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• Both voluntary and mandatory standards raise issues for environmental policy. • Standard-setting is affected by resources, pragmatism and economic considerations. • Despite limitations, standards may take the place of government-set regulation. • Standards for environmental policy should take account of sources of bias. • Improving representation and government's role could improve standard-setting. As a tool to regulate environmental issues, standards play a key role in defining acceptable levels of safety and environmental protection. From a governance perspective, standards are also significant for their inclusion of non-governmental stakeholders, including industry and environmental organizations, in determining the benchmarks upon which policies are enacted. Drawing upon work on Israeli standards for both environmental pollutants in consumer products and 'green building', this paper considers how the use of standards as an environmental policy tool affects how environmental issues are regulated. The research uses written standards, research into standardisation committees and approximately twenty in-depth interviews. Thematic analysis of the use of these standards as environmental policy tools highlighted different issues including the connection between representation of different interests and availability of resources; different rationales for standards that may produce conflict in professional decisions; and implications of the consensus-building approach for balancing interests and driving government policy. We conclude that various factors ought to be taken into account when using standards within environmental policy. We provide policy recommendations including a need to consider the implications of using a standard in the absence of broader regulation; the impact of economic and pragmatic rationales on environmental and health measures in standards; and means to improve the balance of representatives on standards committees. [ABSTRACT FROM AUTHOR]

Health systems worldwide need to be adapted to cope with growing numbers of migrants and to climate-exacerbated morbidity. Heatwaves, water stress, desertification, flooding, and sea level rise are environmental stressors that increase morbidity, mortality, and poor mental health in Sub-Saharan Africa. While most migration is intra-African, climate change is also affecting migration patterns outside the continent. To tackle the health challenges induced by these events, such as infectious diseases and malnutrition, health care providers in Sub-Saharan Africa and in receiving countries in Europe must adapt their systems to provide appropriate health services to these communities. While health systems differ greatly across the global north and south, adaptation measures are similar and should be integrated. We present recommendations for adaptation of health systems to climate-related migration, including strengthening health systems, providing access to healthcare, culturally-appropriate services, policy-oriented research and training, and inter-sectoral collaboration. [ABSTRACT FROM AUTHOR]

Abstract Recent studies have explored how professionals draw boundaries to reach workable solutions in conflictual and contested areas. Yet they neglected to explore the relationships and dynamics between how boundaries are demarcated in rhetoric and in policy. This article examines these relationships empirically through the case of medical cannabis (MC) policy-making in Israel. Drawing on interviews with key stakeholders in the MC policy field, formal policy documents, and observations of MC conferences, this article sheds light on the dynamics between rhetorical boundary-work and what we term regulatory boundary-work , namely setting rules and regulations to demarcate boundaries in actual practice. Results show how certain definitions of and rationales for a discursive separation between "medical" and "recreational" cannabis and between cannabis "medicalization" and "legalization" prevailed and were translated into formal policy, as well as how stakeholders' reactions to this boundary-work produced policy changes and the shifting of boundaries. Both rhetorical and regulatory boundary-works emerge as ongoing contested processes of negotiation, which are linked in a pattern of reciprocal influence. These processes are dominated by certain actors who have greater power to determine how and why specific boundaries should be drawn instead of others. Highlights • Qualitative study exploring boundary-work in MC policy-making in Israel. • Most stakeholders draw boundaries between medical and recreational cannabis. • Rhetorical boundary work is translated into regulatory boundary-work. • Rhetorical and regulatory boundary-work are interrelated processes. • MC emerges as a classification system with distinct local meanings. [ABSTRACT FROM AUTHOR]

Toys and children's products may contain trace metals and organic compounds that are potentially harmful to the health and development of infants and young children. Intergovernmental organizations and individual countries regulate chemicals in consumer products, but a coordinated international approach is lacking. This paper examines the implications of chemical regulation in children's products in large markets for a smaller market, namely Israel. We compared chemical regulations in children's products in the U.S., EU and Israel, and conducted in-depth interviews with diverse stakeholders in the Israeli product standardization process. Israel adopted EU chemical standards for certain chemicals (e.g., trace metals, phthalates) but not others (e.g., bisphenol A, flame retardants, trace metals in children's jewelry). Israeli regulation of chemicals in consumer products relies on regulations in large markets such as the U.S. and EU, which therefore have impacts beyond their territories. However, Israel adopts only product-specific standards and has regulatory gaps due to the lack of an overarching regulatory approach that exists in the U.S. and the EU. Furthermore, Israeli policy is to adopt parallel standards from large markets in order to remove trade barriers, despite their different approaches to chemical regulation, an approach which prioritizes trade considerations over health considerations. We conclude with policy recommendations for Israel, which have relevance for other small markets. [ABSTRACT FROM AUTHOR]

Trace metals and synthetic chemicals including phthalates, bisphenol A and flame retardants, are widely used in toys and childcare products, and may pose acute or chronic adverse health effects in children. In Israel, certain chemicals are regulated in childcare products, but there are still regulatory gaps. We tested regulated and unregulated contaminants in 174 item parts from 70 childcare items with potentially high oral or dermal exposure, including 22 children's jewelry items, 14 toys, 7 diaper-changing mats, 6 baby mattresses, 7 baby textiles and 14 feeding and bathing items. In children's jewelry, an unregulated product in Israel, 23% of samples exceeded the US standard for lead. In toys, a regulated product, we did not detect trace metals above the Israeli standard. In textiles, baby mattresses and diaper-changing mats, phthalates exceeded the European Union standard in 14–45% of tests with a mean of 6.74% by mass for diisononyl phthalate, and 1.32% by mass for di(2-ethylhexyl) phthalate. BPA migration exceeded the EU standard in 14–45% of tests with a mean of 1.03 ppm. The flame retardants polybrominated biphenyls, pentabromodiphenyl, octabromodiphenyl ether, tris(2,3-dibromopropyl) phosphate and tris-(aziridinyl)-phosphine oxide were not detected. For products regulated in Israel, our findings suggest general compliance with mandatory standards. However, a lack of comprehensive chemical regulation means that there are regulatory gaps, and products not regulated in Israel may contain high levels of chemical contamination, exceeding US or EU regulations. The results of this study have prompted the development of an Israeli safety standard for children's jewelry. [ABSTRACT FROM AUTHOR]

Seismic retrofitting is the most effective way to reduce casualties from earthquakes. Yet, seismic retrofitting of vulnerable residential structures faces many impediments. As no single policy measure can overcome these obstacles, seismic retrofitting requires that multiple policy measures be applied in tandem and therefore policy packages are necessary. As seismic threats are spread over multiple locales, differing in their characteristics, no single policy package is likely to fit all settings. Indeed, efforts to promote seismic retrofitting in California, New Zealand and Israel show high variability in success across different locales. Our study builds upon previous work which outlined three potential policy packages for seismic retrofitting, led by market forces, local government and central government respectively. In this study we advance an asymmetric decentralization approach to match the most appropriate policy package to local conditions. We combine this with seismic vulnerability assessment to prioritize the national allocation of retrofitting funds. The approach is applied to the Israeli case, a country that is prone to infrequent large earthquakes and in which there is a large, substandard housing stock. [ABSTRACT FROM AUTHOR]

Abstract: The literature on impact assessment (HIA) registers the importance of stakeholder participation in the assessment process, but still lacks a model for engaging stakeholders of diverse ethnic, professional and sectorial backgrounds. This paper suggests that the multicultural approach can contribute to HIA through a revision of the generic 5-step HIA model, and its implementation in a metropolitan plan in Southern Israel. The health issue scoped by the stakeholders in the HIA is related to land uses in the vicinity of the national hazardous industry and hazardous waste site. The stakeholders were representatives of the diverse populations at stake, including rural Bedouins and Jewish city dwellers, as well as representatives from the public sector, private sector, non-governmental organizations and academia. The case study revealed that a multicultural stakeholder participation process helps to uncover health issues known to the community which were not addressed in the original plan, and provides local knowledge regarding health conditions that is especially valuable when scientific data is uncertain or absent. It enables diverse stakeholders to prioritize the health issues that will be assessed. The case study also reveals ways in which the model needs revisions and improvements such as in recruitment of diverse participants. This paper presents a multicultural model of HIA and discusses some of the challenges that are faced when HIA is implemented in the context of current decision-making culture. [Copyright &y& Elsevier]

Abstract: In the field of policy-making, technical knowledge is generally regarded as objective, true, and sufficient. It is typically positioned in contrast to local knowledge, which is considered subjective and irrelevant to policy-making. This paper follows a growing scholarly trend of re-examining the relationship between technical and local knowledge, in order to show that technical knowledge may be disputable, uncertain, and based on problematic presuppositions, while local knowledge often employs objective and systematic methods. The dichotomy between local and technical knowledge is thereby questioned, with the proposal that there exist multiple types of knowledge that are of relevance to policy-making. In addition, the paper shows that the boundary between individuals who hold different types of knowledge is blurry, and that, in fact, policy-making stakeholders simultaneously employ several types of knowledge. The empirical data for this study comes from a stakeholder participation process in Health Impact Assessment, which focused on land uses in the vicinity of a national hazardous industry and waste site. [Copyright &y& Elsevier]

Abstract: Stakeholder participation is considered an integral part of HIA. However, the challenges that participation implies in a multi-disciplinary and multi-ethnic society are less studied. This paper presents the manifestations of the multiplicity of sectors and population groups in HIA and discusses the challenges that such diversity imposes. Specifically, there is no common ground between participants, as their positions entail contradictory knowledge regarding the current situation, reliance on distinct data and conflicting interests. This entails usage of multiple professional and ethnic languages, disagreements regarding the definition of health and prioritizing health issues in HIA, and divergent perceptions of risk. These differences between participants are embedded culturally, socially, individually and, maybe most importantly, professionally. This complex picture of diverse stakeholder attributes is grounded in a case study of stakeholder participation in HIA, regarding zoning of a hazardous industry site in Israel. The implication is that participatory HIAs should address the multiplicity of stakeholders and types of knowledge, data and interests in a more comprehensive way. [Copyright &y& Elsevier]

Global health threats including epidemics and climate change, know no political borders and require regional collaboration if they are to be dealt with effectively. This paper starts with a review of the COVID-19 outbreak in Israel, Palestine and Jordan, in the context of the regional health systems, demography and politics. We suggest that Israel and Palestine function as one epidemiological unit, due to extensive border crossing of inhabitants and tourists, resulting in cross-border infections and potential for outbreaks' transmission. Indeed, there is a correlation between the numbers of confirmed cases with a 2–3 weeks lag. In contrast, Jordan has the ability to seal its borders and better contain the spread of the virus. We then discuss comparative public health aspects in relation to the management of COVID-19 and long term adaptation to climate change. We suggest that lessons from the current crisis can inform regional adaptation to climate change. There is an urgent need for better health surveillance, data sharing across borders, and more resilient health systems that are prepared and equipped for emergencies. Another essential and currently missing prerequisite is close cooperation within and across countries amidst political conflict, in order to protect the public health of all inhabitants of the region. Unlabelled Image • Global health threats know no political borders and effective response requires regional collaborations. • We review the COVID-19 outbreak in Israel, Palestine and Jordan, in the context of regional demography and politics. • As a lesson from COVID-19, health systems should be better prepared for climate change impacts. • Stronger economies should take a leading role in developing regional resilience and promoting public health. • Regional cooperation can be important for promoting cross-border collaborations to address future climate and public health challenges. [ABSTRACT FROM AUTHOR]

The prediction of the occurrence of infectious diseases is of crucial importance for public health, as clearly seen in the ongoing COVID-19 pandemic. Here, we analyze the relationship between the occurrence of a winter low-pressure weather regime - Cyprus Lows - and the seasonal Influenza in the Eastern Mediterranean. We find that the weekly occurrence of Cyprus Lows is significantly correlated with clinical seasonal Influenza in Israel in recent years (R = 0.91; p <.05). This result remains robust when considering a complementary analysis based on Google Trends data for Israel, the Palestinian Authority and Jordan. The weekly occurrence of Cyprus Lows precedes the onset and maximum of Influenza occurrence by about one to two weeks (R = 0.88; p <.05 for the maximum occurrence), and closely follows their timing in eight out of ten years (2008–2017). Since weather regimes such as Cyprus Lows are more robustly predicted in weather and climate models than individual climate variables, we conclude that the weather regime approach can be used to develop tools for estimating the compatibility of the transmission environment for Influenza occurrence in a warming world. Furthermore, this approach may be applied to other regions and climate sensitive diseases. This study is a new cross-border inter-disciplinary regional collaboration for appropriate adaptation to climate change in the Eastern Mediterranean. Unlabelled Image • The occurrence of Cyprus Lows and Influenza are significantly correlated over Israel, the Palestinian Authority and Jordan. • The occurrence of Cyprus Lows precedes the onset/maximum of Influenza incidence by 1-2 weeks and follows their timing. • This relationship can be used to develop tools to estimate the compatibility of the environment for Influenza occurrence. [ABSTRACT FROM AUTHOR]

A growing body of literature reports associations between exposure to particulate matter with aerodynamic diameters ≤2.5 μm (PM 2.5) and 2.5–10 μm (PM 10-2.5) during pregnancy and preterm birth (PTB). However, the role of ambient temperature in PM-PTB associations was rarely investigated. In Israel, we used Maccabi Healthcare Services data to establish a population-based cohort of 381,265 singleton births reaching 24–42 weeks' gestation and birth weight of 500–5000 g (2004–2015). Daily PM and ambient temperature predictions from a satellite-based spatiotemporal model, at a 1 × 1 km spatial resolution, were linked to the date of birth and maternal residence. Mixed effects Cox regression models, adjusted for covariates, with a random intercept at the mother level were used to assess associations between mean exposure during pregnancy and PTB. We found that exposure to PM 2.5 was positively associated with PTB when the average exposure during pregnancy was either low (first quintile) or high (fifth quintile), compared to exposure in the 2nd-4th quintiles, with hazard ratios (HRs) 1.18 (95% confidence interval [CI], 1.13–1.24) and 1.07 (95% CI, 1.02–1.12), respectively. The results revealed effect modification of temperature. For mothers exposed to low (below median) average temperature during pregnancy, HRs of PTB were 0.93 (95% CI, 0.87–1.00) and 1.21 (95% CI, 1.14–1.29) for the first and fifth PM 2.5 quintiles, respectively, when compared to the 2nd-4th quintiles. However, a reverse trend was indicated for high-temperature pregnancies, where the corresponding HRs were 1.48 (95% CI, 1.39–1.58) and 0.92, (95% CI, 0.96–0.98). In conclusion, consideration of climatic factors can provide new insights into the risk of PTB as a result of exposure to PM 2.5 during pregnancy. [ABSTRACT FROM AUTHOR]

Exposure to low levels of lead in children can cause cognitive deficits (reduced IQ) and behavioral changes such as reduced attention span and increased antisocial behavior. There are no mandatory limits on lead in paint in Israel, with the exception of paints used on toys and children's furniture. However, paints in playgrounds and public areas may be a source of exposure to lead in young children. In this study, we quantified lead concentrations in painted surfaces in public playgrounds and public areas, and in spray paints in Israel, using X-ray fluorescence (XRF). Lead was detected in 43/48 (90%) of surfaces; concentrations exceeded the US regulatory limit for lead in paint (90 ppm) in 4/5 (80%) of tested surfaces on wooden picnic tables and benches, and 22/25 (88%) of surfaces in playgrounds. In 15 surfaces, lead concentrations were 10–700 times higher than the US limit. Out of 11 spray paints sampled, three (27%) had concentrations above the US standard for residential paints. In order to prevent exposure of the general public to lead in playgrounds and public areas and in spray paints, we recommend an integrated approach, including regulatory restrictions (mandatory lead limit of 90 ppm in all paints except labeled industrial paints); awareness raising in the public and in national agencies and local authorities responsible for maintenance in playgrounds, schools and public areas; and encouragement of voluntary measures by industry to prevent sale of industrial paints for use in areas accessible to the public. [ABSTRACT FROM AUTHOR]