The Blood Doping Controls: 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 venous blood collection and the Dried Blood Spot (DBS) method.
Blood tests 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.
The following text and images provide a step-by-step guide to a blood doping control procedure:
Notification and identification
The control staff identify themselves and the athlete is informed about the notification and upcoming control. He is informed of his rights and obligations. The control staff ensure that the athlete’s identity has been established e.g. by means of an identity card, driving licence or by an accompanying third party. By signing the doping control form, the athlete confirms that he received notification of the doping control and that he has understood the correlated rights and obligations. Following a physical exertion, the athlete must wait two hours before blood can be taken or 30 minutes for a serum test.
In the testing area
The waiting and testing areas are separate from each other. The only people allowed in the testing area are the control staff, the athlete undergoing testing and, at his request, an accompanying person, as well as WADA observers and auditors 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 in the waiting area but not in the testing area. Before blood is taken, the athlete must sit in an upright position for at least ten minutes. The waiting time can used to complete the form ‘Questions on the biological passport’ and to answer questions about any medication which may have been taken recently.
Selecting a testing kit
The athlete selects a packaged 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 selected kit, he can choose another one which is intact.
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 sealable plastic bags. Identical numbers should appear on the kits, containers, lids and sticky labels. The blood testing kit contains the tools necessary for taking a blood sample and the blood collection vials.
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 vials.
Taking a blood sample
Blood is usually taken in an upright sitting position. Upon request, the athlete may lie down for the blood collection. Max. 13 ml of blood is required for the test. The blood sample must be taken under completely 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. 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.
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
The athlete should open the containers according to the BCO’s instructions. He then places the blood sample vial into the correct containers and closes the containers with the correct screw lids. The lids should be fully tightened but without over-exertion. They can no longer be unscrewed in the 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 on the form, such as the container number, date and time. The laboratory receives the sample in anonymous format, i. e. only the sample numbers, date and time the blood sample was taken, type of sport, athlete’s gender and, if applicable, any medicines taken are specified. No other personal details are visible to the laboratory staff. To make the analysis process easier, it can be useful to enter any medication taken over the last seven days on the form.
Signing the form and concluding the control
The athlete can now check that the remaining part of the doping control form has been completed correctly and in full. If the athlete wishes to make any comments or complaints, these can be recorded in writing on the form. The BCO, any accompanying individuals and the athlete then sign the form and thereby confirm that the test was carried out correctly. The athlete is given a copy of the completed doping control form. This should be kept in a safe place.
Sending off the blood samples and analysis
Blood samples are placed in a cool box and sent to the laboratory for analysis. The athlete is informed of the result of the doping control by e-mail or by letter. If a banned substance is found in sample A, the athlete has the right to demand the analysis of sample B in his presence.
DBS: Silver pouches are placed in a shipping envelope and sent to the laboratory by registered first-class (A) post.