The World Anti-Doping Agency (WADA) has published its 2017 Prohibited List, to go into effect on January 1.
Among the changes from the 2016 Prohibited List is a shift in the language governing the use of salbutamol, an inhaled medication used to treat asthma, and other drugs of its class (called beta-2 agonists).
“Dosing parameters of salbutamol were refined to make it clear that the full 24 hour dose should not be administered at one time,” WADA wrote in a guide listing the changes from the 2016 Prohibited List.
The new rule keeps the maximum allowable does at 1,600 micrograms over 24 hours, but additionally specifies that only 800 micrograms can be taken in any 12-hour period.
Salbutamol is the medication which led to a suspension of Norwegian skier Martin Johnsrud Sundby. Sundby nebulized 15 milligrams — or 15,000 micrograms — of the medication in a five-hour period in Davos, Switzerland, in 2014 and Toblach, Italy, in 2015.
As a result, Sundby’s urine samples from the two races in question both had over 1,300 ng/mL of salbutamol, well over the WADA limit of 1,000 ng/mL. That limit, which WADA considers “not to be an intended therapeutic use of the substance”, is unchanged in the 2017 Prohibited List.
The Norwegian national team apparently also prescribed asthma medication to healthy athletes. The medications are allowable up to a certain dose, but high doses are prohibited.
WADA’s Senior Manager of Media Relations, Ben Nichols, told Norway’s NRK broadcaster that while taking such drugs without a diagnosis of asthma was not against anti-doping rules, WADA considered it “inappropriate”.
So perhaps not surprisingly, asthma medications are under scrutiny. The use of multiple beta-2 agonists at the same time was added to the “Monitoring List”, meaning that WADA wishes to track the practice and may add it to a future Prohibited List. The metabolic modulator meldonium, for example, was included on the Monitoring List before being moved to the 2016 Prohibited List. Over 100 athletes subsequently had positive tests.
All the beta-2 agonists can still be used with an approved Therapeutic Use Exemption.
The 2017 Prohibited List also includes changes to the listings of some anabolic steroids, growth factors, and metabolic modulators, stimulants, and narcotics.
“It is vital that all athletes take the necessary time to consult the List; and that, they contact their respective anti-doping organizations (ADOs) if they have any doubts as to the status of a substance or method,” WADA Director General Olivier Niggli said in a press release.
The WADA code now explicitly allows the use of inhaled oxygen, something which has been discussed in the cross-country ski world as it has been used extensively by teams such as Finland.
“Supplemental oxygen administered by inhalation, but not intravenously, is permitted. To clarify this, M1.2 now reads ‘excluding supplemental oxygen by inhalation’,” WADA wrote in their guideline document.