Stefanos Kales

Dr. Kales became the Director of the Occupational & Environmental Medicine Residency in July 2006. He is Board Certified in Internal Medicine and Preventive Medicine: Occupational Medicine, and has been elected to Fellowship by both the American College of Physicians and by the American College of Occupational & Environmental Medicine.

Dr. Kales has participated in a wide range of research, advisory and teaching activities on five continents resulting in over 90 publications. His primary research has focused on firefighters. Further studies have sought to identify risk factors for adverse health and employment outcomes, and heart disease in particular. His group’s work is influencing medical standards for firefighter’s fitness for duty, the need for improved wellness programs and methods for determining the causal relationship of heart disease among firefighters to their job activities and other factors.

Dr. Kales’ research on firefighters has received Massachusetts, Federal and Canadian funding. Other collaborations focus on cardiovascular and metabolic risk factors and their evolution over time, including a new cohort study of young adults in Cyprus funded by the Research Promotion Foundation of Cyprus. Additional research areas have included carbon monoxide exposure, chemical terrorism and chemical emergencies and heavy metals. One particular area, related to lead exposure from traditional Indian medications has had wide impact, triggering changes in the regulation of these medications by the Indian and Canadian governments and spurring various American health departments to scrutinize the sale of these folk remedies.

Dr. Kales is on the editorial boards of Environmental Health Perspectives and the Archives of Environmental and Occupational Health. He is an occupational medicine consultant to the Massachusetts/Rhode Island Poison Control Center, served for several years as the medical consultant to Massachusetts' Adult Lead Registry, and worked with the state's regional hazardous materials teams for 10 years.

BS,1985 Bucknell University
MD,1989 Harvard Medical School
MPH,1992 Harvard School of Public Health

• Associate Professor of Medicine, HMS
• Director, Occupational and Environmental Medicine Residency, Harvard School of Public Health
• Division Chief, Occupational and Environmental Medicine,The Cambridge Health Alliance  
• Medical Director, Employee and Industrial Medicine Service, The Cambridge Health Alliance

• Kales: DHS-Harvard Firefighters' Study
• Occupational Medicine Residency at HSPH

Selected reports:

Kales SN, Goldman RH. Mercury Exposure: Current Concepts, Controversies and a Clinic’s Experience. J Occup and Environ Med 2002; 2002;44:143-154.

Kales SN, Soteriades ES, Christoudias SG, Christiani DC. Firefighters and On-Duty Deaths from Coronary Heart Disease: a Case Control Study. Environmental Health: A Global Access Science Source 2003, 2:14.

Saper RB, Kales SN, Paquin J, Burns MJ, Eisenberg, DM, Davis RB, Phillips RS. The Heavy Metal Content of Ayurvedic Herbal Medicine Products. JAMA 2004;292: 2868-2873.

Soteriades ES, Hauser R, Kawachi I, Liarokapis D, Christiani DC, Kales SN. Obesity and Cardiovascular Disease Risk Factors in Firefighters: A Prospective Cohort Study. Obesity Research 2005;13: 1756-1763.

Kales SN, Huyck KL, Goldman RH. Elevated Urine Arsenic: Un-Speciated Results Lead to Unnecessary Concern and Further Evaluations. J Analytic Toxicol 2006;30:80-85.

Kales SN, Christiani DC. Acute Chemical Emergencies. N Engl J Med 2004;350:800-8.

Kales SN, Soteriades ES,Christophi CA, Christiani DC. Emergency Duties and Deaths from Heart Disease among Firefighters in the United States. N Engl J Med. 2007;356:1207-15.

Mbanu I, Wellenius GA, Mittleman MA, Peeples L, Stallings LA, Kales SN. Seasonality and Coronary Heart Disease Deaths in United States Firefighters. Chronobiol Int. 2007; 24: 715–26.

Geibe JR, Holder J, Peeples L, Kinney AM, Burress JW, Kales SN. Predictors of On-Duty Coronary Events in U.S. Male Firefighters. Amer J Cardiol. 2008;101:585–589.

Saper RB,  Phillips RS, Sehgal A, Khouri N, Davis RB, Paquin J, Thuppil V, Kales SN. Lead, Mercury, and Arsenic in U.S. and Indian-manufactured Ayurvedic Medicines Sold over the Internet. JAMA 2008; 300:915-923.

Parks PD, Durand G, Tsismenakis AJ, Vela-Bueno A, Kales SN. Screening for Obstructive Sleep Apnea during Commercial Driver Medical Examinations. J Occup Environ Med. 2009;51:275-282.

Tsismenakis AJ, Christophi CA, Burress JW, Kinney AM, M Kim, Kales SN. The Obesity Epidemic and Future Emergency Responders. Obesity. 2009;17:1648-1650.

Zhang C, Varvarigou V, Parks PD, Gautam S, Vela Bueno A, Malhotra A, Kales SN. Psychomotor Vigilance Testing of Professional Drivers in the Occupational Health Clinic: a Potential Objective Screen for Daytime Sleepiness. J Occup Environ Med 2012;54:296-302.

Baur DM, Christophi CA, Tsismenakis AJ, Cook EF, Kales SN. Cardio-Respiratory Fitness Predicts Cardiovascular Risk Profiles in Career Firefighters. J Occup Environ Med 2011;53:1155-1160.

Anderson JE, Govada M, Steffen TK, Thorne CP, Varvarigou V, Kales SN, Burks SV. Obesity Is Associated With the Future Risk of Heavy Truck Crashes among Newly Recruited Commercial Drivers. Accident Analysis & Prevention [2012 in press].

Baur DM, Christophi CA, Cook EF, Kales SN. Age-related decline in Cardio-Respiratory Fitness among Career Firefighters: Modification by Physical Activity and Adiposity. Journal of Obesity. Vol. 2012, Article ID 710903, 6 pages, 2012. doi:10.1155/2012/710903.

Baur DM, Leiba A, Christophi CA, Kales SN Low Fitness Is Associated With Exercise Abnormalities among Asymptomatic Firefighters. Occup Med London).  [in press].

Kales SN, Tsismenakis AJ, Zhang C, Soteriades ES. State of the Art.  Blood Pressure in Firefighters, Police Officers, and other Emergency Responders. Am J Hypertens. 2009;22:11-20.

Soteriades ES, Smith DL, Tsismenakis AJ, Baur DM, Kales SN. Cardiovascular Disease in U.S. Firefighters: A Systematic Review. Cardiol Rev. 2011;19:202-215.