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 program.

The collection of blood is crucial to detect the fullest range of substances and methods on the Prohibited List. Some of the emerging areas where blood collection can make an important contribution are related to testing for blood doping, for hGH and to monitor selected blood parameters (known as the Athlete Biological Passport Program). Blood sampling 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.

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: erythropoietin (EPO), synthetic oxygen carriers, and blood transfusions. Each is prohibited under the WADA Prohibited List.

• Erythropoietin (EPO) is a peptide hormone that is produced naturally by the human body. EPO is released from the kidneys and acts on the bone marrow to stimulate red blood cell production. An increase in red blood cells improves the amount of oxygen that the blood can carry to the body’s muscles.
• Synthetic oxygen carriers, such as haemoglobin-based oxygen carriers (HBOCs) or perflurocarbons (PFCs), are purified proteins or chemicals having the ability to carry oxygen.
• There are two forms of blood transfusions: autologous and homologous. Autologous blood doping is the transfusion of one’s own blood, which has been stored (refrigerated or frozen) until needed. Homologous blood doping is the transfusion of blood that has been taken from another person with the same blood type. Although the use of blood transfusions for blood doping dates back several decades, its recent resurgence is likely due to the introduction of efficient EPO detection methods.

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.

Every national-level Canadian athlete and every sport is subject to the blood collection program. However, the CCES will begin implementation of the blood program by focusing on endurance sports and power sports.

Athletes selected for doping control will be notified of their selection and informed by the CCES chaperone or doping control officer that they are required to provide a blood sample (in addition to a urine sample).

To detect the presence of blood transfusions and HBOCs, and to monitor selected parameters, two tubes of 3 mL of blood will be collected from the athlete. To test for hGH, two tubes of 5 mL of blood will be collected from the athlete.

Typically, an athlete would be providing two tubes of blood. While unlikely, 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 the athlete’s performance.

As with every doping control mission, a certified and experienced CCES doping control officer is responsible for the overall execution of the sample collection. The CCES doping control officer will guide the athlete through the collection of urine and blood samples.

A certified and experienced phlebotomist (blood collection officer) will be responsible for drawing the blood from the athlete. The blood collection officer will answer relevant questions relating to the blood sample collection procedures, prepare the athlete for the blood sample collection, collect the blood sample, advise the athlete of aftercare procedures and provide first aid to the athlete (in the unlikely event it is required).

The CCES has contracted LifeLabs LP to provide certified, qualified and experienced phlebotomists. LifeLabs phlebotomists will also ensure that all blood sample collection and occupational health and safety activities occur in accordance with LifeLabs Occupational Health and Safety (OH&S) Procedures and are in compliance with any relevant provincial regulations.

No, there is no requirement for the BCO to be of the same sex as the athlete. Should CCES believe that a period of chaperoning may be required for convenience we would look to assign a same sex Doping Control Officer to the testing mission.

The collection of blood is similar to the collection of urine samples. The athlete will be notified of their selection for doping control by a CCES chaperone or CCES doping control officer and informed that a urine and blood sample will be collected. Once at the doping control station, the CCES 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:

• The athlete will be asked to remain seated/relaxed for at least 10 minutes before undergoing venipuncture.
• The athlete 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 tubes, needles, etc.), to inspect the equipment, and to verify sample code numbers.
• The blood collection officer will ask for the athlete’s non-dominant arm, apply a tourniquet to the upper arm, and clean the skin at the puncture site.
• The blood collection officer will draw blood from the athlete and fill each Vacutainer blood tube with the required volume of blood.
• The blood collection officer will place the Vacutainer tubes into the Berlinger A and B bottles.
• The doping control officer will provide instructions to the athlete regarding the sealing of the blood samples.
• The blood samples will be transported by secure chain of custody to a WADA-accredited laboratory for analysis.

Collecting two tubes (3mls in each) of 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.

While the CCES is making every possible effort to make the collection of blood samples as easy and painless as possible for the athletes, if an athlete is prone to fainting when giving blood, it is highly recommended that the athlete have a representative present during doping control. In the event an athlete faints or requires first aid, the phlebotomists on-site will perform first aid.

If the sight of blood makes an athlete nervous, afraid, and/or nauseous, they are encouraged to share those concerns with the blood collection officer and doping control officer.

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