With the 2014 FIFA World Cup Brazil™ about to start, FIFA’s Chief Medical Officer, Professor Jiri Dvorak, and Martial Saugy, the Director of the LAD Laboratory in Lausanne, Switzerland, in charge of the doping analysis for the tournament respond to questions concerning the anti-doping programme that has been put in place for the competition.

FIFA.com: The 2014 FIFA World Cup will kick off in a few days, so what is new in terms of anti-doping compared to previous editions?
Professor Jiri Dvorak:
We are introducing a completely new approach with the implementation of the biological profile (or so-called passport). We are testing all the players from every team prior to the competition in unannounced controls. FIFA is one of the first international sports federation to introduce such a passport, including blood and urine parameters, in a major competition. The results of those analyses will be compared with samples from previous competitions and from in-competition controls during the World Cup in order to detect potential deviations that may indicate an abuse of performance enhancing drugs. It is a logistical challenge to introduce such a large scale programme. However, from the experience of the controls that we have carried out so far, the response from players, coaches and team managers has been very positive, demonstrating the general support of the football community to keep our sport free of doping.

Martial Saugy: FIFA decided to introduce biological monitoring in football because of the added value of the longitudinal and individual follow-up of the players. It is a big challenge due to the number of individuals in a team sport like football in comparison to individual sports like athletics. Nevertheless, the outcome of this approach will be tremendous, also because of the preventive effect of the follow-up. The fact that the players can be subject to controls at any time is very strong deterrent.

The biological profile was already introduced at the Confederations Cup last year. What have the results been so far?
Dvorak:
Last year for the FIFA Confederations Cup in Brazil we had a similar approach. We also tested all participating players prior to the competition, in addition to the routine in-competition controls. The comparison of the analyses of players who underwent several controls – prior to the Confederations Cup, during the tournament or from previous competitions – has not shown any significant deviations so far.

Saugy: The first results are still confidential and not published, but they definitively show that among those top teams, there have been no significant deviations from the norms.

How many samples will you have for each player? Is it enough to establish a profile?
Dvorak:
We are currently compiling the results of the anti-doping tests at EURO 2012, the 2013 and 2014 editions of the Champions League, the FIFA Club World Cup 2011, 2012 and 2013 and the FIFA Confederations Cup 2013, and we will be able to add the results from the 2014 FIFA World Cup – both in- and out-of-competition controls. We organised a conference last November at FIFA to discuss new strategies in the fight against doping and the conclusions were published recently in the British Journal of Sports Medicine. The experts consider that three to four samples should be sufficient to establish an individual profile.

Saugy: We know that from three to four samples, we can begin to build up a proper biological passport for steroids for example. But it is a very individual thing. If we see any deviation from the individual limits, further investigations and tests can be done.

Concretely, what controls will be in place for this World Cup? How many players will be tested and when? Are the controls unannounced? Are you testing urine and blood?
Dvorak:
For the 2014 FIFA World Cup, all participating players are tested unannounced prior to the competition by giving blood and urine samples. Then during the competition two players from each team will be tested after each match for blood and urine, and additional controls can be performed at any other time.

Saugy: All the players have undergone controls pre-competition with blood and urine samples. This is really the optimal programme we can get today in the anti-doping community.

After the revocation of the accreditation of the lab in Rio you had to find another lab abroad to conduct the analysis. Why did you choose Lausanne in Switzerland. Weren’t there other options closer to Brazil?
Dvorak:
To manage such an amount of samples we had the possibility of doing it in Montreal, Los Angeles, Cologne or Lausanne. We made the choice of Lausanne because of the high quality standards of the lab, its experience in the development of the biological profile and also because the samples from the FIFA Club World Cup 2012 and 2013 and the Confederations Cup 2013 were already stored there. This allows us to easily compare past results with the latest tests in the establishment of the biological profile.

With such a long trip, how will you ensure that the samples are safe?
Dvorak:
We are taking all necessary measures to make sure the samples are safe and get to the laboratory as quick as possible. Up to now, from the out-of-competition controls that have been performed with the different teams around the world, 750 blood and urine samples have been delivered to Lausanne. The average time for delivery was 19:50 hours, the shortest in about 4 hours and the longest from several Latin American countries in less than 33 hours. All samples arrived in satisfactory conditions thanks to the use of special automatic cooling boxes that record the temperature during the whole transportation, which allows the lab to monitor the conditions of the samples.

Saugy: All the necessary measures have been taken to preserve the integrity of the samples in order to get the best biological and analytical information from the collected samples.

How will you manage to get the results of the analyses on time?
Dvorak:
The lab in Lausanne is prepared to work 24/7 in order to initiate the analysis immediately upon arrival of the samples and with the objective of providing the results before the following games of the respective teams. This was also one of the reasons for our choice of the lab in Lausanne.

Saugy: We will make every effort to provide FIFA with the results prior to the next game. This is part of the contract and this is clearly our goal.

Isn’t it a huge challenge for the lab to handle so many tests in such a short time?
Saugy:
It is indeed a big challenge for us, but we are already used to that kind of major event. Our laboratory is part of the CHUV (University Hospital in Lausanne) and is used to emergency services. And of course, the good relationship we have with FIFA helps a lot. Since the accreditation of the laboratory in Rio was revoked, we prepared carefully all the analyses and organisation with Professor Dvorak in order to get the samples in proper condition and to analyse them as soon as they arrive in the lab. This is a challenge, but the laboratory team is proud to be part of the event.

Football is often criticised for not doing enough in the fight against doping. How would you respond to such criticism?
Dvorak:
The FIFA Medical Committee is of the opinion, based also on discussions with other sports federations, that our strategy of focusing on education and prevention combined with a programme of stringent in- and out-of-competition controls pays off. The introduction of the biological profile for the FIFA World Cup including both blood and steroid parameters shows our consequent follow-up of this strategy in the fight against doping. If we look at World Anti-Doping Agency statistics we can see that football is by far the number one sport in terms of anti-doping tests – around 30,000 tests each year – and the number of positive cases compared to other sports is very low.

Saugy: FIFA has been investing in the field of anti-doping research for many years. Since the 1998 World Cup in France, our laboratory has been collaborating with FIFA and Professor Dvorak to establish the best strategies in the fight against doping. As far back as the 2002 World Cup in Korea/Japan, FIFA collected the first blood samples and implemented EPO tests in football. Now, its key role in the implementation of biological monitoring is also a consequence of years of research in the steroid profiling of football players.