Health Articles

 

Microsoft word - doping control manualfinal tue1-6-12.doc

Doping  Control  Manual  
2012  Anti-­‐doping  Rules  
Therapeutic  Use  Exemption  (TUE)  
 
 
 
FIRS  Sports  Medicine  Commission  
Viale  Tiziano  74  
00196,  Roma,  Italy  
Doping  Control  Manual  TUE  December  2009v1   General Information

Doping control may occur during any FIRS Events. Athletes, who use medications that are included on the
Prohibited List, must fill in the Therapeutic Use Exemption form with their physician. The completed TUE
forms must be submitted to the FIRS doping control officer at least 30 days before the event. All documents
(TUE form and medical evidence attachments) must be written in English or Spanish. Generic names of
medication must be used.
Information about Therapeutic Use Exemption (TUE)

For substances and methods on the Prohibited List
FIRS athletes, like other athletes, may have illnesses or conditions that require them to take particular
medications. If the medication that an athlete is required to take to treat an illness or condition happens to fall
under the Prohibited List, a Therapeutic Use Exemption will give the athlete the authorization to take the
needed medicine. Athletes may apply for a TUE for any treatment involving a substance or method on the
Prohibited List.
Medical evidence needed to support the diagnosis
There needs to be objective medical evidence to confirm the diagnosis and the need for treatment with a
prohibited substance. This medical evidence must be supplied by the treating doctor and sent together with the
TUE application. Medical evidence shall include complete medical history (for example onset of the disease,
family history, triggers, severity, etc.), results of all examinations and laboratory investigations and/or the
imaging studies.
Required in official FIRS Events
All international level athletes defined as athletes in the FIRS Registered Testing and/or players entering in an
FIRS World Championship, or a Major Games, who use prohibited substances and/or methods, must fill the
TUE Form and submit the Application to the FIRS. FIRS is responsible for accepting applications and granting
the certificates. All TUE applications will be reviewed by the FIRS Medical Committee. If approved, the
athlete can begin treatment after receiving the authorization notice from the FIRS. In rare cases of an acute life
threatening condition retroactive approval will be considered.
Reciprocal Approval of TUE
FIRS medical commission will accept, by reciprocal arrangement, any TUE issued by a FIRS
approved anti-doping organization (ADO) in conformity with the WADA International standards for
TUE. ADOs include other International Federations and National anti-doping organizations.
Sanction fee for late TUE applications
The TUE applications need to be sent to FIRS at least 30 days in advance of the FIRS event. The sanction fee of $50
US may be applied for the late incoming TUE applications. The sanction fee, if applied, shall be paid by the
National Federation of the applying athlete.
Doping  Control  Manual  TUE  December  2009v1   Validity of granted TUE's
After FIRS Medical committee has reviewed a TUE application and granted a permission to use a
prohibited substance or method, the athlete will receive a TUE certificate from the FIRS. The athlete
should carry a copy of the certificate with him/her to all rollersports events. The certificate should be
presented to the doping control officer at the time of testing.
All TUE's are granted for a limited period of time. At least 30 days before the expiry date, a new TUE
application must be sent to the FIRS together with up-to-date medical evidence. The validity of the
TUE is dependent on the prohibited substance or method, but normally TUE's are valid for 2 - 4
years.
All TUE's granted by FIRS are valid in the different national events and competitions around the
world.
How to apply for a TUE?

Athletes with no valid TUE or TUE issued by FIRS

Download and fill in the FIRS TUE form from FIRS webpage
• Request TUE through ADAMS • Alternatively a TUE application form can be downloaded from FIRS web page www.rollersports.org under Sports Medicine or Documents The TUE form requires both the athlete's and the physician's signature
Gather required medical evidence
• Complete medical history (including onset of the disease, family history, triggers, severity)
• Results of all examinations
• Laboratory investigations and/or the imaging studies
• Confirmation that there is no suitable permitted medication available or objective reason why
any permitted medication is not suitable • That proposed treatment substances or methods are not performance enhancing
• The condition requiring treatment is no as the result of the use of prohibited substances or

Send the completed TUE form together with the medical evidence to the FIRS
• TUE's can be sent to the FIRS by fax, e-mail or post (see contacts below)
Athletes with existing TUE from another Anti-doping Organisation
• Athletes should apply to FIRS for reciprocal recognition of existing TUE at least 30 days before the event or immediately on being notified of inclusion in Registered Testing Pool (RTP) • Athlete should download FIRS TUE application form and complete personal information section and prescribing doctor details. • Athlete should attach a copy of o TUE certificate from ADO o Copy of all medical information supplied to issuing ADO Doping  Control  Manual  TUE  December  2009v1   o Copy of any correspondence from ADO • Athletes should sign the TUE application form
FIRS will provide written confirmation that the TUE has been accepted by reciprocal arrangement
within 30 days of receipt.
Instructions for athletes using asthma medication
Permitted medications
• All inhaled glucocorticosteroids
• Salbutamol, salmeterol nd formoterol in therapeutic range for treatment of asthma
ASTHMA MEDICATIONS REQUIRING TUE
• Terbutaline require a full TUE (with medical evidence – see below – asthma TUE)
(Reason why use of salbutamol and salmeterol is not suitable must be provided. • Full pulmonary function tests must be provided and criteria for TUE must be met Asthma medication declared on the doping control form
• The use of salbutamol, provided the level in the urine is less than 1000 ng/ml (dosage
guideline max. 1600 µg/24 h), formoterol 30ng/ml (dosage guideline max 36 mcg/24 hours)
and salmeterol by inhalation do not require a TUE, but should be declared on the doping
control form at the time of testing. These substances when used in other ways, for example
orally (tablets), are still prohibited and require TUE's.
• Inhaled Asthma medications that include salbutamol are: Airomir, Atrodual, Buventol,
Ipramol, Salipra, Ventilastin and Ventoline. Inhaled Asthma medications that include
salmeterol are: Seretide and Serevent.
• Inhaled Glucocorticosteroids do not require a Therapeutic Use Exemption (TUE), but should
be declared on the doping control form at the time of testing.
Asthma medication requiring a TUE
• Beta-2 agonists e.g. terbutaline are prohibited and require a Therapeutic Use Exemption (TUE).
• The request for a TUE should include a complete medical file with a clear explanation of why an
alternate medication is being prescribed.
Summary of requirements for the medical file in case of treatment of asthma with terbutaline
(attach to TUE application):
A complete medical history A comprehensive report of the clinical examinations with specific focus on the respiratory system A report of spirometry with the measurement of the Forced Expiratory Volume in 1 second (FEV1) , Forced Vital capacity (FVC) and FEV1/FVC% • If airway obstruction is present, the spirometry wil be repeated after inhalation of a short acting Beta-2 agonist to demonstrate the reversibility of bronchoconstriction In the absence of reversible airway obstruction on spirometry, a bronchial provocation test is required to establish the presence of airway-hyper responsiveness • If spirometry and bronchial provocation tests are negative, then an opinion of a doctor familiar with the diagnosis and management of asthma wil be required to confirm the diagnosis on the clinical history, Examples of Beta-2 agonists including terbutaline : Bricanyl
Doping  Control  Manual  TUE  December  2009v1  
Glucocorticosteroids requiring a TUE
• All glucocorticosteroids are prohibited in competition when administered by oral, intravenous,
intramuscular or rectal routes and require a TUE.

Glucocorticosteroids declared on the doping control form
• Glucocorticosteroids used by intraarticular, periarticular, peritendinous, epidural, intradermal and
inhalation routes do not require a Therapeutic Use Exemption (TUE), but should be declared on the
doping control form at the time of testing.

Permitted Glucocorticosteroids
• Topical preparations when used for inhalation, auricular, buccal, dermatological (including
iontophoresis/ phonophoresis), gingival, nasal, ophthalmic and perianal are not prohibited and do not
require a TUE.

Advice for Pseudoephedrine (PSE)
WADA has reintroduced pseudoephedrine (PSE) to the 2010 Prohibited List as a specified stimulant
prohibited in-competition at a urinary threshold of 150µg/mL Pseudoephedrine is commonly used
for treating allergic nasal catarrh (flu). The established threshold levels may be reached (rarely, but
possibly) by some individuals within 6-20 hours of intake of some long-lasting therapeutic
formulations.
Advise athletes to stop taking PSE pills at least 24 hours before competition.
For therapeutic applications during the In-Competition period, consider the use of alternative
permitted medications upon previous consultation with a physician, or apply for a Therapeutic Use
Exemption (TUE) for the use of PSE for therapeutic purpose(s).
Pseudoephedrine products are for example: Sudofed,Aerinaze, Cirrus and Duact.
Read carefully the contents on the medication packaging of any preparation as the ingredients may
vary from country to country.
Food Supplements & Naturopathic Products
These products are largely unregulated and can't be guaranteed as safe with regard to doping control.
Several athletes using food supplements worldwide, and including within FIRS, have tested positive
to a stimulant substance after using food supplements. Some examples of prohibited sunstances in
supplements are methylhexeanamine, geranium, forthane, floradine. There are many others. Athletes
have absolute liability for substances found in their system; penalty is anything between a warning
and two years suspension and loss of all awards
More information
More information and answers to Anti-Doping related questions can be asked from FIRS doping
control officer by e-mail or phone (see contact information below).
Doping  Control  Manual  TUE  December  2009v1  
Anti-Doping information can also be found on the internet:
FIRS web page www.rollersports.org Sports Medicine
WADA web page www.wada-ama.org World Anti-Doping Code
Useful links

WADA Prohibited substances list 2010
http://www.wada-ama.org/Documents/World Anti-Doping Program/WADP-Prohibited-list/WADA
Prohibited List 2010 EN.pdf
www.rollersports.org sportsmedicine
Download the FIRS TUE form
www.rollersports.org

Links to National Anti-Doping agencies
http://www.wada-ama.org/en/Anti-Doping-Community/NADOs/List-of-NADOs/

Contact details
Dr Patricia Wallace
+61 418 920 466
Doping Control Officer
+61 8 95311845
Federation Internationale de Roller Sports
+61 8 95313030
Viale Tiziano 74
Email [email protected]
00196, Rome, Italy
Doping  Control  Manual  TUE  December  2009v1  

Source: http://www.rollersports.org/component/phocadownload/category/47-therapeutic-use-exemptions?download=93:doping-control-manual-tue-2012-pdf