What happens in a drug test - blood

23 Aug 2010

BLOOD TESTING

Why is blood testing part of the Anti-Doping Programme?

Blood testing is completed for two main purposes:
1) Direct detection of prohibited substances
Some doping agents and doping methods can be revealed directly in blood samples. These include growth hormone, blood transfusions and CERA.
2) Indirect detection of prohibited substances by using blood profiles which forms part of the Athlete Biological Passport.

Is blood collection necessary?

The World Anti-Doping Agency (WADA), International Federations and National Anti-Doping Organizations all agree that blood sampling and testing for doping control is a viable, dependable and necessary element of a complete and robust anti-doping programme. The collection of blood is crucial to detect the fullest range of substances and methods on the Prohibited List. Blood testing will further assist in providing a level playing field for all athletes and provide an additional means for athletes to demonstrate they are competing cleanly.

When did Sport Ireland begin collecting blood samples?

The Irish Sports Council (now Sport Ireland) began blood testing in December 2009 and continues to incorporate the collection of blood samples into its testing programme. Like urine testing, blood testing can take place both in-competition and out-of-competition. 

Which sports/athletes will be blood tested?

Every national-level Irish athlete and every sport, in accordance with the Irish Anti-Doping Rules, could be blood tested. However, the Irish Sports Council will begin implementation of the blood program by focusing on endurance sports and power sports.

 

Who is responsible for collecting blood samples?

As with every doping control mission, an accredited Doping Control Officer (DCO) is responsible for the overall management of the sample collection. The testers will guide you through the collection of blood samples. A certified and experienced phlebotomist , Blood Collection Officer (BCO), is responsible for drawing the blood, advising you of aftercare procedures and providing first aid to you (in the unlikely event it is required).

 

How will you know if you need to provide a blood sample?

Similar to urine testing, at the time of notification the tester will tell the athlete if they are subject to a urine or blood test, or both.

 

What are the procedures for blood collection?

The principles of blood collection is similar to the collection of urine samples. You will be notified of your selection for doping control by a tester and informed that a urine and/or blood sample will be collected. In some cases, depending on the type of blood test that is being undertaken, it may be a requirement that you have not taken part in strenuous exercise for at least two hours. Once at the doping control station, the Irish Sports Council doping control officer will explain the process to the athlete and the athlete will have the opportunity to ask questions. In summary, the process will unfold as follows:

  • You will be asked to remain seated/relaxed for at least 10 minutes before undergoing venipuncture.
  • You will be asked to select the blood collection equipment to be used for the session from a number of available kits (including Berlinger blood kit, Vacutainer blood testtubes, needles, etc.), to inspect the equipment, and to verify sample code numbers.
  • The blood collection officer will ask for your non-dominant arm, apply a tourniquet (a constricting or compressing device used to control venous and arterial circulation to an extremity for a period of time) to the upper arm, and clean the skin at the puncture site.
  • The blood collection officer will draw blood and fill each Vacutainer blood testtube with the required volume of blood.
  • The blood collection officer will place the Vacutainer testtubes into the Berlinger A and B bottles.
  • The doping control officer will provide instructions to you regarding the sealing of the blood samples.
  • The blood samples will be transported by secure chain of custody to a WADA-approved laboratory for analysis.

How much blood is collected?

Normally two tubes of blood are collected, each containing 3-5mls. Typically, an athlete would be providing two tubes of blood. While not common, it is possible that an athlete might be required to provide four tubes of blood. The volume of blood collected for the purposes of doping control would not have an impact on your performance.

 

Can the BCO be a different gender to the athlete?

Yes, there is no requirement for the BCO to be of the same sex as the athlete. Should the Irish Sports Council believe that a period of chaperoning may be required for convenience we would endeavour to assign a same sex Doping Control Officer/Chaperone to the testing mission.

 

How long will the blood collection process take?

Collecting blood is a very quick process but as with any anti-doping procedure we must ensure the integrity of the sample and the well being of the athlete. The blood collection officers have been instructed to take as much time as needed. As this is an anti-doping test there also is the essential sample collection form to be completed in its entirety in a thorough fashion. Experience has shown that from start to finish the procedure takes about 30 minutes.


I am afraid of needles and could faint easily at the sight of blood!

While the Irish Sports Council makes every possible effort to make the collection of blood samples as easy and painless as possible for you, however if you are prone to fainting when giving blood, or should the sight of blood make you nervous, afraid, and/or nauseous, inform the blood collection officer and doping control officer of your concerns. It is highly recommended that you have a representative present with you during the doping control process and who can assist you with the blood collection process (e.g. view the collection of blood etc). You will have the option of sitting or lying down when the blood sample is being provided. In the event an athlete faints or requires first aid, the blood collection officers are trained in first aid.

Can I resume physical activity immediately after providing a blood sample?

The volume of blood provided does not prevent you from exercising afterwards. To minimize bruising to the arm, it is advisable that you do not undertake any strenuous exercise using the arm where blood was drawn for at least 30 minutes after sample collection.

 

What if I refuse to be tested?

Although you are entitled to refuse to provide a sample please bear in mind that a refusal might be treated as a doping violation by your NGB. The tester will advise you of the consequences of failing to comply with sample collection procedures. The sanction for refusal is a period of ineligibility of up to 2 years from sport. For more information on sanctions, read Article 7 of the Irish Anti-Doping Rules.

 

Results Management

It takes longer for the laboratory to process blood tests, so in general it will be about ten weeks before you receive a result, compared to about six weeks for urine testing. As per the urine testing, the Irish Sports Council will send the results of the drug test to the athlete's NGB, whose responsibility it is to send a results letter to each individual athlete.

 

What is blood doping?

Blood doping is the misuse of certain techniques and/or substances to increase one's red blood cell mass, which allows the body to transport more oxygen to muscles and therefore increase stamina and performance.

There are three widely known substances or methods used for blood doping: erythropoiesis-stimulating agents (e.g. EPO, CERA), synthetic oxygen carriers, and blood transfusions. Each is prohibited under the WADA Prohibited List.

 

What is hGH?

Human growth hormone (hGH) is a hormone that is synthesized and secreted by cells in the anterior pituitary gland located at the base of the brain. hGH is known to act on many aspects of cellular metabolism and is also necessary for skeletal growth in humans. The major role of hGH in body growth is to stimulate the liver and other tissues to secrete insulin-like growth factor (IGF-1). IGF-1 stimulates production of cartilage cells, resulting in bone growth, and also plays a key role in muscle and organ growth. hGH is prohibited both in- and out-of-competition under the WADA Prohibited List.

 

ATHLETE BIOLOGICAL PASSPORT

Which sports/athletes will be subject to the athlete biological passport?

Every national-level Irish athlete and every sport, in accordance with the Irish Anti-Doping Rules, could be blood tested. However, the Irish Sports Council will begin implementation of the athlete biological passport by focusing on endurance sports and power sports.

 

What is the Athlete Biological Passport?

The biological passport is an amalgamation of results of anti-doping tests carried out on an athlete. The athlete biological passport contains the following information:

1. test results (urine and blood)

2. the athlete's haematological profile over time (based on blood testing)
Blood samples are taken over time. The athlete's haematological parameters are analysed and their haematological profile is drawn up. The profiles are interpreted using a computer program that takes into account factors that may affect the blood parameters and provides an indication of whether there is normal variation or the variation may be as a result of blood doping.

A full blood count can be taken on the samples with the following markers currently being considered for the blood profile:
- HCT: Haematocrit
- HGB: Haemoglobin
- RBC: Red blood cells count
- RET%: The percentage of reticulocyte
- RET#: Reticulocytes count
- MCV: Mean corpuscular volume
- MCH: Mean corpuscular haemoglobin
- MCHC: Mean corpuscular haemoglobin concentration
- OFF-hr Score: Index of stimulation Blood profile score

3. the athlete's steroid profile over time (based on urine testing)
Urine samples are taken over time and the athlete's level of steroids in their urine is analysed and their steroid profile is established.

The haematological profile can detect blood manipulation (for example whether EPO has been
taken), whereas the steroid profile can identify whether exogenous steroids have been taken
(for example testosterone). Individual haematological and steroid profiles allow the permanent monitoring of variations in an athlete's biological parameters. Abnormal variations can be considered as proof of doping, even if no limit has been exceeded. Controlled medical doping with fixed limits then becomes too risky for the cheat.

 

Why am I sometimes required to rest for 2 hours before a blood sample can be taken for the Athlete Biological Passport?

There is a WADA requirement that athletes are in a physiological "steady state" at the time of sample collection and therefore an athlete cannot have taken part in strenuous exercise in the last two hours before the collected of the blood sample. The Council will generally plan blood tests to be completed to avoid long waiting periods, therefore it is very important that athletes keep their training details up to date through the online whereabouts system.

 

How could I be sanctioned under the Athlete Biological Passport?

The biological passport requires a rigorous protocol, the stages of which are detailed below.

Each sample is analysed by a laboratory accredited by WADA. The WADA statistical model, developed by the Lausanne Laboratory, is then applied to the results of the analyses to determine whether the profiles can be considered abnormal. Using this model, it is possible to if there any issues of concern and these details are then passed to the expert group.

Expert Group

Blood profiles will be submitted for interpretation to a group of experts made up of specialists in the analysis of blood parameters for anti-doping purposes. Experts then recommend to the ISC what action should be taken, for example opening disciplinary proceedings for a possible anti-doping rule violation.

ISC 's decision

Based on the experts' opinions, the ISC may decide to open disciplinary proceedings which
may lead to the sanctions stipulated by the World Anti-Doping Code.

 

Data Protection with regard to the Athlete Biological Passport

The Irish Sports Council will store biological passport profiles electronically. We will only be sharing this information with our expert panel in accordance with the WADA requirements, and in special cases, with international sport federations who also operate in accordance with the ABP program and WADA Privacy Standards. We will not be sharing the profiles with National Governing Bodies
The confidentiality of this data will be handled in the exact same way as confidential data from any other anti-doping test or therapeutic use exemption application.

 

Do you have additional questions or concerns?

To discuss additional questions or concerns regarding the Irish Sports Council blood testing programmes, please contact Siobhan Leonard tel: 00353 1 8608829 or sleonard@irishsportscouncil.ie

Read Questions and Answers on the Athlete Biological Passport and the WADA Athlete Biological Passport Operating Guidelines on the WADA website

 

Downloads

Sample Collection Procedures - Urine and Blood Leaflet .pdf (size 423.8 KB)