The anti-doping authority of The Netherlands (Doping Autoriteit) has called for clarity in the World Anti-Doping Agency’s (WADA) rules on salbutamol in comments provided on the 2019 Prohibited List, which is due to be published by 1 October. Earlier this month, the International Cycling Union and WADA cleared Chris Froome after he was able to show that a urine test alone cannot indicate whether an athlete has inhaled salbutamol at above WADA’s permitted limit; and that producing a pharmacokinetic study (CPKS) proving that salbutamol concentration in urine at above levels permitted by WADA is consistent with inhalation below WADA’s limit is close to impossible.

‘Over the last year, it became obvious that the practical framework for performing such a controlled pharmacokinetic study is not clear enough’, reads the Doping Autoriteit submission (PDF below). ‘We therefore propose to make this framework more clear, and suggest WADA to publish an additional guideline document for performing controlled pharmacokinetic studies’.

The submission also reveals that WADA’s List Expert Group (LiEG) is undertaking studies designed to distinguish inhaled usage of beta-2 agonists – such as salbutamol – from oral usage, but these studies have yet to be published. The Doping Autoriteit advises that the completion and sharing of these studies should be made ‘a priority’.

Other recommendations include:

• Removing the distinction between ‘prohibited in competition’ and ‘prohibited out of competition’ to create a single List of substances prohibited at all times;
• The addition of Thyroid Hormones to the Prohibited List, due to evidence of their widespread misuse in sport;
• Allowing women to use clomifene, a fertility drug, as ‘we believe there are no potential performance or AAS post-cycle benefits for women to use it’.