Evidence-based public health messaging on the non-visual effects of ocular light exposure: a modified Delphi expert consensus

Evidence-based public health messaging on the non-visual effects of ocular light exposure: a modified Delphi expert consensus

Introduction In addition to vision, light regulates circadian rhythms, sleep, mood and alertness. Despite growing scientific understanding, there remains a gap in translating this knowledge into accessible, evidence-based guidance. The goal of this paper is to formulate scientifically grounded statements about the influence of light on human psychological and physiological health, intended for dissemination to the public and policymakers.

Methods An international consortium of 21 experts convened at the Ladenburg Roundtable in April 2024. Experts were selected based on their scientific contributions to chronobiology, psychology, neuroscience, and the measurement and practical application of light. Through a structured, iterative modified Delphi process, 27 statements were developed. Each statement included a simplified public-facing version and contextual information to support understanding. Consensus was assessed using predefined thresholds of agreement (>75% endorsement). Statements not meeting consensus were revised and re-evaluated.

Results Of the 27 proposed statements, 26 reached the threshold for consensus, with high levels of agreement across diverse topics. One statement did not reach consensus due to insufficient scientific evidence and was excluded, while another was revised based on feedback and subsequently accepted. The iterative revision process significantly improved the clarity, accuracy and accessibility of the final statements. A readability assessment showed an average sentence length of 14.8 words and a Flesch-Kincaid Grade Level of 8.6, indicating that the statements suit a broad, non-specialist audience. The final consensus statements are available at lightforpublichealth.org.

Conclusions This expert consensus provides clear, accessible messages about how light affects human health. The statements offer a practical tool for public education and policymaking and can be used by public-health multipliers (eg, schools, employers, healthcare providers and urban planners) to promote healthier light exposure in daily life. They highlight the importance of recognising light as a key factor in health, alongside sleep, nutrition and physical activity.