SCIENTIFIC POINT OF VIEW Rasmus Damsgaard, MD, PhD; FIS Medical - PowerPoint PPT Presentation

1 RATIONEL PANIC – FROM A SCIENTIFIC POINT OF VIEW Rasmus Damsgaard, MD, PhD; FIS Medical Committee

S-EPO (erythropoeitin) 2

The production of Red Blood Cells 3

FIS Blood Testing 4 FIS before Bengt Saltin FIS after Bengt Saltin 17 17 16 16 Male Male 15 15 Female Female 14 14 13 13 1987/1988 1989 1994 1995 1996 1997 1998 1999 2001/2002 1987/1988 1989 1994 1995 1996 1997 1998 1999 2001/2002 Morkeberg J, Saltin B, Belhage B, Damsgaard R. Blood profiles in elite cross- country skiers: a 6-year follow-up. Scand J Med Sci Sports. 2008 Feb 17

Blood Profiles 5 Normal EPO positive 20 3 19 18 17 2.5 16 15 14 2 13 12 11 10 1.5 9 8 7 1 6 5 4 0.5 3 2 1 0 0 23-Nov-01 27-Nov-01 1 4-Dec-01 1 6-Dec-01 05-Jan-02 1 8/01 /02

Blood Profiles 6 Normal EPO positive

Erythropoietin 7

The EPO Test ( Lasne F , de Ceaurriz J. Nature 2000) 8 Neo- Eprex Early Later TdF Control recormon EPO inj. EPO inj. Cyclist Subject 1998

EPO Profile 9

EPO Profile 10

Previous EPO technical document 11

Olympic Athlete (ref. Süddeutschen Zeitung ) 12 Blood Collection Period: 2000-2010 • No. of blood screenings >100 • No. of Urine EPO = unknown but many • Abnormal blood profile • No. of positive EPO tests = 0 •

Blood Profile Results (ref. Süddeutschen Zeitung) 13 FACTS Olympic Athlete Normal o Haemoglobin variation <5% o Reticulocytes range 1%-3.5% o Withdrawing of 1300 mL blood = reticulocytes >2.5% o EPO injections >4000 IE three days a week = reticulocytes >2.5% o Extensive but unknown no. of negative EPO tests in- and Out-Of-Competition DOPING CONCLUSION • EPO in large amount or a combination of EPO and blood transfusion with constant hemodilution (saline or albumin) for10 consecutive years including the Olympic Games, World Championships and World Series without being caught…

Olympic Athlete (Medical Condition) 14 • Benign Reticulocytosis

Clenbuterol 15  Beta2agonist (asthma medication)  Clenbuterol may increase fat free mass in some animals  Clenbuterol is not approved for human or animal treatment  Clenbuterol is, however, found in meat from livestock (11% in Mexico – an increase of 6%)  There is no scientific evidence that Clenbuterol is anabolic in humans  Clenbuterol is found in some nutritional supplements without being declared  A number athletes have been tested positive for low concentrations of clenbuterol especially after competing in Mexico and China  A number of tourists returning from Mexico and China have been found with Clenbuterol in their urine. Contents that were not present upon departure.

Clenbuterol 16  One of the largest food poisoning cases involving clenbuterol happened in Shanghai in September 2006, when 336 people were hospitalized after eating pig meat or organs contaminated with the additive, China Daily  Many more cases of recent clenbuterol poisoning is published

Clenbuterol (ref. Cyclingnews.com) 17 Dimitrij OVTCHAROV’s

Two Cases of Clenbuterol (ref. Cyclingnews.com, Sport Federations, various News papers) 18  Same International Federation  Same competition  Same hotel  Same food  Same time

Two Cases of Clenbuterol 19 Athlete 1 (5 months) Athlete 2 (11 months)  Positive test 25 April 2010  Positive test 25 April 2010  Notified late September  8 October 2010 2010 sanctioned 1 year  21 March acquitted from the use of Clenbuterol  8 June, decision appealed by WADA

PS. 20 • The case with the table tennis player, Dimitrij Otcharov , who was tested positive with a similar content of Clenbuterol was acquitted and his case was NOT APPEALED.

Thank You 21