The Blood Doping Control: Venous Blood Collection and Dried Blood Spot
Unlike urine testing, blood may be taken by two different, but not mutually exclusive, methods. A distinction is made between the Dried Blood Spot (DBS) method, and venous blood collection. Both types may be conducted in addition to or independently of urine testing. They differ in three fundamental ways: the place from which the blood is drawn, the amount of blood required, and the testing kit needed. Hence, certain steps of the control procedures differ slightly; details described below.
Notification and Identification
The control staff must provide proof of identity. The athlete receives written notification of the place, time and type of control. She is informed of her rights and obligations. The control staff ensure that the athlete’s identity has been established in the proper manner e.g. by means of an identity card, driving licence or by a third person accompanying her. By signing the doping control form, the athlete confirms that she received notification of the doping control. The form can be completed on paper or, as is more commonly done at Antidoping Switzerland, electronically via tablet.
Venous blood collection: Following a competition or strenuous training session, the athlete must wait two hours before blood can be taken. Thereby, the athlete is constantly supervised.
The control area
The waiting and testing areas are separate from each other. The only persons allowed in the testing area are the control staff, the athlete and at her request a person to accompany her and, if required, WADA observers and auditors and assessors from Antidoping Switzerland. The athlete may ask for the control procedure to be explained. A blood sample may be taken in addition to a urine sample (see urine doping control procedure). The athlete may eat and drink during the test, but not in the testing area.
Venous blood collection: Before blood is taken, the athlete must sit in an upright position for at least ten minutes. She can use this time to complete the form "Questions on the biological passport" and to answer questions about any medication she may have taken recently.
Selecting a testing kit
The athlete selects a packaged testing kit and a blood collection kit. There should be at least three kits to choose from and the packaging must be intact. If the athlete is not happy with the kit she has selected, she can take a second and a third one.
Venous blood collection: Each testing kit contains a collection container for sample A (red number) and a container for sample B (blue number), an unmarked container, sticky labels and three sealable plastic bags. The blood testing kit contains the instruments necessary to take a blood sample and the blood collection tubes.
DBS: The silver pouch contains two secure sealable plastic bags with one DBS card each (for the A and B samples), two portions of desiccant gel each, and a tamper-proof strip with which to seal the pouch again. The hygiene set comprises a disinfectant wipe, two swabs, a safety lancet, a minivette and a plaster. The numbers on the set (the silver pouch), the secure plastic bags, the DBS cards and the tamper-proof strip must all be identical.
Labelling the blood samples
The athlete sticks a label on each of the blood collection tubes and one on the "Questions on the biological passport" form.
DBS: not necessary
Giving a blood sample
While capillary blood collection only involves pricking a finger, venous blood collection requires a needle to be inserted into a vein. This also means that the amount of blood collected differs. With the DBS method, a minivette is used to saturate the two DBS cards with a large drop of blood each. By contrast, the venous method fills two blood collection tubes.
Blood is usually given in an upright position. The blood sample must be taken under totally hygienic conditions. The Blood Control Officer (BCO) takes a blood sample using the relevant blood collection device, and then cleans and covers the point at which the needle entered the skin.
Venous blood collection: The athlete may lie down to give blood if she wishes. 13 ml of blood is required for the test.
DBS: The DBS collection method requires good blood flow to the finger (the middle or ring finger, as the athlete wishes). Here, it helps shake the hands, let them hang by the sides for a couple of minutes, or briefly hold them into warm water.In exceptional cases, capillary blood may also be taken from the earlobe.
Sealing the collection material
Venous blood collection: The athlete should open the containers according to the BCO’s instructions. She then places a blood sample tube in the correct container and closes the containers with the correct screw lid. The lids are easy to close tightly. They cannot be screwed in a reverse direction and cannot be reopened. The lids are cut open in the laboratory and cannot be reused.
DBS: Put each of the DBS cards in a secure sealable plastic bag along with the two portions of desiccant gel. Make sure that the number on the card is visible. The two bags are then sealed with the tamper-proof strips and placed in the silver pouch. This is then closed using the large blue tamper-proof strip.
Completing the control form
The BCO enters further details, such as the container or DBS card numbers, on the form. The laboratory only receives the sample numbers plus the date and time the blood sample was given, type of sport, the athlete’s gender and if applicable, any medicines taken. No other personal details are seen by the laboratory staff. The red part of the form (page 6) is placed in one of the plastic bags.
Signing the form
The athlete can now check that the remaining part of the doping control form (pages 2 to 5) has been completed correctly and in full. Urine and blood samples may be taken at the same time and recorded on the same form. If the athlete wishes to make any comments or complaints, these can be recorded in writing on the form. The BCO, any accompanying persons and the athlete then sign the form and so confirm that the test was carried out correctly.
Concluding the control
The athlete is given a copy of the completed doping control form. This should be kept in a safe place. The athlete is informed of the result of the doping control by e-mail or by letter.
Venous blood collection: The athlete should not make any energetic movements with the arm from which blood was taken for up to 30 minutes after the doping control.
Sending off the blood sample for analysis
Venous blood collection: Blood samples are placed in a cool box and sent to the laboratory for analysis. Sample A is tested initially, if a banned substance is found in this sample, the athlete has the right to demand a second analysis, of sample B.
DBS: Silver pouches are placed in a shipping envelope and sent to the laboratory by registered first-class (A) post.