DCD Seminar 8 - Practical issues.ppt - European Athletics · monitor the flow of personnel in and out of the DCS and to prevent any unauthorized access ... • If athlete refuse to

Practical Issues

Part 1.The Doping Control StationThe Doping Control Station

• Solely to be used as Doping Control Station during

competition

• Clearly identified

• Sufficiently spacious (have potential number of athletes

plus chaperones plus accompanying persons in mind)

General Overview

plus chaperones plus accompanying persons in mind)

• Shall consist of an adequate waiting room and at least

two administrative working rooms and adjacent WCs

(both men and women) for urine tests

• Fully equipped with all necessary IAAF-approved

materials for doping control

• Security officer be positioned outside the DCS in order to

monitor the flow of personnel in and out of the DCS and

to prevent any unauthorized access

General Overview

to prevent any unauthorized access

Responsibility of the Competition organiser to ensure the

facilities are clean and adequate and that all materials

are acceptable prior to the start of the competition

Layout of Doping Control Station

• Provide special access passes for authorized access

(athletes and their accompanying persons)

• Clearly indicate that unauthorized access is forbidden

• Provide security guard at entrance

Securing the Doping Control Station

• Enough space for expected athletes

• Beverages (cold, room temperature, hot)

• TV or internet, if possible

• No phones or cameras allowed

The Waiting Room

• Number should be proportional (preferably minimum of

two rooms

• Close to the toilets

The Processing Rooms

• Equipped with table, 4 chairs, waste basket,…

• Bed (Blood station)

• Refrigerator, storage of material and samples

• Must ensure privacy of athletes

The Processing Rooms

• Spacious

• Must give room for DCO to check sample

giving

• Ideally equipped with mirror behind

• toilet

The Toilets

• toilet

• One for female and one for male

• Old stadium

• Inadequate or insufficient rooms

• Open Air event (marathons, cross country)

What if... .. ... the conditions are not perfect?

• Open Air event (marathons, cross country)

Inspection is necessary to assure that minimum

requirements are met:

• Controlled access

• Conditions for comfort and privacy of the athlete

• Integrity and security of the sample

Part 1.The Doping Control StationThe Doping Control Station

Part 2.Selection of athletesSelection of athletes

• Final position basis and/or random basis

• Other method including Target Testing

• Broken or equalled an Area and/or World Record

• National record if required

Selection of Athletes

• National record if required

• EPO test in race walking or running event (from 400 m upwards). Blood Sample shall be taken if it is practicable to do so

• Selection decisions disclosed only to those who need to know and as late as possible

• Selection may take into account some or all of the following factors:

– Abnormal bilogical parameters

– Injury


– Injury

– Behavior indicating doping

– Athlete reinstatement after a period of ineligibility

– Reliable information from a third party

– Major improvements in performance

– Athlete association with a third party such as coach or doctor with a history of involvement in doping

– Athlete test history

• In order to ensure that a greater percentage of ”at risk” athletes is selected

• It is recommended that athletes be chosen from different events including qualification rounds


• Even distribution among gender

• It is recommended that the winner shall be tested if the number of tests is enough

• DCD make the distribution among events before the competition

• DCD choose a trustworthy person to witness the place selection on site

• An equal distribution among countrys could also be into consideration

• If blood testing is to be done DCD must have contact with European Athletics/IAAF prior to the competition to recieve a proposal due to IAAF profile data bank


recieve a proposal due to IAAF profile data bank

• European Athletics/IAAF documented method shall be used for random selection

• Selection process must NOT be revealed to media

Part 2.Selection of athletesSelection of athletes

Part 3.Notification ProcessNotification Process

• No Advance Notice

• Unrestricted access to all areas

• Avoid in field or track if possible

• Preferably a.s.a.p after Mixed Zone

Notification of Athletes

• Preferably a.s.a.p after Mixed Zone

• Athlete normally the first one notified

• Accreditation card with photo is acceptable

• Under observation at all times

• Athletes rights and obligations

• Doping Control Chaperone script

• Sign an appropriate form

• Doping passes if available


• Doping passes if available

• If athlete refuse to sign chaperone must report to DCO/DCD

• No photos or autographs

• No mobile phone during notification process

• Document the reasons for any delay to DCS and/or leaving DCS after reporting for testing

• If the DCO gives approval for leaving DCS he shall agree either the time of his return or his return upon completion of an agreed activity


of an agreed activity

Part 3.Notification ProcessNotification Process

Part 4.Partial sample conductPartial sample conduct

• The Rules

IST: International Standard for Testing and IAAF anti-doping regulations edition 2011

Partial Sample Conduct

Where the volume of urine is insufficient:

< 90 ml (it is a minimum requirement, more is better especially for EPO analysis), the DCO shall conduct a partial Sample collection procedure.

Scope

The procedure begins with informing the Athlete that the Sample is not of Suitable Volume of Urine for Analysis and ends with the provision of a Sample of sufficient volume.


sufficient volume.

(irrespective of the time necessary for this)

Responsibility

The DCO has the responsibility for declaring the Sample volume insufficient and for collecting the additional Sample/s to obtain a combined Sample of sufficient volume.

Requirements

If the Sample collected is of insufficient volume, the DCO shall inform the Athlete that a further Sampleshall be collected to meet the Suitable Volume of Urine for Analysis requirements.


shall be collected to meet the Suitable Volume of Urine for Analysis requirements.

The DCO shall instruct the Athlete to select partial Sample Collection Equipment

Requirements

The DCO shall then instruct the Athlete to open the relevant equipment, pour the insufficient Sample into the container and seal it as directed by the DCO. The DCO shall check, in full view of the Athlete, that the


the container and seal it as directed by the DCO. The DCO shall check, in full view of the Athlete, that the container has been properly sealed

They Check that the equipment code number and the volume and identity of the insufficient Sample are recorded accurately by the DCO. The DCO shall retain control of the sealed partial Sample

While waiting to provide an additional Sample, the Athlete shall remain under continuous observationand be given the opportunity to hydrate.

Collection of urine Samples until a sufficient volume of


Collection of urine Samples until a sufficient volume of urine will be provided by combining the initial and additional Sample/s.

The athlete break the seal(s) of the partial sample containers

Urine should only be discarded when both the A (2/3) and B (1/3) bottles have been filled to a minimum of 90 ml

The Suitable Volume of Urine for Analysis shall be


The Suitable Volume of Urine for Analysis shall be viewed as an absolute minimum

Part 4.Partial sample conductPartial sample conduct

Part 5.Specific GravitySpecific Gravity

(at a given temperature and pressure,

e.g. 20°°°°C, 1.013 bar, no unit)

The SG is a relative density to clean water at the same

Urine

Density r = mass/volume (g/cm3)

Specific Gravity (SG)

The SG is a relative density to clean water at the same

temperature.

Example r (Urine sample, 20 °°°°C) = 1.020 g/mlSG (Urine sample) = 1.020/0.9982 = 1.0218

Obs: Instrument calibration at the same temperature

as the measurement.

Measuring specific Gravity (SG)

Refractometer

– Indirect measurement of SG

– The refractive index of urine is a measure

for how much the speed of light is

reduced inside the medium.

Dipstick (unreliable)

100 ml of a urine sample with a Specific gravity (SG) of 1.020 are diluted with

Resulting SG Dilution

100 ml 1.010 2 fold

300 ml 1.005 4 fold

Diluted urine samples

900 ml 1.002 10 fold

1900 ml of water 1.001 20 fold

While urine dilution not necessarily constitute a problem for

steroid analysis due to increased signal/noise ratio, a 10- or

20-fold dilution will most probably result in EPO levels below

the detection limit.

• Scope

The procedure begins with the DCO informing the Athlete that a further Sample is required and ends with the collection of a Sample that meets the requirements for Suitable Specific Gravity for Analysis, or appropriate follow-up action by the ADO if required.

Suitable Specific Gravity for AnalysisLow Gravity

for Suitable Specific Gravity for Analysis, or appropriate follow-up action by the ADO if required.

• Responsibility

The ADO is responsible for establishing procedures to ensure that a suitable Sample is collected. If the original Sample collected does not meet the requirement for Suitable Specific Gravity for Analysis, the DCO is responsible for collecting additional Samples until a suitable Sample is obtained.

The DCO shall check the residual urine to ensure that it meets the requirement for Suitable Specific Gravity for Analysis

Threshold of density must be:

Suitable Specific Gravity

Threshold of density must be:

<1.005 if refractometer is used

<1.010 if refractometer is not used

Requirements

While waiting to provide additional Samples, the

Athlete shall remain under continuous observation


Athlete shall remain under continuous observation

Requirements

The Athlete shall be encouraged not to hydrate, since this may delay the production of a suitable Sample. In


this may delay the production of a suitable Sample. In a delay of at least one hour.

Empty the bladder just after the discovering of the low specific gravity.

There are exceptional circumstances which mean

that for logistical reasons it is impossible to continue


that for logistical reasons it is impossible to continue

with the Sample Collection Session. Such exceptional

circumstances shall documented accordingly by the

DCO.

IAAF Comments – Good practice

Empty the bladder and don’t drink during one hour, take a new sample,


After many attempts, if the gravity stay low stop the procedure, make a report and send all the samples to the laboratory.

If the day after you have the possibility to re-test the athlete, do it.

Requirements

The DCO shall record that the Samples collected belong to a single and the order in which the


The DCO shall record that the Samples collected belong to a single Athlete and the order in which the Samples were provided.

Requirements

The DCO shall send to the laboratory for analysis all

Samples which were collected, irrespective of


Samples which were collected, irrespective of whether or not they meet the requirement for Suitable

Specific Gravity for Analysis

Part 5.Specific GravitySpecific Gravity

Part 6.TUE issuesTUE issues

Athlete has an illness or condition that require him/her

to take particular medication(s)

What is a Therapeutic Use Exemption (TUE)?

A Therapeutic Use Exemption (TUE) may give the athlete the authorisation to take the needed medicine(s).

The medication(s) given to the athlete happens to fall under the Prohibited List

• The athlete would experience significant health

problems without taking the prohibited substance or

method

• The therapeutic use of the substance would not produce

What are the criteria for granting a TUE?

• The therapeutic use of the substance would not produce

significant enhancement of performance

• There is no reasonable therapeutic alternative to the use

of the otherwise prohibited substance or method.

• World Anti-Doping Code

• International Standard for TUEs

• International Federations (IFs) and National Anti-

Who grants TUE

• International Federations (IFs) and National Anti-Doping Organizations (NADOs) must have a process, whereby athletes with documented medical conditions can request a TUE.

• Such request shall be appropriately dealt with by a panel of independent physicians called a Therapeutic Use Exemption Committee (TUEC).

• IFs and NADOs, through their TUECs, are then responsible for granting or declining such applications.

International Federation• International level athlete

• Athlete entered in an international event for which a TUE

issued by his International Federation (IF) is required

Where should an athlete submit a TUE Application?

issued by his International Federation (IF) is required

National Anti-Doping Organization (NADO)• National level athlete

� Athletes must not submit TUE Applications to more than

one Organisation

� WADA does not accept TUE Applications from athletes

� Athletes must request a TUE before taking a prohibited

Where should an athlete submit a TUE Application?

� Athletes must request a TUE before taking a prohibited

medication, at least 30 days before taking part in an

event

� Special protocols for TUE Applications may be in effect

during Major Events. Ask European Athletics or IAAF

medical department if there is any variation in the TUE submission protocol for the Event

During the control management

What should an athlete do if he/she is notified for

doping control while using a prohibited substance

under a granted TUE?

• When filling out the doping control form, DCO has

to ask the athlete to declare the substance or to ask the athlete to declare the substance or

medication being used and to specify that a TUE

has been granted

• It is preferable but not mandatory to attach the

copy of the TUE Approval form

Should athletes declare all medications (prescription or

otherwise) on the Doping Control Form at the time of

doping control?

• Yes! Athletes are advised to declare all medications and

other substances that are being taken or have been

taken in the previous seven days

During the control management

taken in the previous seven days

Part 6.TUE issuesTUE issues

Part 7.Supervision of preparation and Supervision of preparation and

conduct of testing and actions

after the event

After Having Accepted a Mission• Get acquainted with details of all applicable Anti-Doping

related rules and guidelines

• Obtain contact details of the Local Organising

Committee

• Contact the official in charge of doping control as soon

as the person is appointed by the LOC/Meeting

OrganiserOrganiser

• Obtain all relevant information from the Official in charge

of doping control concerning the proposed doping

control arrangements at the competition (staffing,

facilities, supplies, etc).

• Be aware of the respective national anti-doping

authorities and responsibilities to conduct tests

Actions to take before the Event

• Evaluate the adequacy of the Doping Control Station

(location & set up)

• Maintain regular contact with the official in charge of

doping control

• Provide progress report to the European Athletics Head • Provide progress report to the European Athletics Head

Office on regular basis

• Arange travel details to the venue with the LOC

• In case of pre-competition testing, obtain:

– Final Entries

– Athletes’ accommodation details

(room numbers, date and time of arrival)

• Evaluate the adequacy of the Medical Services

(if also appointed as Medical Delegate)

• Get information from LOC regarding:

– equipment to be used

Actions to take before the Event

– equipment to be used

– transportation of samples after testing

• Plan meeting with DCO in charge

• Plan meeting with Doping Control Chaperones

Check Requirements for DCOs

• Authorisation

• ID with name and photo

• Language (english mandatory)

• Familiar with IAAF forms and equipment• Familiar with IAAF forms and equipment

• Familiar with IAAF Anti-Doping rules and regulations

• Sufficient in numbers and of each gender

• Phlebotomist if needed (special ID)

• Must not be a minor

• Sufficient in number and of different gender

• No other duties during the Event

• Free from conflict of interest with athletes that might be

Check Requirements for Chaperones

• Free from conflict of interest with athletes that might be

tested

• Ability to:

- maintain confidential information

- Ability to speak English

- Ability to demonstrate respectful

• Training/education/exprience

– Aware of athletes rights and obligations

– Familiar with IAAF Notification Form

• Official authorisation and/or Identification card

Check Requirements for Chaperones

• Official authorisation and/or Identification card

• Equipped with pencil, clipboard, watch and mobile

phone

Checklist for Chaperones!

• Briefing of staff

• Review final doping control plan for Event

• Inspect Doping Control Station to ensure that

facilities meet requirements of IAAF Rules

• Check Security in Doping Control Station

Actions to take immediatelybefore the Event on Site

• Check Security in Doping Control Station

• Check sufficient number of collection vessels,

sample containers, partial sealing equipment

• Inspect place of notification

• Check Doping Control Request form in TIC

• Check the availability of special passes for athletes

and accompanying persons for the Doping Control

Do not forget to:

Request any appropriate modifications and/or

improvements if necessary

Attend the Technical Meeting

Select athletes for testing (under witness)

Tasks of the DCD during the Event

• Supervise notification of Athletes

• Supervise the sample collection

• Be a link between National Federations and Doping

Control staff

• Try to remind athletes to get tested if World or • Try to remind athletes to get tested if World or

European records are set

• Receive blood screening result from laboratory (if

feasible) and evaluate immediately on site (if

applicable)

Be there and ensure a smooth and comfortable way of testing.

After Sample Collection is finished

• Make sure that all samples were collected

• Make sure that athletes are transported to the hotel

• Help with completing the Chain of Custody Form

• Ensure proper storage or transportation of samples

• Collect the original documentation• Collect the original documentation– IAAF Notification Forms

– IAAF Doping Control Forms

– Additional test request forms

• Ensure that the copy of the dully signed Chain of

Custody form is delivered to European Athletics

DCD is the last person who leaves the Doping Control Station

Part 7.Supervision of preparation and Supervision of preparation and

conduct of testing and actions

after the event

Part 8.Medical exceptional Medical exceptional

circumstances

How to manage them?

Annex D - Collection of urine Samples

• D.1 Objective

Emergencies during the Doping

Control

• D.1 Objective

To collect an Athlete’s urine Sample in a manner that ensures:

– Consistency with relevant principles of internationally recognised standard precautions in healthcare settings so that the health and safety of the Athlete and Sample Collection Personnel are not compromised;

• Medical chief of the competition to confirm if the

athlete has to go for a long time in a hospital for

emergency.

• In case of a short treatment, the chaperone should

escort the injured athlete to the medical facilities at

Emergencies during the Doping

Control

escort the injured athlete to the medical facilities at

the stadium or to the hospital

• If testing is not possible, the chaperone has to inform

the DCO and DCD and make a written report to

explain these exceptional circumstances.

• In case of a long lasting treatment, European

Athletics advises to stop the control and to do

another test when it is possible.

IAAF Protocol

• Intravenous (IV) infusions are prohibited in and out of competition

• Criteria for evaluating whether IV treatment is medically

Infusion Therapy

• Criteria for evaluating whether IV treatment is medically legitimate or not:

1. the medical treatment (MT) must be necessary to cure an illness or injury of the particular athlete

2. under the given circumstances, there is not valid alternative treatment available which would not fall under the definition of doping

3. the MT is not capable of enhancing the athlete’s performance

IAAF Protocol

• Criteria for evaluating whether IV treatment is medically legitimate or not:

4. the MT is preceded by a medical diagnosis of the

Infusion Therapy

4. the MT is preceded by a medical diagnosis of the athlete

5. the MT is diligently applied by a qualified medical personnel in an appropriate medical setting

6. adequate records of the MT are kept, and are available for inspection.

Part 8.Medical exceptional Medical exceptional

circumstances

Practical Issues

Documents

DCD Seminar 8 - Practical issues.ppt - European Athletics · monitor the flow of personnel in and out of the DCS and to prevent any unauthorized access ... • If athlete refuse to