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Online Education > Past ACMT Conferences > 2012 Chelation Course

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On February 29, 2012, ACMT in conjunction with ATSDR hosted a one day conference at the Centers for Disease Control and Prevention in Atlanta, GA on the use and misuse of metal chelation therapy. We are pleased to offer a rebroadcast of each module. After a simple registration, you will be emailed a link to the recording.

The Current Use of Chelation In American Healthcare: An Overview
Paul M. Wax, MD, FACMT, University of Texas, Southwestern, Dallas, TX 

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1. Describe the chelators currently used
2. Discuss the frequency of use of these chelators
3. Describe the spectrum of health care providers who prescribe chelators including allopathic physicians and alternative and complementary medicine providers;
4. Describe the indications for which chelators are currently prescribed both FDA approved indications and off-label indications

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Public Health Department Response
Carl Herbrandson, PhD, Minnesota Department of Health, St. Paul, MN

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1. Describe the questions asked of state public health departments by the public
2. Characterize the risk communication skills necessary to translate information to the public
3. Define and differentiate “public health concern” and “individual health risk”
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Unapproved Chelation Products Available Over the Internet
Charles E. Lee, MD, US Food & Drug Administration, Silver Spring, MD

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1. Describe the availability of unapproved chelation products over the internet
2. Discuss the reasons such products are available
3. Explain the risks associated with the use of internet derived chelator
4. Describe the role of the FDA to prevent the over the counter sale and distribution of supplements or chelation drugs intended to treat heavy metal intoxication

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"Normal" vs. "Clinically Relevant Abnormal" Laboratory Test Results
Richard Wang, DO, FACMT, Division of Laboratory Sciences, NCEH, Atlanta, GA 

Objectives:

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1. Discuss the role of population data in the evaluation of individual patients
2. Describe the impact of genetic polymorphisms on normative data
3. Describe one example of the dose or body burden gap between deficiency and toxicity status
4. Explain the distinction between an elevated tissue concentration and poisoning

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Considerations in the Choice of Laboratory and Analytical Methods
Robert L. Jones, PhD, Division of Laboratory Sciences, NCEH, Atlanta, GA

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1. Describe three important criteria to consider when selecting an analytical laboratory
2. Describe the laboratory principles that predict reliability in analytical measurements.
3. Discuss the difference between analytical tests used to screen populations from those used to rule-in or rule-out pathologic conditions.
4. Describe the scientific basis and 2 potential problems with Inductively Coupled Plasma Mass Spectroscopy

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Biomonitoring, Biological Matrix Decisions, and Analytical Testing Using Alternative Biologic Matrices & Sample Collection and Reporting of Metal Measurements
Kathleen Caldwell, PhD, Division of Laboratory Sciences, NCEH, Atlanta, GA  

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1. Describe the role of hair testing in identification of fetal exposure to methyl mercury in epidemiologic studies
2. Discuss 3 characteristics of hair testing that are relevant to interpretation of levels of metals in hair 
3. Discuss common laboratory issues that often confound measurements performed in alternative biological matrices. 
4. Discuss the utility of 24 hour urine collections vs spot urine collections
5. Describe the role of reporting urinary creatinine corrected measurements
6. Describe methods to evaluate for sample contamination from equipment used during collection
   
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History and Current Recommendations for Provoked Challenge Urine Testing
Anne-Michelle Ruha, MD, FACMT, Banner Good Samaritan Medical Center, Phoenix, AZ 

Objectives:

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1. Describe the historic use of chelation challenge testing in acute metal poisoning
2. Discuss the concept of "body burden" and organ-specific toxicity or measurements

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The Scientific Basis for Chelation: Animal Studies and Lead Chelation
Donald Smith, PhD, University of California-Santa Cruz, Santa Cruz, CA 

Objectives:

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1. List the reasons that animal derived data is relied upon for evaluating human toxicity and treatment modalities
2. Discuss the types of animal studies used in assessing human toxicity and treatment modalities
3. Explain the limitation of interpreting animal derived data with respect to human toxicity and treatment modalities  

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The Role of Chelation in the Treatment of Lead Poisoning
Walter J. Rogan, MD, MPH, National Institute for Environmental Health Sciences, Research Triangle Park, NC

Objectives:
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1. Discuss the clinical toxicity of lead on human health
2. Describe the known beneficial effects of chelation therapy on lead poisoning
3. Identify the risk/benefit issues associated with chelation therapy for lead poisoning  

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The Role of Chelation During Pregnancy in the Lead Poisoned Patient
Mary Jean Brown, ScD, Centers for Disease Control and Prevention, Atlanta, GA 

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1. Describe the risk/benefit issues to the mother of chelation therapy for lead
2. Describe the risk/benefit issues to the developing child of chelation therapy for lead 
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The Weight of the Evidence: The Role of Chelation in the Treatment of Arsenic and Mercury Poisoning
Michael J. Kosnett, MD, MPH, FACMT, University of Colorado, Denver, CO 

Objectives:

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1. To recognize the clinical and laboratory findings associated with acute and chronic intoxication by inorganic arsenic and various forms of mercury
2. To understand experimental and clinical data pertaining to the use of chelating agents in the treatment of arsenic and mercury intoxication
3. To identify rationale regimens for the clinical use of specific chelating agents in the treatment of intoxication by arsenic and mercury compounds
4. Identify the risk/benefit issues associated with chelation therapy for arsenic and mercury poisonings.

 
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The Role of Chelation in the Treatment of Other Metal Poisonings
Silas W. Smith, MD, New York University, New York, NY

Objectives:

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1. Describe the indications for chelation in other types of metal poisonings including cobalt, chromium, bismuth, cadmium, and aluminum (final list to be determined)
2. Discuss the risk/benefit issues for chelation of other metals
3. List the chelators that are most appropriate for each of these metals 

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The Use and Abuse of Chelation Therapy for Autism Spectrum Disorders
Jeffrey Brent, MD, PhD, FACMT, University of Colorado, Denver, CO

Objectives:

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1. Describe the indications for chelation therapy in patients with autism spectrum disorders (ASD)
2. Discuss the scientific data implicating mercury from vaccines as a cause of ASD, and the weaknesses thereof
3. Explain the pitfalls in the diagnosis of mercury toxicity 

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Panel Discussion: Practical Application of Evidence-Based Chelation Recommendations
Charles A. McKay, MD, FACMT, University of Connecticut, Hartford, CT 

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1. Summarize the available evidence for or against chelation therapy in
a variety of clinical conditions engaging the panel (other faculty)
2. List the important steps in assessing existing and new claims
regarding effectiveness of chelation therapy;
3. Explain the evidence based medicine approach to grading the usefulness of chelation therapy
4. Summarize the reasons that provoked challenges are not recommend 

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Funding for this conference was made possible (in part) by the cooperative agreement award number 1U61TS000117-03 from the Agency for Toxic Substances and Disease Registry (ATSDR). The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.