relevant disturbance of the temporal organization or order of physiology, endocrinology, metabolism and behaviour, is probably detrimental for human beings. On the basis of our synthesis, and in line with suggestions by other researchers voiced decades ago, light must, functionally, be considered as a drug equivalent. In this vein, the very timing, quality (wavelength), quantity (dose) and side effects, including chronodisruption, of light exposures can be critically important for health and disease in man. As a promising means to foster public health, we advocate an appropriate balance of exposures to the key Zeitgeber light in terms of light hygiene, implying strong and appropriate rather than weak and confusing temporal information. This focus on light hygiene, and thus on the key Zeitgeber light, does not mean to ignore that there are multiple entrainment pathways for our circadian clocks. Indeed, when dealing with light, chronodisruption and a multitude of adverse health effects, we ultimately need to consider Zeitgeber cues, and their possible interplay, beyond light alone. Confusions of the temporal programmes in humans can also stem from physical and social activities, stress and facets of food intake. And yet, since light possesses a rather unique and exclusive Zeitgeber role and in view of its ubiquitous nature, a specific, preventative focus on light hygiene, as a contribution to a general Zeitgeber hygiene, is warranted. (C) 2009 Elsevier Ltd. All rights reserved.