CAS 2008/A/1470 World Anti-Doping Agency (WADA) v. Fédération Internationale des Luttes Associées (FILA) & Mohamed Ibrahim Abdelfattah

Related case:

CAS 2007_A_1365 WADA vs FILA & Mohamed Ibrahim Abdelfattah
December 11, 2007

• Wrestling
• Doping (refusal to submit to an out of competition doping control)
• Identification of the entities entitled to conduct out-of-competition testing
• Standard of proof under Swiss law
• Absence of departure from the applicable standards

1. Based upon the applicable rules of the relevant international federation, WADA as well as the national anti-doping organization of any country where an athlete is present is authorized to conduct out-of-competition testing on any athlete affiliated to the international federation.

2. Swiss law allows for a wide variety of methods of proof, ranging from a magistrate’s deductions from presumptions and evidence to direct proof such as written documents, witness statements, confessions, evidence of facts, experts, etc. It is on the basis of the evidence before them that the members of a CAS panel, in full discretion, must come to an opinion – their firm conviction (“intime conviction”) – as to facts established. A CAS panel may consider any evidence, even circumstantial evidence. Therefore, based on objective criteria, a panel must be convinced of the occurrence of an alleged fact. However, no absolute assurance is required; it suffices that the tribunal has no serious doubts on a specific fact or that the remaining doubts appear to be light. Those methods of proof are applicable for the evaluation by a CAS panel of an athlete’s actual command of the English language. Accordingly, a panel can consider than an athlete was able to understand the statements that were being made to him in English and to answer and to ask questions such that the sample-collection session could take place in a fair manner and that no interpreter was needed.

3. The requirements included in the applicable regulations regarding notification process, identification requirements, sample collection process, information about rights and duties and planning obligations are fully complied with when, based on the facts and evidence submitted by the parties, (i) the alleged deviations by the doping control officer from the anti-doping rules and the International Standard for Testing are not proven and (ii) the panel is convinced beyond reasonable doubt that the doping control officer correctly identified himself to the athlete who was informed of and understood his/her rights and obligations.

In July 2007 the World Anti-Doping Agency (WADA) reported an anti-doping rule violation against the Egyptian wrestler Mohamed Ibrahim Abdelfattah after he refused to provide a sample out-of-competition to USADA agents acting as representative of WADA.

However the International Federation of Associated Wrestling Styles (FILA) decided on 31 July 2007 to impose a warning on the Athlete for his anti-doping violation.

WADA appealed this decision with the Court of Arbitration for Sport (CAS) and on 11 December 2007 (CAS 2007/A/1365) the Panel decided to annul the Appealed Decision and to refer the case back to FILA.

During the CAS proceedings a set of FILA disciplinary decisions were rendered between July 2007 and September 2007 including the imposition on the Athlete of a 6 months sanction on 28 September 2007.

As a result of the CAS decision of 11 December 2007 (CAS 2007/A/1365) the Athlete's case was referred back to FILA and on 19 December 2007 the FILA Federal Appeal Commission decided to confirm the previous sanction imposed on 28 September 2007.

Hereafter WADA filed a new appeal with CAS against the confirmed FILA sanction of 6 months. WADA requested the Panel to set aside the Appealed Decision and to impose a 2 year period of ineligibility on the Athlete.

WADA contended that the USADA agents had the authority to conduct the out-of-competition testing on the Athlete. He was duly informed of his rights and obligations as well as of the consequences of a refusal to submit to doping control.

WADA asserted that the Athlete’s allegations are in contradiction with the statements made by the USADA agents. Here the Athlete alleged that departures from the Rules and the IST occurred and that serveral of his personal rights were violated, notably because of his lack of ability in English.

The Panel establishes that USADA had the authority to conduct the out-of-competition sample collection on the Athlete and that no departure from the applicable regulations occurred during the notification process. The Panel finds beyond any doubt that the Athlete’s level of English must have been sufficient to permit him to understand the statements that were being made to him in English.

The Panel concludes that the Athlete committed an anti-doping rule violation and he failed to establish that he bears No Significant Fault or Negligence in this case.

Therefore on 3 September 2008 the Court of Arbitration for Sport decides:

1.) The Appeal of the WADA against the decision rendered on 19 December 2007 by the FILA Federal Appeal Commission is admissible.

2.) The decision rendered on 19 December 2007 by the FILA Federal Appeal Commission is set aside.

3.) Mr Mohamed Ibrahim Abdelfattah is declared ineligible for a period of 24 months running from 18 June 2008, less a period of 6 months which has already been served by the athlete.

4.) All results achieved between 24 January 2008 and 17 June 2008 are disqualified and any medals, points and prizes obtained during such period are forfeited.

5.) This award is pronounced without cost, except for the Court Office fee of CHF 500 (five hundred Swiss Francs) already paid and to be retained by the CAS.

6.) All other motions or prayers for relief are dismissed.

CAS 2007/A/1365 WADA v/FILA & Mohamed Ibrahim Abdelfattah

Related case:

CAS 2008_A_1470 WADA vs FILA & Mohamed Ibrahim Abdelfattah
September 3, 2008

In July 2007 the World Anti-Doping Agency (WADA) reported an anti-doping rule violation against the Egyptian wrestler Mohamed Ibrahim Abdelfattah after he refused to provide a sample to USADA agents acting as representative of WADA.

Consequently the International Federation of Associated Wrestling Styles (FILA) decided on 31 July 2007 to impose only a warning on the Athlete for his refusal.

Hereafter in August 2007 the World Anti-Doping Agency (WADA) appealed the decision of FILA with the Court of Arbitration for Sport (CAS). WADA requested the CAS Panel to set aside the FILA decision of 31 July 2007 and to impose a 2 year period of ineligibility on the Athlete.

Also in this case a number of FILA disciplinary decisions were rendered between July 2007 and September 2007 regarding the Athlete’s provisional suspension and the imposition of a 6 months sanction.

The Panel establishes that the Appealed Decision was a ‘final’ decision and that the appeal filed by WADA was admissible. The Panel finds that the Appealed Decision was adopted by a FILA body - the Executive Committee - which clearly did not hold the power and competence to adopt such a disciplinary decision. Accordingly, the Panel deems the Appealed Decision to be null and void.

The Panel determines to refer the case back to FILA, so that the FILA Federal Appeal Commission may adopt a final disciplinary decision with regard to the Athlete's case. Thereafter, any dissatisfied party will still have the right to appeal before the CAS.

Therefore the Court of Arbitration for Sport decides on 11 December 2007 that:

1.) The Appeal of WADA against the FILA Executive Committee's decision of 31 July 2007 is admissible.

2.) The FILA Executive Committee's decision of 31 July 2007 is set aside.

3.) The case of Mr Mohammed Ibrahim Abdelfattah is referred back to FILA, so that the FILA Federal Appeal Commission may render its decision within the currently pending appellate procedure.

4.) The award is pronounced without costs, except for the Court Office fee of CHF 500 (five hundred Swiss Francs) already paid by WADA and to be retained by the CAS.

5.) FILA shall pay an amount of CHF 1'500 (one thousand five hundred Swiss Francs) to WADA as a contribution towards its costs.

CAS 2009/A/1915 World Anti-Doping Agency (WADA) v. Polish Wrestling Federation (PWF), Kamil Blonski & Wojciech Zieziulewicz

• Wrestling
• Doping (methyltestosterone)
• Applicability of the WADA Code
• No significant fault or negligence and principle of proportionality
• High standard of athletes’ responsibility for nutritional supplements
• Investigation required before the consumption of a nutritional supplement
• Duty of care required for no significant fault or negligence

1. In accordance with Article R58 of the Code the “applicable regulations” refer to the statutes and regulations of the International Federations (IFs) which must be incorporated by the National Federations (NFs). As a signatory of the WADA Code (WADC), IFs incorporate the WADC into their Constitution and Anti-Doping Rules (ADR). Through this channel only, the WADC may apply. The rules of NFs are applicable to the extent that they do not conflict with the rules of IFs.

2. The proportionality principle which had been applied by CAS panels as a general legal principle in its earlier jurisprudence has been codified in Article 10.5 of the WADC 2003 allowing a sanctioning authority to consider exceptional circumstances of the case in order to lower the sanction instead of imposing a fixed sanction. Through the WADC 2003 the principle of proportionality was codified and thereby adjusted to the needs of the anti-doping law. The codification is in line with the requirements of the general proportionality principle and human rights. CAS has stated at various occasions that the WADC “enables the Panel to satisfy the general principle of proportionality” and there is no room to apply the proportionality principle beyond the application of Article 10.5.2 WADC 2003.

3. As it is generally known, nutritional supplements are often contaminated with or contain prohibited substances which are not declared on the label or package. The high standard of responsibility has been specified by warnings issued by the sport organizations. In practicing sport the athletes are bound by the provisions of their IF including its ADR and the high duty of care requested therein. This is a severe professional duty of care which is not incumbent on normal citizens and goes far beyond the standards of duty applicable to normal people.

4. Against the background of the content of the manufacturer’s website and the leaflet of the product, further investigation is mandatory before the consumption of a nutritional supplement. A check of the announcements in the internet and the product label, its package or leaflet is not sufficient. Even if the website and leaflet do not indicate prohibited substances openly, it is common knowledge that food supplements often contain undeclared substances or are contaminated with prohibited substances. Therefore, it is part of the athletes’ responsibility not to trust publicity on the website or the content of the label or leaflet.

5. By simply trusting the club personnel in what nutritional supplements they are given and the oral information provided by the support personnel that the products are clean, the athletes do not exercise the duty of care which is required in order to bear no significant fault or negligence only. Even if it is accepted that the athletes are misled by the club personnel and the seller and distributor of the supplements which are in close economic relation with the club, they are not relieved from their personal responsibility to make sure that no prohibited substance enters their bodies. Athletes do not escape liability when they simply trust their club’s staff or other supporting personnel.

On 15 May 2009 the Polish Wrestling Federation (PWF) decided to impose a 1 year period of ineligibility on the Polish wrestlers Kamil Blonski and Wojciech Zieziulewics after their A and B samples tested positive for the prohibited substance Methyltestosterone. Despite the appeal of the World Anti-Doping Agency (WADA) the decision was uphold by the PWF on 29 June 2009.

Hereafter in July 2009 WADA appealed the PWF decision with the Court of Arbitration for Sport (CAS). WADA requested the Panel to set aside the decision of 29 June 2009 an to impose a 2 year period of ineligibility on the Athletes.

WADA rejected the arguments in favour of the Athletes and argued that the Fault or Negligence of the Athletes was significant for using a product that clearly indicated that it enhance performances.

The PWF contended that the Athletes had established how the prohibited substance had entered their system and that they had acted not intentionally and with a normal degree of fault. The Athletes used the product to gain weight and they did not conceal the use of the product.

Considering the evidence in this case the Panel concludes that the Athletes could not demonstrate No Significant Fault or Negligence because they failed to conduct a thorough investigation of the product in question before using it.

Therefore on 12 August 2010 the Court of Arbitration for Sport decides:

1.) Tho appeal of WADA is declared admissible and upheld.

2.) The decision of the Disciplinary Arbitration Commission of the PWF adopted on 29 June 2009 is set aside.

3.) Mr. Kamil Blonski and Mr. Wojciech Zieziulewics are sanctioned with a two year period of ineligibility starting on the date of this Award. The period of provisional suspension served by Mr. Kamil Blonski and Mr. Wojciech Zieziulewics since 17 December 2008, i.e.,one year, seven montht and 26 days, shall be credited against the total period of two years.

4.) All competitive results obtained by Mr. Kamil Blonski and Mr. Wojciech Zieziulewics from 17 December 2008 through the commencement of the applicable period of ineligibility shall be disqualified with all resulting consequences, including forfeiture of any medals, points and prizes.

5.) This Award is pronounces without costs except for the non-reimbursable Court Office Fee of CHF 500,- allready paid and to be retained by the CAS, The parties bear their own legal and other costs. PWF is ordered to contribute CHF 3.000,- to the costs incurred by WADA.

6.) All other prayers for relief are dismissed.

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.

Following 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 Appealed Decision 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. Neither had 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 had 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 / 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 / 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 / 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 / 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 / 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 / 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.