9 October 2017

Case against Matej Tóth raises further questions about ABP process

The Athletics Integrity Unit (AIU) is currently examining a 4 October decision to clear Rio 2016 50km race walk champion Matej Tóth, after he was provisionally suspended due to an irregularity in his Athlete Biological Passport (ABP). Toth was provisionally suspended in July, forcing him to miss the London 2017 World Championships, however the Slovak Athletic Committee (SAZ) accepted that various factors caused a 4 May 2016 sample to return low levels of haemoglobin.

The ABP works by monitoring blood values over time, developing a haematological profile for each athlete. ‘Through changes in biological Markers of doping collated over an Athlete’s career, the ABP can be used to establish ‘Use’ per Code article 2.2 without necessarily relying on the detection of a particular Prohibited Substance or Prohibited Method’, reads the Athlete Biological Passport Operating Guidelines.

It appears that this is what happened in Tóth’s case. He argued that 24 samples were collected from him from 2009 to 2016, one of which reported low levels of haemoglobin. It is understood that the decline in haemoglobin from March to May 2016 was steep, following a sharp increase in haemoglobin values up until the deadline for the Rio 2016 Olympics.

Tóth argued that the 4 May 2016 sample was collected late in the evening, with most of the other blood values collected early in the day. Analysis of Tóth’s blood values over a seven year period by Dr. Róbert Mistrík showed that haemoglobin values reported by Tóth were much higher in samples taken early in the day. Tóth also argued that food and drink taken during the day can also affect blood values, which is why most medical blood monitoring requires a sample to be taken at a certain time of day, with no food or drink consumed prior to sample collection.

On 4 May, he was also required to give urine samples and so drank a litre of water in order to be able to produce the required sample amount. He argues that such hydration can also affect blood values. In addition to this, Tóth was treated for tibial tendon inflammation during March and April 2016. This apparently involved ‘aggressive’ treatment involving rheumatic anti-inflammatory agents, radiation therapy and x-rays, all of which have an effect on blood formation.

He argues that a subsequent steep increase in haemoglobin values was caused by staying in a hypoxic environment. Utilising a hypoxic environment – such as training at altitude or sleeping in an oxygen tent – is thought to stimulate hematopoiesis, or formation of blood cells. It is not considered a prohibited method by the World Anti-Doping Agency (WADA).

Potential questions about the ABP process

It appears that the IAAF brought forward an anti-doping rule violation (ADRV) against Tóth based on a single blood value. This has echoes of the Claudia Pechstein saga, however the case against Tóth appears to be even more spurious. The decision to bring forward an anti-doping rule violation (ADRV) against Pechstein was based on three blood values, not one.

For an ADRV to be brought against an athlete under the ABP system, significant hurdles must be cleared…

Under the ABP Guidelines, when a haemoglobin concentration falls outside of the expected range for the individual concerned, an Atypical Passport Finding (ATPF) is generated. This is then sent to an independent expert, who must decide if the value concerned indicates ‘likely doping’. If this hurdle is met, the reading is then sent to a panel of three experts. If all three agree, then a documentation package is created, which is sent to the anti-doping organisation concerned (in this case, the SAZ). The athlete is also shown the documentation package and offered the chance to provide explanations before an ADRV is brought against them.

Tóth says he brought forward 250 pages of evidence from seven experts, including seven annexes, in support of his case. The reliance on one value, and on the non-medical evidence (i.e. proximity to the Rio Games) to bring forward an ADRV against Tóth raises questions as to how diligent reviews of potential ABP cases are – especially when one considers that higher profile stars have been flagged as ‘likely doping’ under the same system.

Tóth has missed the chance to compete at the IAAF’s London 2017 World Championships due to this case. The AIU has 21 days from 4 October to decide whether to appeal.

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