The ITF released its summary of anti-doping data for 2013 on Wednesday, showing a significant increase in the number and percentage of blood tests, both in and out of competition, while the number of urine tests fell slightly from 2012. Dr Stuart Miller, the head of the tennis anti-doping programme, says the number of blood tests will rise again in 2014 as the implementation of the biological passport continues. In an exclusive interview, Dr Miller sat down with The Tennis Space in Melbourne towards the end of the Australian Open to discuss some of the pressing issues. Here is part one of a two-part interview:
Do you freeze samples and retest them? If so, for how long do you keep them?
It doesn’t happen to every sample. Let me rephrase that. It does happen to every sample but under different circumstances, depending on the type of sample. We collect A and B samples for the vast majority of cases and once the A sample’s been analysed, the B sample is kept on every single sample. It has to be, in case the B sample needs to be analysed (or) if the A sample turns positive or if the anti-doping organisation concerned asks for an analysis for some other reason, which can happen on occasions. Then there are samples collected that are designed to be stored, of which there are some, and those will depend on the nature of the sample, the time of year it’s collected, the quality of analysis. We certainly don’t store all the samples, for (an unlimited) length of time.
Is that a cost thing? Part of it is. Part of it is trying to get the right balance between trying to detect cheating at the earliest possible time, compared to the benefits that might accrue with storage and not detecting the cheating and letting them play for a period of time. So there is a balance to be struck. And of course there is a cost side to storing samples as well, so it’s always a balance.
I understand you now test players on their days off in grand slams. When did that start? That’s been permitted under the rules for as long as I can remember. I can’t talk about before my time but it’s been an option for many years.
Has it been stepped up recently?
There is more, around the programme in general, not just in single events, there is more sample collection when players are not competing than there used to be.
Wada set the parameters for the biological passport? Who analyses the data and how is it done? Biological passport analysis, and when I say analysis I mean determination of whether it’s sufficiently suspicious or there is the sufficient possibility that there’s been doping (and) that it should be referred on to a process that is set, is determined automatically, based on a fairly sophisticated statistical model of the likelihood that variations you see in those parameters occurred by reasons other than doping. Doesn’t mean it is doping, but it means that one of the possibilities would be doping. That’s a great strength of the programme, because of the, under normal circumstances, stability of human blood parameters. Then you can detect possibility of doping based on relatively minor pertubations from those stable values. That’s not to say that there aren’t alternative explanations. The common alternative explanations are ones like training at altitude, which artificially stimulates production of red blood cells, blood donation, which does the same thing, various pathologies. Once a passport has been identified as abnormal then the process that follows tries to eliminate those alternative possibilities. As part of collection of biological passport samples, athletes are asked a number of questions, (including) ‘have you trained at altitude recently? ‘have you exercised in the last two hours’ and ‘have you given blood recently?’ Although those aren’t necessarily binding they are indicative of where the process needs to go. Athletes are always given the opportunity to explain any circs that might not be apparent from the resource themselves. But that initial move from normal to abnormal to let’s start an investigation is done automatically and it’s flagged up automatically in the system. As yet, we haven’t got there (done any investigations).
Who does it?
They are known as an expert panel. There are various groups of experts in haematology. They’re generally haematologists, sports physiologists, or exercise physiologists – blood haematologists, who have an expertise in blood parameters and the effects of exercise on them. There are groups of experts that are employed by some international federations – a limited number – often they are allied to Wada-accredited laboratories and effectively there is a list of people who are known and accepted to act as an experts and you contact them to work on your behalf, either to review, as a matter of course, which is what you’re supposed to do, even normal profiles, so that these experts don’t just see abnormal profiles and have a context of normal profiles against which to compare them.
How do you build a case?
You don’t necessarily need more samples once the possibility of doping has been identified because the idea of the passport is that the information you already have is what indicates the possibility of doping., What you need to do is build up a scenario that explains the results in a doping context. Part of that is eliminating the alternatives. So, you get a profile that’s automatically flagged up by the system, you then refer it to an expert, the expert will look at it and on the face of it, well the athlete said he had not had any blood transfusions, had not been training at altitude, said I haven’t been exercising recently, so that eliminated the simplest level of alternative possibilities. I think one possible cause is still doping and therefore we need to get the athlete’s explanation and then refer it back to the experts. That’s what the guidelines say, we stuck another hurdle in there – we at that point send the case to our review board, the independent review board is the group that decides whether there have been any departures from the required procedures in sample collection, transport to laboratory, analysis, procedures, interpretation anyway. That’s not part of the guidelines but we’ve put it anyway as another check and balance. (To protect themselves) “and the athlete”. If they come back and say no departures, we think there is still a case to answer we send the case back to a panel of three experts now, invite the athlete to provide an explanation, so the expert panel now has the profile, the initial experts’ opinion, the independent review board’s confirmation there are no departures, there, athletes’ explanation and then they review all those things together. If they still unanimously believe doping is the likely cause, you would proceed on to a hearing. From an anti-doping authority’s point of view, it’s not just: here’s our sample in the bottle, but here’s our profile but here’s our explanation of what did happen, in the same way that here’s our explanation of why there’s a violation with a prohibitive substance because it’s there in the bottle. That’s where biological passport differ slightly from the traditional case because you have to construct as the prosecuting body an explanation for doping. You can’t just say: ‘we’ve eliminated everything else’, it’s not enough. You have to say it’s because of this, this and this. It’s quite complicated.
Sounds like it would take a long time to get to the hearing stage?
We haven’t done one yet so I can’t give you an idea of that. But everybody has to have time to do their part in the case. I can’t imagine it will be less than the three months that we currently allow for. We developed that three-moth guideline on the basis of experience. And that’s how it became a guideline. But I can’t imagine it being less than three months.
Do you expect appeals, legal action?
I’d say there are two answers to that. The first is the generic issue of athletes appealing against first instance sanctions. There is some culture of appeal on the grounds that it’s protection of my reputation, but the barriers to entry to the Court of Arbitration for Sport are 1000 Swiss francs, which in the grand scheme of the cost of defending yourself is relatively small. And given that the appeal process is effectively a start from nothing process, there’s no discouragement whatsoever, and maybe there shouldn’t be, there’s no discouragement from filing appeals, so I think the tendency is towards ore filing of appeals than not. Specifically in relation to passport cases, the concept of: “haven’t failed a test” doesn’t apply here, you probably won’t fail any test, it’s not about failing a test, it’s about have you violated the rules, at some point in time by using a prohibited substance, at a time when it was prohibited. Because the evidence may appear to be less definitive – as in no prohibited sample in a bottle, you’re presuming on the basis of evidence that I have done something, but you haven’t seen me do it, you haven’t caught me doing it, that might influence the number of appeals. We’ll have to wait and see. There have been appeals to CAS (the Court of Arbitration for Sport) in other sports so that might point to what might happen in tennis.
If you retest a sample and you find something that wasn’t banned then but is now, is that a doping offence?
No. You can’t retroactively change the rules to make something banned that wasn’t. What may happen is that you develop over an intervening period you develop a more sensitive test for a substance that was prohibited at the time but may have been undetectable. Human Growth Hormone is an example. But then you go back and find that with your more sensitive test you’re able to detect something you couldn’t detect at the time. That’s one of the benefits and reasons you may re-test samples.