53. There is also evidence to support the theory
that many athletes may take illegal performance enhancement technologies
without knowingly doing so, for example through the consumption
of contaminated nutritional supplements. Dr Anna Casey from QinetiQ
told us that she considers that "one of the major threats"
to the 2012 Olympics is potential contamination of food supplements,
taken in good faith by athletes.
54. WADA has been aware of potential contamination
of food supplements and the problems this may cause for some time.
Professor Ljungqvist told us that during the first two years of
WADA's existence, a working group was established to look into
the area of food supplements. The research carried out by a group
in Cologne, led by Hans Geyer, showed that between 15 and 20 per
cent of the food supplements tested were contaminated by or contained
banned substances which were not indicated on the labels.
This evidence is, however, disputed by ESSNA who have told us
in written evidence that although it has been alleged that "there
are unscrupulous manufacturers who place on the market products
that contain prohibited and sometimes dangerous ingredients and
that there are also manufacturers who market products to elite
athletes but who mislabel their products", they have seen
no "substantive evidence" to support this assertion
and can see no commercial benefit to a company from adopting such
55. Dr John Brewer, representing GlaxoSmithKline
(GSK), recognised that, since there is a plethora of supplements
that are available for athletes, "it is always going to be
very difficult and very confusing for the athletes to know what
works and also what is free of banned substances". Mr Brewer
therefore made the plea for a recognised standard of labelling
of such products.
Dr Casey supported this view, telling us that "that there
has to be, between now and 2012, more effort put into making available
certified, contaminant-free food supplements".
Mr John Scott from UK Sport agreed that "the whole issue
of supplements remains a major challenge" and that UK Sport
would "love to see an industry standard in the supplements
56. Dr Brewer also told us that the products GSK
produces are currently tested at HFL Ltd, one of the UK's WADA-accredited
testing laboratories, to ensure that all of their products are
free of substances on the WADA banned list.
However, a "major concern" for GSK at the moment is
that there is a suggestion that WADA may remove their accreditation
from laboratories testing manufacturers' supplements. Mr Brewer
felt that this "is a very backward step for WADA to be taking"
since having such quality assurance for athletes is important.
Professor Ljungqvist from WADA explained the rationale behind
the decision to remove accreditation from WADA laboratories testing
commercial supplements. He said that if a laboratory tests or
is asked to test certain food supplements to determine whether
or not they may be contaminated, if the results show that they
are not, it is not possible to conclude from that one result that
subsequent batches will not be contaminated, and the laboratory
may therefore risk issuing false and misleading reports. Professor
Ljungqvist said that "we have told the laboratories not to
become involved in an area which is so poorly regulated at the
57. We firmly believe that it is the responsibility
of the individual athlete to determine what is being taken into
their own body. However, we also consider it important that an
athlete has sufficient assurance on the purity of any non-prohibited
substance they may wish to consume. We believe that accreditation
of laboratories testing commercial supplements for use in sport
provides such assurance to athletes. We
do not believe that it is in the best interest of the athlete
for WADA to remove its accreditation from laboratories testing
commercial supplements for use in sport. We recommend that the
Minister for Sport maintain pressure on WADA to secure the continuing
accreditation of laboratories which also test commercial supplements.
In addition, we recommend UK Sport take the lead in working with
relevant bodies to put in place a certification system for supplements
used in sport to regulate against contamination of food supplements
and provide assurance to athletes on the purity of what they are
58. Athletes may also accidentally take a banned
substance because they do not realise that such a substance is
contained within the Prohibited List. For example, we heard from
Dr Hamilton of UK Athletics that athletes may accidentally take
ephedrine, a decongestant found in many cold remedies and that
"we can all make those mistakes".
We also heard that medical practitioners may not always be aware
of the WADA Prohibited List, and the substances and technologies
on it, or understand the implications for athletes of using certain
substances. John Scott from UK Sport told us that his organisation
puts "a lot of effort" into ensuring that there is education
material available to doctors to enable them to make informed
decisions with regard to specific athletes who are elite performers.
However, UK Sport's effort in this area may not be sufficient.
Dr Bruce Hamilton of UK Athletics told us that what is and is
not acceptable for the medical treatment of athletes can be confusing
to doctors. He raised the use of glucocorticoids, steroids used
to provide relief for inflamed areas of the body. Glucocorticoids
may be used to treat joint inflammation, as a corticoid steroid
injection or through the mouth, for example in arthritis. Use
of glucocorticoids through either of these routes is prohibited
without a TUE. However, glucocorticoids can also be taken as a
nasal preparation, for example for allergic rhinitis, use of which
is which is not prohibited by WADA. Dr Hamilton felt that whether
such substances and their routes of administration could be used
was sometimes unclear to doctors and that differences in regulation
between use of the same substance, for example via different routes,
could be "subtle".
We are concerned that doctors may not always understand what is
deemed acceptable treatment for athletes. We
recommend that UK Sport consult upon and review its education
material aimed at general practitioners and other medics on the
issues faced by athletes, providing further education if this
is deemed necessary to clarify WADA prohibited substances and
the routes via which such substances may be given.