CAS 2007_A_1399 WADA vs FILA & Maria Stadnyk

17 Jul 2008

CAS 2007/A/1399 World Anti-Doping Agency (WADA) v. International Federation of Associated Wrestling Styles (FILA) & Maria Stadnyk

Related case:
Swiss Federal Court 4A_416_2008 Maria Stadnyk & Azerbaijan Wrestling Federation vs WADA & FILA
March 17, 2009

Wrestling
Doping (furosemide)
WADA’s obligations with respect to decisions taken by associations and federations
CAS power of review
Precondition to the defence of No Significant Fault or Negligence
Sanction in case of delays in the process not attributable to the athlete

1. There is no obligation for WADA to inform itself on an ongoing basis about decisions that are going to be taken by associations and federations. Rather, federations, such as FILA, obligate themselves to report on compliance with the World Anti-Doping Code in order to keep WADA updated (according to Article 17 of FILA Anti-Doping Regulations). It cannot possibly be expected of WADA to monitor the web sites of sport associations in order to find out whether any sanctions have been suspended. As a matter of practice, it is also often impossible for WADA to monitor such decision-making processes as these proceedings and decisions are not necessarily displayed on websites.

2. According to Article 57 of the CAS Rules, a CAS panel is entitled to review the case de novo and the athlete’s rights are preserved notwithstanding how the earlier decision-making process took place within the first instance.

3. Establishing how a prohibited substance entered an athlete’s system is a fundamental precondition to the defence of “no significant fault or negligence” under the applicable rules.

4. According to the applicable Anti-Doping Regulations, delays in the hearing process or other aspects of Doping Control not attributable to the athlete, the federation concerned or the Anti-Doping Organization imposing the sanction may start the period of ineligibility at an earlier date commencing as early as the date of sample collection. Fairness does require that the period of ineligibility starts earlier if – for reasons beyond the athlete’s control, notably linked to the fact that WADA was informed very late about the decision under appeal and therefore this proceeding began later and linked to the fact that the number of questions raised by this case made the CAS proceedings more protracted than usual – the athlete had to live with the uncertainty of whether s/he could prepare for and validly participate in qualifications for the Olympic Games, despite this being a particularly important event in any athlete’s career.


On 31 May 2006 the International Federation of Associated Wrestling Styles (FILA) decided to impose a 1 year period of ineligibility on the Ukrainian wrestler Maria Stadnyk after her sample tested positive for the prohibited substance Furosemide. At that time she was registered with the Ukrainian Wrestling Association and later registered with the Azerbaijan Wrestling Federation.

After deliberations between the World Anti-Doping Agency (WADA) and FILA the case was reopened and on 4 September 2006 a sanction of 2 years was imposed by FILA. However on 20 June 2007 the FILA Appeal Commission decided to reduce the sanction and to impose a 15 month period of ineligibility on the Athlete. Here new evidence was introduced that showed that the Athlete’s drink was spiked by another Athlete.

Hereafter in October 2007 WADA appealed the FILA decision of 20 June 2007 with the Court of Arbitration for Sport (CAS). WADA requested the Panel to set aside the FILA decision of 20 June 2007 and to impose a 2 year period of ineligibility on the Athlete.

WADA contended that the Athlete tested positive for a prohibited substance and that she failed to establish how the substance entered her system nor that she established No Fault or No Significant Fault.
The Athlete denied the intentional use of the substance nor that she had problems to fit into her weight category. She asserted that the evidence demonstrated that another Athlete spiked her drink.

The Panel considered the coinciding statements and testimony of the Athletes in question and the certain points of relevance. Here the Panel finds on balance that it is improbable that the Athlete’s drinking water was spiked with Furosemide by another Athlete as alleged while it is more probable than not that the other Athlete did not sabotage the Athlete’s drink. As a result the Panel concludes that the Athlete failed to establish how the substance entered her system nor that she establish No Fault or Nog Significant Fault.

Therefore on 17 July 2008 the Court of Arbitration for Sport decides:

1.) The Court of Arbitration for Sport has jurisdiction to decide the present dispute.
2.) The appeal filed by the World Anti-Doping Agency on 11 October 2007 is admissible.
3.) The World Anti-Doping Agency's appeal is granted.
4.) The decision of FILA, dated 20 June 2007, is set aside.
5.) Ms. Maria Stadnyk is sanctioned with a two-year period of ineligibility, starting on 26 April 2006 and having expired on 25 April 2008.
6.) All results obtained by Ms. Maria Stadnyk in any competitions between 26 April 2006 and 25 April 2008 are disqualified and any medals, points or prizes obtained are forfeited.
7.) The Azerbaijan Wrestling Federation shall pay to WADA an amount of CHF 5,000 (five thousand Swiss Francs) as compensation for fees and expenses incurred in connection with this atbitration.
8.) The award is rendered without costs, except for the CAS office fee that is retained by CAS.
9.) All other prayers for relief are dismissed.

The effects of growth hormone on body composition and physical performance in recreational athletes: a randomized trial.

4 May 2010

The effects of growth hormone on body composition and physical performance in recreational athletes: a randomized trial / Udo Meinhardt, Anne E. Nelson, Jennifer L. Hansen, Vita Birzniece, David Clifford, Kin-Chuen Leung, Kenneth Graham, Ken K.Y. Ho. - (Annals of Internal Medicine 152 (2010) 9 (4 May); p. 568-577)

  • PMID: 20439575
  • DOI: 10.7326/0003-4819-152-9-201005040-00007


Abstract

Background: Growth hormone is widely abused by athletes, frequently with androgenic steroids. Its effects on performance are unclear.

Objective: To determine the effect of growth hormone alone or with testosterone on body composition and measures of performance.

Design: Randomized, placebo-controlled, blinded study of 8 weeks of treatment followed by a 6-week washout period. Randomization was computer-generated with concealed allocation. (Australian-New Zealand Clinical Trials Registry registration number: ACTRN012605000508673)

Setting: Clinical research facility in Sydney, Australia.

Participants: 96 recreationally trained athletes (63 men and 33 women) with a mean age of 27.9 years (SD, 5.7).

Intervention: Men were randomly assigned to receive placebo, growth hormone (2 mg/d subcutaneously), testosterone (250 mg/wk intramuscularly), or combined treatments. Women were randomly assigned to receive either placebo or growth hormone (2 mg/d).

Measurements: Body composition variables (fat mass, lean body mass, extracellular water mass, and body cell mass) and physical performance variables (endurance [maximum oxygen consumption], strength [dead lift], power [jump height], and sprint capacity [Wingate value]).

Results: Body cell mass was correlated with all measures of performance at baseline. Growth hormone significantly reduced fat mass, increased lean body mass through an increase in extracellular water, and increased body cell mass in men when coadministered with testosterone. Growth hormone significantly increased sprint capacity, by 0.71 kJ (95% CI, 0.1 to 1.3 kJ; relative increase, 3.9% [CI, 0.0% to 7.7%]) in men and women combined and by 1.7 kJ (CI, 0.5 to 3.0 kJ; relative increase, 8.3% [CI, 3.0% to 13.6%]) when coadministered with testosterone to men; other performance measures did not significantly change. The increase in sprint capacity was not maintained 6 weeks after discontinuation of the drug.

Limitations: Growth hormone dosage may have been lower than that used covertly by competitive athletes. The athletic significance of the observed improvements in sprint capacity is unclear, and the study was too small to draw conclusions about safety.

Conclusion: Growth hormone supplementation influenced body composition and increased sprint capacity when administered alone and in combination with testosterone.

Primary funding source: The World Anti-Doping Agency.

Systematic review: the effects of growth hormone on athletic performance.v

17 Mar 2008

Systematic review : the effects of growth hormone on athletic performance / Hau Liu, Dena M. Bravata, Ingram Olkin, Anne Friedlander, Vincent Liu, Brian Roberts, Eran Bendavid, Olga Saynina, Shelley R. Salpeter, Alan M. Garber, Andrew R. Hoffman. - (Annals of Internal Medicine 148 (2008) 10 (20 May); p. 747-758)

  • PMID: 18347346
  • DOI: 10.7326/0003-4819-148-10-200805200-00215


Abstract

Background: Human growth hormone is reportedly used to enhance athletic performance, although its safety and efficacy for this purpose are poorly understood.

Purpose: To evaluate evidence about the effects of growth hormone on athletic performance in physically fit, young individuals.

Data sources: MEDLINE, EMBASE, SPORTDiscus, and Cochrane Collaboration databases were searched for English-language studies published between January 1966 and October 2007.

Study selection: Randomized, controlled trials that compared growth hormone treatment with no growth hormone treatment in community-dwelling healthy participants between 13 and 45 years of age.

Data extraction: 2 authors independently reviewed articles and abstracted data.

Data synthesis: 44 articles describing 27 study samples met inclusion criteria; 303 participants received growth hormone, representing 13.3 person-years of treatment. Participants were young (mean age, 27 years [SD, 3]), lean (mean body mass index, 24 kg/m2 [SD, 2]), and physically fit (mean maximum oxygen uptake, 51 mL/kg of body weight per minute [SD, 8]). Growth hormone dosage (mean, 36 microg/kg per day [SD, 21]) and treatment duration (mean, 20 days [SD, 18] for studies giving growth hormone for >1 day) varied. Lean body mass increased in growth hormone recipients compared with participants who did not receive growth hormone (increase, 2.1 kg [95% CI, 1.3 to 2.9 kg]), but strength and exercise capacity did not seem to improve. Lactate levels during exercise were statistically significantly higher in 2 of 3 studies that evaluated this outcome. Growth hormone-treated participants more frequently experienced soft tissue edema and fatigue than did those not treated with growth hormone.

Limitations: Few studies evaluated athletic performance. Growth hormone protocols in the studies may not reflect real-world doses and regimens.

Conclusion: Claims that growth hormone enhances physical performance are not supported by the scientific literature. Although the limited available evidence suggests that growth hormone increases lean body mass, it may not improve strength; in addition, it may worsen exercise capacity and increase adverse events. More research is needed to conclusively determine the effects of growth hormone on athletic performance.

Growth hormone, IGF-I and insulin and their abuse in sport.

31 Mar 2008

Growth hormone, IGF-I and insulin and their abuse in sport / R.I.G. Holt, P.H. Sönksen. - (British Journal of Pharmacology 154 (2008) 3 (June); p. 542-556)

  • PMID: 18376417
  • PMCID: PMC2439509
  • DOI: 10.1038/bjp.2008.99


Abstract

There is widespread anecdotal evidence that growth hormone (GH) is used by athletes for its anabolic and lipolytic properties. Although there is little evidence that GH improves performance in young healthy adults, randomized controlled studies carried out so far are inadequately designed to demonstrate this, not least because GH is often abused in combination with anabolic steroids and insulin. Some of the anabolic actions of GH are mediated through the generation of insulin-like growth factor-I (IGF-I), and it is believed that this is also being abused. Athletes are exposing themselves to potential harm by self-administering large doses of GH, IGF-I and insulin. The effects of excess GH are exemplified by acromegaly. IGF-I may mediate and cause some of these changes, but in addition, IGF-I may lead to profound hypoglycaemia, as indeed can insulin. Although GH is on the World Anti-doping Agency list of banned substances, the detection of abuse with GH is challenging. Two approaches have been developed to detect GH abuse. The first is based on an assessment of the effect of exogenous recombinant human GH on pituitary GH isoforms and the second is based on the measurement of markers of GH action. As a result, GH abuse can be detected with reasonable sensitivity and specificity. Testing for IGF-I and insulin is in its infancy, but the measurement of markers of GH action may also detect IGF-I usage, while urine mass spectroscopy has begun to identify the use of insulin analogues.

Detecting autologous blood transfusions: a comparison of three passport approaches and four blood markers.

10 Mar 2011

Detecting autologous blood transfusions: a comparison of three passport approaches and four blood markers / J. Mørkeberg, K. Sharpe, B. Belhage, R. Damsgaard, W. Schmidt, N. Prommer, C.J. Gore, M.J. Ashenden. - (Scandinavian journal of medicine & science in sports 21 (2011) 2 (April); p. 235-243)

  • PMID: 19903320
  • DOI: 10.1111/j.1600-0838.2009.01033.x


Abstract

Blood passport has been suggested as an indirect tool to detect various kinds of blood manipulations. Autologous blood transfusions are currently undetectable, and the objective of this study was to examine the sensitivities of different blood markers and blood passport approaches in order to determine the best approach to detect autologous blood transfusions. Twenty-nine subjects were transfused with either one (n=8) or three (n=21) bags of autologous blood. Hemoglobin concentration ([Hb]), percentage of reticulocytes (%ret) and hemoglobin mass (Hbmass) were measured 1 day before reinfusion and six times after reinfusion. The sensitivity and specificity of a novel marker, Hbmr (based on Hbmass and %ret), was evaluated together with [Hb], Hbmass and OFF-hr by different passport methods. Our novel Hbmr marker showed superior sensitivity in detecting the highest dosage of transfused blood, with OFF-hr showing equal or superior sensitivities at lower dosages. Hbmr and OFF-hr showed superior but equal sensitivities from 1 to 4 weeks after transfusion compared with [Hb] and Hbmass, with Hbmass being the only tenable prospect to detect acute transfusions. Because autologous blood transfusions can be an acute practice with blood withdrawal and reinfusion within a few days, Hbmass seems to be the only option for revealing this practice.

Biochemistry, physiology, and complications of blood doping: facts and speculation.

1 Aug 2006

Biochemistry, physiology, and complications of blood doping: facts and speculation / Giuseppe Lippi, Massimo Franchini, Gian Luca Salvagno, Gian Cesare Guidi. - (Critical Reviews in Clinical Laboratory Sciences 43 (2006) 4; p. 349-391)

  • PMID: 16769597
  • DOI: 10.1080/10408360600755313


Abstract

Competition is a natural part of human nature. Techniques and substances employed to enhance athletic performance and to achieve unfair success in sport have a long history, and there has been little knowledge or acceptance of potential harmful effects. Among doping practices, blood doping has become an integral part of endurance sport disciplines over the past decade. The definition of blood doping includes methods or substances administered for non-medical reasons to healthy athletes for improving aerobic performance. It includes all means aimed at producing an increased or more efficient mechanism of oxygen transport and delivery to peripheral tissues and muscles. The aim of this review is to discuss the biochemistry, physiology, and complications of blood doping and to provide an update on current antidoping policies.

Erythropoiesis-stimulating agents and other methods to enhance oxygen transport.

24 Mar 2008

Erythropoiesis-stimulating agents and other methods to enhance oxygen transport / S. Elliott. - (British Journal of Pharmacology 154 (2008) 3 (June); p. 529-541). - Special Issue: Themed Section: Drugs in Sport: Guest Editors: Professor J.C. McGrath and Professor D.A. Cowan

  • PMID: 18362898
  • PMCID: PMC2439521
  • DOI: 10.1038/bjp.2008.89


Abstract

Oxygen is essential for life, and the body has developed an exquisite method to collect oxygen in the lungs and transport it to the tissues. Hb contained within red blood cells (RBCs), is the key oxygen-carrying component in blood, and levels of RBCs are tightly controlled according to demand for oxygen. The availability of oxygen plays a critical role in athletic performance, and agents that enhance oxygen delivery to tissues increase aerobic power. Early methods to increase oxygen delivery included training at altitude, and later, transfusion of packed RBCs. A breakthrough in understanding how RBC formation is controlled included the discovery of erythropoietin (Epo) and cloning of the EPO gene. Cloning of the EPO gene was followed by commercial development of recombinant human Epo (rHuEpo). Legitimate use of this and other agents that affect oxygen delivery is important in the treatment of anaemia (low Hb levels) in patients with chronic kidney disease or in cancer patients with chemotherapy-induced anaemia. However, competitive sports was affected by illicit use of rHuEpo to enhance performance. Testing methods for these agents resulted in a cat-and-mouse game, with testing labs attempting to detect the use of a drug or blood product to improve athletic performance (doping) and certain athletes developing methods to use the agents without being detected. This article examines the current methods to enhance aerobic performance and the methods to detect illicit use.

Blood doping: infusions, erythropoietin and artificial blood.

1 Apr 2007

Blood doping : infusions, erythropoietin and artificial blood / E. Randy Eichner. - (Sports Medicine 37 (2007) 4-5 (April); p. 389-391)

  • PMID: 17465616
  • DOI: 10.2165/00007256-200737040-00030


Abstract

As science marches on, athletes and coaches march close behind. Researchers have long been interested in how red cell mass and blood volume affect exercise capacity. Interest in blood doping soared after the 1968 Mexico City Olympics. Studies in the 1970s and 1980s suggested that transfusing red cells could speed endurance performance. Diverse athletes of the time were accused of blood doping. In the late 1980s, recombinant human erythropoietin (EPO) began to supplant transfusion for doping. EPO use is a suspect in nearly 20 deaths in 4 years in European cyclists. In the 1998 Tour de France, a team was ejected for using EPO and six other teams quit the race. The beat goes on; in recent years, diverse endurance and sprint athletes have been caught or accused of using EPO. Tests to detect EPO are improving but are not yet foolproof. As EPO tests improve, blood transfusion is back in vogue and some athletes may have infused artificial blood. Tests for detecting artificial blood also exist, but it seems it will take widespread, year-round, unannounced, out-of-competition testing and stern penalties to deter blood doping.

Factors influencing the steroid profile in doping control analysis.

1 Jul 2008

Factors influencing the steroid profile in doping control analysis / Ute Mareck, Hans Geyer, Georg Opfermann, Mario Thevis, Wilhelm Schänzer. - (Journal of Mass Spectrometry 43 (2008) 7 (July); p. 877-891)

  • PMID: 18570179
  • DOI: 10.1002/jms.1457


Abstract

Steroid profiling is one of the most versatile and informative screening tools for the detection of steroid abuse in sports drug testing. Concentrations and ratios of various endogenously produced steroidal hormones, their precursors and metabolites including testosterone (T), epitestosterone (E), dihydrotestosterone (DHT), androsterone (And), etiocholanolone (Etio), dehydroepiandrosterone (DHEA), 5alpha-androstane-3alpha,17beta-diol (Adiol), and 5beta-androstane-3alpha,17beta-diol (Bdiol) as well as androstenedione, 6alpha-OH-androstenedione, 5beta-androstane-3alpha,17alpha-diol (17-epi-Bdiol), 5alpha-androstane-3alpha,17alpha-diol (17-epi-Adiol), 3alpha,5-cyclo-5alpha-androstan-6beta-ol-17-one (3alpha,5-cyclo), 5alpha-androstanedione (Adion), and 5beta-androstanedione (Bdion) add up to a steroid profile that is highly sensitive to applications of endogenous as well as synthetic anabolic steroids, masking agents, and bacterial activity. Hence, the knowledge of factors that do influence the steroid profile pattern is a central aspect, and pharmaceutical (application of endogenous steroids and various pharmaceutical preparations), technical (hydrolysis, derivatization, matrix), and biological (bacterial activities, enzyme side activities) issues are reviewed.

Exploring the potential ergogenic effects of glycerol hyperhydration.

1 Nov 2007

Exploring the potential ergogenic effects of glycerol hyperhydration / Jeff L. Nelson, Robert A. Robergs. - (Sports Medicine 37 (2007) 11; p. 981-1000)

  • PMID: 17953468
  • DOI: 10.2165/00007256-200737110-00005


Abstract

During athletic competition or recreational pursuits, a body's hydration level can become compromised, resulting in a decrement in performance. Glycerol (1,2,3-propanetriol) has been used to induce hyperhydration in an attempt to offset the deleterious effects of dehydration. When glycerol is consumed orally, it is rapidly absorbed primarily in the small intestine. It is reported to be evenly distributed among all fluid compartments, with the exception of the cerebral spinal fluid and aqueous humour, and promotes hyperhydration by inducing an osmotic gradient. Through an increase in the kidney's medullary concentration gradient, water absorption in the nephron is enhanced. When glycerol is consumed, the plasma glycerol concentration increases in proportion to the dose ingested, which easily exceeds the glycerol saturation point resulting in urinary glycerol excretion. Thus, without supplemental glycerol ingestion, there will be a decrease in the osmotic gradient resulting in a loss of hyperhydration. The ergogenic nature of glycerol has been investigated as to its effect on fluid retention, thermoregulation, cardiovascular responses and performance. While many studies provide evidence of hyperhydration, others do not. Only two studies reviewed showed a thermoregulatory advantage. Furthermore, the preponderance of evidence neither weighed for or against cardiovascular or performance advantages. What makes one study provide favourable results while another study does not is unclear. Possible explanations may include subject characteristics, environmental factors, research design, whether fluids with or without glycerol were given during exercise, the rate at which fluids are initially given to induce hyperhydration, the time between peak hyperhydration/peak plasma glycerol concentration and the trial (i.e. exercise), the glycerol dose (i.e. 1.0 g/kg body mass) and what it is based upon, the percentage glycerol solution (i.e. 5%, 20%), the variation of time between the end of the hydration protocol and the beginning of exercise, or perhaps the intensity of exercise (fixed, variable, percentage maximum oxygen uptake). What is clear is that glycerol has the capacity to enhance fluid retention. In so doing, glycerol hyperhydration may be a logistically preferred method due to concomitant decrease in urine output and free-water clearance, which may give a performance advantage by offsetting dehydration. Future research should focus on maintaining plasma glycerol concentrations at levels necessary to maintain osmotic forces required to support continued hyperhydration. Potential benefits of glycerol should be further explored to identify the circumstances or factors that may contribute to an ergogenic effect.

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