Most people rarely think about the air they breathe, the water flowing from their taps, or the fields they drive past on the way to work. Prof. Lena Novack thinks about little else. For the Ben-Gurion University researcher and Soroka Medical Center epidemiologist, these ordinary parts of everyday life are living datasets, capable of revealing why some communities suffer higher rates of disease than others, and, just as importantly, how those diseases might be prevented before they ever appear.
"It means you take everything in the environment and test how it impacts us," Novack says. We actually do everything." Environmental epidemiology may sound like a niche scientific discipline, but Novack describes it almost as detective work. Every project begins with a deceptively simple question: could something invisible in our surroundings be quietly shaping our health? The answers, she says, can ultimately reshape public policy. "When you find a risk factor in environmental epidemiology, you eliminate it, or diminish it, for the entire population."
Unlike physicians treating one patient at a time, Novack's work is measured across cities, regions, and sometimes the entire country. "If I say an industry is polluting, the next day they may get a guideline from the Ministry of Health to put filters on the chimneys," she explains. "You won't feel it on one specific person. But you will feel it on the entire population." That conviction runs through every aspect of Novack's work, also explaining why her research rarely remains confined to academic journals. She argues that environmental epidemiology is one of the few fields where statistical models can become government policy, and where spreadsheets can eventually change regulations, infrastructure, and even a country's drinking water.
Born in St. Petersburg, Novack made aliyah in the early 1990s, arriving in Nitzana, a small educational village in the Negev that has welcomed many new immigrants, at the age of 19. She then spent six months learning Hebrew before she started attending Ben-Gurion University, where she eventually earned three degrees. During that period, Novack simultaneously studied biostatistics in Jerusalem, a field that later became the quantitative foundation of her research. After a postdoctoral fellowship in Boston, she returned to Israel and joined both Ben-Gurion University and Soroka Medical Center, where she continues her professional work.
"My main job is actually at Soroka," she says. "Half of the time I'm spending at Ben-Gurion University, but working in the hospital defines me because I'm working with clinicians a lot. I'm coming from the clinical field, and I'm much more exposed to that side. I'm trying to combine academics and the hospital." That combination has shaped the character of her research, as rather than studying environmental questions in isolation, Novack's laboratory works hand in hand with physicians treating patients every day.
When asked about her work, she explains, "We try to tackle everything that comes our way." She adds, "If someone has an idea – be it a researcher or a doctor, we make an effort to address it." Environmental epidemiology has expanded to cover nearly any such inquiry. While air pollution remains a primary focus, it is just one part of a much larger field. "We study pollution, meteorological factors, barometric pressure, solar radiation, heat, and dust storms," she details. "Additionally, we examine drinking water across the country, agricultural fields nearby, flowering seasons related to allergies, and pesticides or fertilizers linked to diseases like Parkinson's. It's extremely broad."
"It never gets boring, we can study light one day, and meteorology another. Every day I'm talking to different people. It's not only physicians, it's physicists, chemists, geographers... Literally everybody." Unlike laboratory research that may take decades to influence medical practice, environmental epidemiology often aims directly at decision-makers. "When we start studying something, we already see the end," she explains. "Every epidemiologist thinks this way. In environmental epidemiology, we have to think about how we're going to disseminate the findings." That practical orientation has produced an extraordinary variety of collaborations. At any given moment, Novack estimates that around twenty projects are running simultaneously through NEHRI, the joint Soroka and Ben-Gurion University laboratory that she heads.
Perhaps the clearest illustration of her philosophy came from one of her largest studies, conducted in collaboration with Magen David Adom's blood services and funded by the Ministry of Environmental Protection. The team collected nearly 6,000 blood samples from blood donors across Israel and analyzed roughly 2,000 of them for heavy metals, aiming to determine whether residents of Haifa Bay had higher concentrations than people elsewhere in the country.
The overall picture turned out to be reassuring. "We found that, overall, we have pretty moderate levels of heavy metals compared to Europe and the United States," Novack says. Yet important regional differences emerged. "There were higher levels of chromium and lead in Haifa Bay compared to other parts of the country. There was more arsenic and cadmium in Tel Aviv, probably because of traffic, while chromium and lead mostly come from industry." Once published, the study acquired a life of its own, and the public reaction was immediate. "The Knesset restarted the committee on removing industries from Haifa Bay," she says. "We were invited to present our results."
Although subsequent political events slowed the initiative, the experience fundamentally changed her understanding of how scientific evidence moves through society. "If you want policymakers to know it, of course you submit reports to the ministries and talk to media," she says. "But that's also partially how you move things." Novack remains uncomfortable with sensationalism, yet she also recognizes that evidence alone does not necessarily change policy; research has to reach people in order to reach governments.
One project examines the almost complete absence of magnesium in Israel's desalinated drinking water and its possible relationship to cardiovascular disease. "We're analyzing exactly how much magnesium we have in the drinking water in Israel, now that more than 50% of which is desalinated water," she says. "In desalinated water we have zero." The objective is not simply to publish another paper. "Once we show it with statistical evidence," she says, "you put this on the table for the Ministry of Health. That's the only way they can decide whether we actually have to add magnesium into our desalinated water."
Novack does not portray herself as a solitary scientist making these discoveries alone. "I lead the lab called NEHRI. It's a mutual initiative of Soroka and Ben-Gurion. The work is driven by a small, multidisciplinary team. The laboratory's medical student researchers – Nitzan Sagie, Kineret Grant-Sasson, Ilan Libes, Uri Levi, Yuval Arnon, and Adi Shiloh – are deeply involved in analyzing the data that underpin the studies, while programmer Mark Friedman develops and supports the computational infrastructure that enables much of the research. "I'm not doing the studies alone," she says. "It's the lab doing them."
Perhaps that collective perspective mirrors the discipline itself. Environmental epidemiology is concerned less with exceptional individuals than with populations, less with dramatic medical breakthroughs than with countless small improvements whose effects become visible only over the years. For Novack, that scale is precisely what makes the work worthwhile. "When you think about the impact," she says, "that makes it exciting. When you think about the purpose, it helps."
Written in collaboration with BGU
The Environment and Climate Change portal is produced in cooperation with the Goldman Sonnenfeldt School of Sustainability and Climate Change at Ben-Gurion University of the Negev. The Jerusalem Post maintains all editorial decisions related to the content.
