Possibility of analytical finding of glycerol caused by self‐catheterization in doping control

Abstract

Glycerol is listed on the World Anti-Doping Agency (WADA) prohibited list as a masking agent principally because the administration of glycerol increases plasma volume and decreases the concentration of haemoglobin and the value of haematocrit in blood. Glycerol is a naturally occurring substance; therefore, the threshold is set as 1.0 mg/mL in the WADA technical document (WADA TD2013DL). In a WADA-accredited doping control laboratory, three doping control urine specimens collected from impaired athletes were determined to contain a high concentration of glycerol (>1.0 mg/mL); two of these specimens were considered adverse analytical findings (AAFs). Self-catheterization is necessary for athletes with neurological disorders such as neurogenic bladder dysfunction. We conducted a simple simulation of self-catheterization as an experimental test using urethral catheters with an antiseptic agent containing glycerol to confirm the influence of this antiseptic agent on the quantitative value of glycerol in doping control analysis. Some users employ a catheter with glycerol solution (ca. 1 mL) to avoid pain during use. The urine sample passed through such a catheter exhibited a glycerol concentration (4.94 mg/mL) greater than the threshold level. In September 2014, the threshold for glycerol will change from 1.0 to 4.3 mg/mL (WADA TD2014DL); however, a possibility exists for the quantitative value of glycerol in doping control analysis to exceed the threshold because of the use of an antiseptic agent containing glycerol for self-catheterization. The AAF for glycerol for impaired athletes, particularly those who participate in Paralympic sports, should account for the use of a catheter with glycerol.

Screening and confirmation of a glycerol‐positive case

“…Because the sport was kick‐boxing, an attempt to manipulate blood‐parameters was unlikely. Glycerol is also used as a lubricant for self‐catheterization in particular by impaired athletes suffering from neurogenic bladder dysfunction . Because the sample was obtained from a non‐impaired athlete, this latter possibility could also be excluded.…”

Annual banned‐substance review: analytical approaches in human sports drug testing

“…Among the ‘other masking agents’, primarily glycerol was in the focus of anti‐doping research lately. Two AAFs were reported concerning glycerol (applicable decision limit at that time was 1.3 mg/mL) in samples collected from impaired athletes, which were plausibly attributed to the introduction of glycerol via urine catheters . The simulation of the scenario confirmed the possibility and an advice on how to handle (self‐)catheterization for doping control sample collection with specific warning as to the possible contamination with glycerol was requested.…”

The Road to Rio: Medical and Scientific Perspectives on the 2016 Paralympic Games

“…In Paralympic sport, issues related to an athlete's disability may, at times, lead to unique and complex challenges related to sample collection, the interpretation of results, and the granting of therapeutic‐use exemptions that are central to conducting a rigorous testing program. For example, in 2014 a paper was published noting that several Japanese athletes had tested positive for glycerol—a substance that is prohibited, given its potential for use as a masking agent [3]. On further investigation, it was discovered that these positive tests were the result of the athletes' use of a glycerol‐containing lubricant for self‐catheterization [3].…”

“…For example, in 2014 a paper was published noting that several Japanese athletes had tested positive for glycerol—a substance that is prohibited, given its potential for use as a masking agent [3]. On further investigation, it was discovered that these positive tests were the result of the athletes' use of a glycerol‐containing lubricant for self‐catheterization [3]. Shortly thereafter, the World Anti‐Doping Agency testing standards were adjusted to increase the urine threshold value that constitutes a positive test, making this error unlikely to occur in the future.…”