Environmental responsibility in the Israeli health system in the era of climate change: a required paradigm shift.

backgroundEnvironmental management in the Israeli health system is driven primarily by safety regulations. Such regulations aim to reduce hazardous exposures to employees, patients, and visitors, as well as some specific aspects of broader environmental toxicity to humans and nature. Most environmental precautions in the system target traditional exposures and do not specifically consider the health system's own impact on climate change. This article aims to justify incorporating climate change mitigation actions into short- and long-term plans in Israeli health organizations and present a schematic strategic roadmap to do so. MAIN BODY: Climate change poses many threats to global health, including risks from severe weather events, changes in vector-borne diseases, increased hazardous air pollutants, food and water shortages, and adverse effects on reproductive health. The most effective effort in climate change mitigation is reducing greenhouse gas emissions to the atmosphere. Ignoring the health sector's emissions contradicts the ancient medical principle: first, do no harm (primum non-nocere). Furthermore, many climate mitigation methods introduce additional health co-benefits. Special attention and medical considerations are needed to safely reduce emissions from the health sector. This article reviews healthcare's most common emission sources, including energy consumption, transportation, food, waste, supplies, and the supply chain. An organizational carbon management strategy should include recognizing the problem and committing to action, estimating the organizational carbon footprint, developing and prioritizing alternative interventions, and developing a carbon management plan with measurable short- and intermediate-term goals.

conclusionClimate mitigation in the health sector is encompassed by the moral obligation of the Israeli healthcare system to do no harm. Performance measures to support GHG emission reductions should be adopted into the existing, successful Israeli programs of quality measures in medicine, both in the community and hospitals. In addition, Israel academic institutions for health and medical education should incorporate sustainable health into their curricula for students of health professions and as part of continuous medical education. Such policy actions will contribute to a healthy health system that supports climate change mitigation while providing health co-benefits to the Israeli population.