The objective of this course is to encourage a critical understanding of doping. To achieve this goal, this course will rely on a multidisciplinary approach that allow you to see how different disciplines get into a single object, in different perspectives and in often complementary ways. This approach will also allow us to appreciate the complexity of a subject like doping. Doping in sports is a complex practice whose definition and identification is the result of socially and historically constructed norms. This course offers to shed light on the processes that led to the use and prohibition of doping substances. Performance enhancement or physical transformation are two aspects of doping which are seen as problematic, yet even as we speak companies are making fortunes selling body improvement and other forms of “human enhancement” to us. These apparent contradictions will be analysed to show that beyond sanitary questions, doping raises many social, scientific and legal issues. In efforts to control doping, governments and sports authorities have put into place institutions responsible for defining what falls into the category of doping, but also what prevention, repressions and research methods to put into effect. This course will also explore biological control measures such as the biological passport, key legal dimensions, organisations that produce performance, as well as the sociological dimensions of doping. Besides the Professors of University of Lausanne, the best experts of doping are involved in this course: experts from an Anti-doping Laboratory (LAD- Lausanne-Switzerland), from the CAS (Court of Arbitration for Sport), from the UEFA (soccer), and from the WADA (World Anti-Doping Agency). Teaser: https://www.youtube.com/watch?v=20Q3eR_g7rU Main Learning Outcomes At the end of the course the participants will be able to : 1. Identify the “cultural” dimension of doping, that is as a historical practice linked to the transformation of social norms, 2. Go from a binary way of thinking - for or against doping - to an understanding of the complexity of this phenomenon which is biological, psychological and sociological, all at the same time, 3. Recognize the institutions, the actors and the practices of the fight against doping, 4. Explain how the social and organisational context influences individuals decisions and how this influence can be reduced by effective prevention measures, 5. Identify how the fight against doping is led and how testing is carried out.
1- How accredited laboratories work and how bioanalyses are carried out
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Do curso por University of Lausanne
Doping : Sports, Organizations and Sciences
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Module 4 - Bioanalytical and forensic approaches to doping
Module four presents bioanalytical and forensic substance detection and analysis methods. It is made up of 4 interviews carried out with doping experts from the Swiss Laboratory for Doping Analysis (LAD) in Lausanne (Switzerland), that will explain: - how bioanalyses are carried out (Norbert Baume, head scientist at the LAD); - how the biological passport works (Neil Robinson, head scientist at the LAD); - forensic approaches to doping (François Marclay, research scientist at the LAD); - atypical analysis results and the evolution of the future of the fight against doping (Martial Saugy, director of the LAD).
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Fabien OhlProfessor of Sociology of Sports / Professeur en Sociologie du Sport
Faculté des Sciences Sociales et Politiques (SSP)
[MUSIC]
Good day.
Could you introduce yourself please.
Yes, my name is Norbert Baum.
I work here at the Swiss Laboratory for doping analysis.
I've been working here for about ten years.
I did my doctoral work here at this laboratory.
And I obtained a PhD in Biology and
I specialized in sports sciences at the University of Losan.
Since 2007 I've been responsible for the operational side,
which means all of the activities in the laboratory.
Well I'm going to ask you a few questions about the way in which the laboratory
actually operates.
This is an accredited laboratory, and
also about the way the bio-essays are carried out.
So, the ones that you're responsible for.
First of all, tell us a little about an accredited laboratory.
What does this mean?
Well, an accredited laboratory, an anti-doping laboratory in other words, for
it to be able to carry out tests, it has to be accredited.
There are two types of accreditations that depend one on the other.
First of all, there's the WADA, the World Anti Doping Agency accreditation.
WADA.
So, it's a fairly long, complicated process to obtain accreditation for
new laboratory that wishes to be accredited.
It's a process that will take roughly two years.
After two years, if all of the tests have been passed successfully,
a laboratory will be accredited.
In order to obtain this accreditation from WADA,
a laboratory research has to also be ISO compliant,
ISO accredited, and the quality standards are ISO 1725.
This ISO accreditation takes place every five years.
This year we have a re-accreditation visit.
And every 18 months, we have monitoring visits to ensure that
the quality of the work done in the laboratory is suitable.
And for the ISO standard, is it people from WADA who come or others?
Well, we're accredited by the SAS, the Swiss Accreditation Service.
They work together with the World Anti Doping Agencies.
So, it's not just anybody from that accreditation service who will be able to
come to see us.
It is somebody who has to be trained based on the special training for
World Anti-Doping Agency.
Now we also hear about ISO standards, TD standards.
Now we have an anti-doping code
which has a sort a synthesis of everything that takes place in the anti-doping area.
And then in terms of the code there are international standards that
are associated with it.
There are five of these.
One of them is called the international standard foreign laboratories ISL,
where we have a full description, so that in at a doping laboratory can
work according to the rules and is inconfirmative with the code.
Now, there are technical documents at different levels.
Technologi-ments are much more specific.
They are specific to the work which is done in the laboratory.
These are not norms or standards.
These are the rules according to which we have to work.
Well all this is extremely restrictive, isn't it?
Yes, it is extremely restrictive.
Because in order to be able to maintain this accreditation from the WADA,
we have follow-up checks, monitoring checks that are carried out by WADA.
>> But in each country, can all laboratories be accredited easily?
>> Well, no.
I think it's important to know that there are 32 laboratories that are accredited by
WADA all over the world.
Most of them are in Europe.
There are 18 laboratories in Europe.
Only one in Oceania.
It is located in Sydney.
There's one in Africa, six in Asia and six in the America.
So you can see that the distribution, the world distribution is not at only uniform.
And then of course things depend much on the interest
of the people who run these laboratories.
It's very restrictive, in order to maintain a laboratory accredited,
it is very difficult.
So, if I'm an athlete in a certain geographical area,
say anti-doping tests might be difficult,
because to get samples, to check them might be difficult.
Well that's a very good question.
We have to make a distinction between what we do and the anti-doping tests.
They are also regulated by one of these five international standards.
And these anti-doping tests are regulated only by the international federations,
the national federations, or the IOC, or the anti-doping agencies.
We have absolutely no power, no authority over the tests that are carried out.
In fact, if you live in a country, let's take a country in the middle of Africa,
somewhere where there are no laboratories, it is not because there
are no laboratories that there will be no checks,.
However, access to certain countries is much more complex.
But that is not our business.
We get samples from African countries, from Switzerland and so on.
So there's cooperation at an international level.
Do you assist other laboratories to exchange information?
Well, accreditation from the WADA actually stipulates two things.
The first thing is that we have to have R&D activity.
The second thing is we have to co-operate with other laboratories.
What does co-operate mean?
It means that if, for example, from our laboratory,
let's say we set up a new technology, a new technique, to detect doping.
Then we are going to communicate scientifically,
to be able to ensure that this technique is set up in other laboratories.
That's an obligation, so we're doing two things at the same time.
On the one hand, we have to cooperate, but we're cooperating with laboratories
who are our competitors in terms of providing services.
Now as far as providing services, we can see that some people have taken samples.
But how do things go from the time the sample is taken up until the result?
Is it easy?
Is it very restrictive?
Well, nothing is easy here.
Now, in terms of the test, as I said earlier.
If we take the Swiss anti-doping agency located in Bern.
If they decide to check an athlete,
they're going to get a doping control officer to carry this out.
Some are professionals, some are amateurs,
but they are trained based on the existing standards.
Then they decide who is going to be tested and over which period.
They're going to define a ten-day period for
example or maybe two days if they want to target a specific period.
And then the tropical officer has to go and find that athlete.
And to find the athlete there is something that we call the geographical whereabouts.
Athletes must provide their whereabouts to these officers so that they can be found.
Or else there are tests at the place where they are competing.
So they carry out samples, they collect urine or blood samples.
If blood has to be sampled then the restrictions, there are much more
stringent because the blood that has to be taken has to be carried or
transported under conditions that are very special between 2 and 12 degrees Celsius.
And they have to get to the laboratory within 36 hours of collection.
And then there's an additional 12 hour So in other words,
the analysis has to be carried out.
The test has to be done within 48 hours after the sample was taken.
So for Lausanne, it comes from that'll be relatively easy.
Easy to do, but it's coming from Africa,
it's going to be extremely difficult to stick to these rules.
And who decides whether it should be urine or blood that is being sampled?
Now once again, it is the federation or
the sampling body that decides to test the athlete.
But then things get more complex after that,
because international federations don't necessarily have their own samplers.
So they will ask special agencies for sampling,
sampling agencies, five or six have been set up.
So, the federation will ask a sampling facility to do it.
They will do it, they will send the samples.
So there's one additional person if you will, in this chain and then the more
people you have in the process, the likelihood that there might be a mistake.
Well, yes, that's one of the major concerns that we have in combating
doping because as I said,
an accredited laboratory is checked very closely by the WADA.
However, everything which takes place before the sample arrives at
the laboratory before the analysis.
As we see it, there's a bit of a lack of coordination and
regulation for things to take place correctly.
So then all of the sudden, the burden is on the laboratory and it's difficult to
manage sometimes and then in the phases or stages that follow the analysis.
We're talking about the storing, description and so on, who decides for
how long you are going to keep the samples and what you are going to do with them?
Well, when a sample arrives here,
there's a whole series of tests that we will carry out in order to check whether
there are any prohibited substances in the matrix,in the urine or the blood.
And then up until the third version, the 2015 version of the code, all
negative samples, we had to keep them for three months before they were destroyed.
Now what we do is we get in touch with the customers to
ask whether we should destroy them or not.
Now, for some years now, there's the long term storage
approach which is launched by the IOC, International Olympics Committee.
Now what happens there?
We're going to store the mean of negatives so that they can be re-analyzed.
Years later, sometimes with new methods that are must more specific,
much more sensitive.
Perhaps new substances have been found, so we're going to go backwards.
In other words, it's a retrospective analysis where the problem of long term
storage.
Logistics are complicated because we're talking about the volume of storage and
how can we organize ourselves so that we can find the right sample years later?
Now the world agencies, national agencies, federations,
do they regularly ask you to carry out this sort of reanalysis?
Increasingly so, yes, this is why to respond to an earlier question,
our customers do ask us to keep samples that they select.
Once again, they are the ones who select the samples because we're working
anonymously.
We only have numbers or codes.
So they will select based on criteria that might be performance or
suspicion they must have based on some investigations.
And on the basis of this, they're going to ask us to store a particular sample and
then they will come back and analyze them later.
So we're talking about significant responsibilities that you have to collect
then there's this whole distribution chain, storage of the samples.
From a legal point of view, Are you able to do this actually?
Well, from a legal point of view, we are responsible for a sample from the moment
it enters the safety barrier of the laboratory.
Before that, we're not responsible, that's the major concern I was talking about
earlier, the responsibilities piling up on us here.
So we're responsible from the time we receive it until it is destroyed.
Now, in the case of a positive result or an abnormal result,
we have to ensure the chain of custody of the sample in the laboratory.
In other words, we have to track all movements of the sample and
we're working of course with IT computers, but there are some manual stages.
Anyway, because it's going to be separated into several aliquots depending on what
we're looking for.
So we have from using computers we're tracing or tracking it but also, we have
to be able to show that a particular time a sample was stored at four degrees,
handled by a particular person because the sports,
the arbitration tribunal, it might go as far as that court.
Now when you say aliquot, what do you mean?
Well, an aliquot is a small amount of a sample.
Afterwards it is going to be manipulated.
It will be analyzed using analytical tools that we have.
But what are your methods what are the main methods
that you use to analyze these aliquots?
Well, that in fact is one of the benefits in working here,
we have a whole range of analysis.
We do a lot of work with gas chromatography or
liquid chromatography coupled with mass spectrometry.
The basic principle is that we're going to attempt to separate all of
the components of a mixture, urine in this case and then identify them.
And then quantify them if we have to provide a specific concentration
that's analytical chemistry in fact what we're doing.
And then there are then biological or biochemical analyses
such as the detection of electrophoresis stimulating agents.
We use gel migration and then we have
a whole series of immunological tests.
Detection of antigens and antibodies.
So as you can see, it's a very global approach and
that's one of the most difficult things is that,
we have to be at the cutting edge of a number of different disciplines.
To be at the cutting edge, do you have time to carry out research and
development activities on all these things?
Well, as I mentioned earlier, we have to carry out R and D.
We identify development by the fact that we are improving on existing methods,
whereas research, well that is establishing new methods,
new procedures that allow us to detect doping in an athlete.
What about financial constraints that you might have?
You have to self finance, depends on laboratories.
You have to find time for research but also funds, money, resources are needed.
Yes, definitely, as you said.
The fact that we provide services allows us to roughly cover the costs.
Generated by these tests, where part of the University of Lausanne and they give
us a budget that makes it possible for us to carry out these laboratory activities.
Now as far as R and D goes, we have a number of anti-doping bodies who finance,
who fund projects such as the WADA for example.
Or the US anti-doping agency which has a budget to subsidize research projects but
of course this has to go through an expert review process who will
determine whether or not a particular project is relevant.
After this then, we have some federations and
anti-doping bodies who have budgets, as well, who have funds.
But we have to then go and find this, and
it's extremely complicated, in some cases, to find funds.
Now, can you tell us how the results of the tests are done?
What happens to them when they're negative, when they're positive?
What happens next?
>> Well, if we take it up, take it from the beginning, we get the sample.
We receive the sample.
Then we are going to carry out a screening test.
So the sample will undergo a whole series of tests to detect a maximum
number of substances that are on the list of substances.
>> Do you determine which substances you are looking for?
>> Well, we have a standard menu, which we're going to apply to all samples.
However, much more specific tests which require more time,
which are more expensive, then it's requests that come from
the clients to look at an EPO or growth hormone.
>> But if somebody says for example, I need a more in depth analysis?
>> No, well what they'll do is they'll say we know that this is an athlete who is
suspicious, shall we say and we have found some things that
are a little bit problematic in people surrounding this athlete.
So they might say, we want you to look specifically for EPO or
Growth Hormone in this sample.
So it's at their request.
And then we work with the units for evaluating the passport
who are going to provide expert advise about the biological profiles.
Because they have indications of possible manipulation with EPO and so on.
>> But do you send the information back to the federation and to the WADA?
>> Well, yes.
A sample will be analyzed for the screening test.
If it's negative, it'll be negative.
It will be expressed as such.
We have ten days,
ten working days, from the time we receive it until the report is produced.
Now, if we have a sample that is suspicious as a result of the screening,
in other words, we detect something that is anomalous.
Then we have a confirmation analysis carried out on sample A,
which will then confirm it.
And if we confirm it's positive, we're not going to use the term positive.
We're going to say that it's an atypical or abnormal result.
Why? Because positive already includes
a value judgement where as if we say it is typical or
anomalous, that doesn't have a value judgement.
After this, the federation will do its work, will contact the athletes,
ask the athlete if the athlete agrees or not, if he wants to challenge it, and
if he wants to go to sample B, this counter-analysis.
Then we have to open up sample B if that's the case.
It has been sealed up until that point in the presence of the athlete
where necessary.
And we carry out this analysis and then we will test it and
then the two will be identical, and the last stage will be the arbitration court.
>> But many people are involved here and there has to be corporation with WADA,
for example.
Do things always happen in a relatively easy fashion?
What is difficult and what works well?
>> Well what is difficult is that each customer has his or her own requirements.
Now, a report, for example, we produce reports on paper.
Hard copy.
Some of them want us to send this by mail.
Others want to have them scanned and then sent by email.
Others by fax, so customers have specific requirements and
needs, in addition it's all results have to go into a world database,
Adams, which is managed by WADA and for,
it's to be able to have an overall picture of what is happening in the laboratory.
So it's very complicated, for sure.
But on the other hand, if we can have
relationships of trust with the various affiliations with laboratories,
then we're going to have, I think, a situation which will make our job easier.
>> Now, when you say laboratories work together.
But given the diversity of customers to the international federations,
also, agree amongst themselves and discuss these matters?
>> I think they do, consult.
Perhaps, among themselves.
Once again, I cannot be certain of that, but let me tell you that one month ago
about, they want to organize a symposium in Lousanne,
here, which brought together all stakeholders in combating doping,
what the federation sampling agencies and
Laboratories as well for the time were pushing to try to be involved
in everything which relates to anti-doping, combating doping.
Up until now, we've been considered to be service providers whereas the scientific
knowledge is within the walls of the anti-doping laboratories and so we
are trying to force our way in, basically, to be a part of this discussion.
[MUSIC]
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