Vanderbilt Corporate Health Services - Workers' Compensation Division

Vanderbilt Center for Occupational and Environmental Medicine (VCOEM)

3319 West End Avenue - Suite 930
Nashville, TN 37203-1035

Tel: 615-936-0422 Fax: 615-936-0423

VCOEM provides

advice on occupational medicine policy issues to the Vanderbilt Medical Center
representation on professional matters at the local, state and national level (e.g. Tennessee Workers' Compensation Cost Containment Committee, Tennessee and American Colleges of Occupational and Environmental Medicine)
consultation on workers' compensation case management issues to Vanderbilt Corporate Health Services and Vanderbilt physicians
lectures and presentations to medical students and MPH students at Vanderbilt and at Meharry Medical College, and physicans and nurses, case managers and claims adjusters in the occupational health and workers' compensation community
expert services on complex medical or scientific issues in administrative, regulatory, or legal proceedings in the areas of occupational and environmental medicine to employers, insurance companies and defense and plaintiff attorneys

Occupational and Environmental Medicine is primarily a preventive medicine specialty which attempts to identify and prevent adverse health effects from exposure to hazards at work or in the environment. The specialty also embraces rehabilitation of injured workers, and promotion of the general health, wellness and productivity of working populations. An expert is a person invited to educate, provide opinions and testify about scientific, medical, technical or other specialized circumstances involved in a dispute in order to bring special training, knowledge, skill or experience where matters in legal dispute are beyond the average person's knowledge.

Jonas Kalnas, MD, MIH, MSc

Dr. Jonas Kalnas has a bachelor’s degree in chemical engineering from McMaster University (1971) and a M.D. from the University of Western Ontario (1976) in Canada. He obtained a Master of Industrial Health (1978) and a Master of Science in Environmental Health Sciences (1979) from the Harvard School of Public Health, and did a research fellowship in lung diseases at the Mayo Graduate School of Medicine (1980). Dr. Kalnas has practiced occupational and environmental medicine in pharmaceutical and petrochemical companies, in a government regulatory agency, and as an independent consultant. He is board certified in occupational medicine, and is a Fellow of the American College of Preventive Medicine and of the American College of Occupational and Environmental Medicine. In 2002, Dr. Kalnas joined the Vanderbilt Center for Occupational and Environmental Medicine (VCOEM) where he provides expert services on complex medical or scientific issues in administrative, regulatory or legal proceedings.

Examples of Services

Toxicology & Epidemiology

*Hazard Assessment*	A worker asks if exposure to silica dust over many years might have caused her stomach cancer. You know that silica causes silicosis of the lung. The Material Safety Data Sheet states that silica has been recognized to cause lung cancer, but does not state anything about other cancers such as stomach cancer.
*Cancer / Disease Causation*	A worker reports neurological symptoms that he thinks are related to his job. He works with solvents and grinds heavy metals, but he also uses pesticides on his vegetable farm. All these exposures are known to have the potential to cause neurological problems. You need to determine which exposure is the most probable cause of his symptoms.
Medical Monitoring	You want to implement a medical monitoring program for workers exposed to lead and mercury. Your occupational medicine clinic/provider can provide this service, but you need help in designing a protocol.

Causation & Impairment Issues

Causation & Impairment

An injured person (from work, product exposure or other accident) receives substantially different causation opinions or impairment ratings from two medical evaluations, and you need a medical expert to evaluate the case and help to resolve the differences.

Plaintiffs & Claimants

You suspect that exposure to a substance at work (or in the environment, or in a product) may have caused your client’s illness. You need to evaluate the claim, and to assemble the medical and scientific information that may support the claim.

Defendants & Respondents

Your client has been sued by a worker (or a customer using a product, or a person living near the plant) claiming that an illness was caused by your client’s operations or product. You need to decide if there is merit to the claim, and to assemble the medical and scientific information to defend your client’s position if the available evidence does not support the claim.

Risk Management

Special Programs & Oversight

You identify a need for a program to provide medical monitoring or other preventive interventions to address toxic, physical or ergonomic hazards

in your workplace. You need medical input for program development

and ongoing oversight.

Hazard Communication

You receive a bulletin warning that a certain chemical has been found to

be associated with cancer in a study of workers in another industry. Your company has been using this chemical for several decades, and you

need to determine what to communicate to your employees, and/or your customers.

Public Relations

Residents near your plant think that emissions from your site are contaminating their environment and have caused illnesses in the community, and you need to address their concerns.