The Netherlands’ Kira Toussaint, who tested positive for Tulobuterol after a November 2nd doping test at the Beijing stop of the FINA World Cup Series, has voluntarily withdrawn from competition while her case is being decided. Tulobuterol, which is used in some countries to treat asthma, is listed on WADA’s banned substance list under Beta-2 Agonists, and she says FINA’s letter to her stated that a reading of 0.000000001 grams was found in the test.
As Toussaint explained, in order to be a WADA-approved doping facility, testing needs to be accurate to 7 decimals, or to a ten-millionth. While most labs in Europe provide results to 7 decimals, the Chinese testing facility shows results to 8 decimals, and that is the reading that Toussaint’s sample gave. She also pointed out that Tulobuterol is much more widely available in Asia than it is in Europe, suggesting she may have ingested it involuntarily. Furthermore, adding to the perfect storm that is clouding her case, she says that the doping test that she took was the fastest she’s ever done, taking about 10 minutes. Had it taken her an hour to provide the urine sample, the trace element may have decayed enough to be undetectable in her urine sample.
Toussaint does use medication for her asthma, but it is not Tulobuterol. She takes an inhaled formoterol under the brand name Foster, for which there is a specific clause in the World Anti-Doping Code allowing its use without a TUE:
Except:
Inhaled formoterol: maximum delivered dose of 54 micrograms over 24 hours;
Tulobuterol, the substance that showed up in her system, is a relatively-new asthma treatment that is only legal in a few countries, mostly in Asia.
Toussaint has not yet received a ruling from FINA. In the meantime, she is training but not competing and hoping for the best. We spoke with Toussaint about her ordeal:
Have you identified the source of contamination?
“My team around me and I are looking into that still. We don’t know yet. Because there’s not even a case [against me] yet. But I said in an earlier statement that I didn’t take [Tulobuterol]. Or to the best of my knowledge. Of course, I’ve thought about it a million times. ‘How is this even possible? How can this happen?’ In my mind it must be contaminated food. But first of all, it’s very hard to prove, so we don’t know yet.”
What was detected?
“The amount they found was 8 zeros and a 1 [after the decimal]. The particular thing about that is, if the base urine sample had been tested in a European doping lab or a Japanese doping lab, in those labs they only detect to 7 zeros. But in China they have better detection instruments so they can detect to 8 zeros. I usually think that it’s great that they have that detection stuff but for me right now, it’s very frustrating to know that if the same urine sample would have been tested in another lab that it wouldn’t have been positive. For me it’s double: on the one hand I think it’s good they have those good detection instruments but in this case it’s very frustrating for me.”
Testing Lab
“It seems unfair, but WADA has a rule that to be a WADA-certified doping lab you need to be able to detect 7 zeros behind the comma and if you can do 8, that’s great. That’s what they are saying. It’s a minimum standard. If you can do better that’s good. It’s unfair if people are tested to different standards. But that’s the case now and there’s not much I can do about that, so I don’t want to dwell on that.”
About Tulobuterol
“First of all the substance is very rare. There only have been four positive tests ever with this and they were all in Japan. The substance is only used in Asia, in China, Japan, South Korea, and there’s actually one South American country, in Venezuela you can get it as well. So it’s very not common. So there [are] not [many] cases previously with this substance.”
Editor’s note: Tulobuterol is administered via a transdermal patch on the skin.
“The half-life of this substance is 144 minutes; that’s like 2.4 hours. That’s pretty important in this case because let’s say it was contaminated food. The concentration of the substance was extremely low. My doping test from that day was my quickest doping test ever. It took me only ten minutes and then I was done. [The way half-life works is that if] you start with 10 grams of a substance, and the half-life is one hour, after one hour you only have 5 grams left. After 2 hours you have 2.5 grams left. So with this substance, 2.4 hours is the half-life so it’s really quick out of your body. And this was my fastest doping test. Everybody that takes drug tests knows that sometimes it takes long, sometimes it takes short. But this one was only 10 minutes. But if I would have peed 2 hour later it most likely would have been out of my system, or under the traceable amount of 8 zeros after the comma. So the half-life time is so small that maybe other people that ate the same food had a test later and they didn’t test positive because it was already out of their system. I don’t know, that’s speculation. But these are the things that are going through my mind.”
Other Testing
“I’ve been tested at all the World Cups. Also at the stops at Tokyo and Singapore which were after China, and those were completely normal.”
TUE (therapeutic use exemption)
“People were thinking I have a TUE for my asthma medication, but I don’t. This asthma medication is a very light medication that everybody that has asthma can use without having to request a TUE. So there was a misconception about that.
“The article explains that if you don’t have asthma, then asthma medication isn’t going to help you. Your bronchi are at normal standing. If you have asthma, they narrow down a little bit. If you take medication they go back to normal. It’s not like they grow bigger, or they make you perform better. They just go back to the normal size.
“I’m a very light asthma patient. My asthma is triggered by chlorine and humidity. When you are in a pool with chlorine and high humidity, that doesn’t help. So that’s why I use the asthma medication, to go back to my normal lung function. It is completely normal for athletes to have asthma. My asthma is not extreme and the medication I use, I don’t need a TUE for that. What I want to imply with that is that the substance that was traced in my body wouldn’t even have any benefit, first of all because the concentration was so low, and second of all, I already use the medication that works for my asthma. It’s not like if you take another medication that your lungs are going to grow bigger, or open more.”
What was the procedure?
“I came home the Saturday before World Championships started. The first thing I did on Monday, I went to see the head of the Dutch doping authority to ask him, ‘What happens now? What’s going on?’ I had no idea. I got informed by them what the next steps were, and then I hired a lawyer. Nothing much has happened since then. We have to wait until FINA finally makes the case.
“It’s not like it has to be public already but my thing was, I felt like I had to lie about [not going to World Championships]. I felt so terrible that I had to lie to people. And I didn’t want to do that so that’s why I decided to come public with it. To say, ‘This is what happened to me,’ because this is how it feels. It’s something that out of my control that happened to me. It’s kind of out of my control what’s going to happen now. That’s why I went public with it. I had nothing to hide. Besides the fact that this can stain my reputation a lot, which is really terrible. I’m heartbroken about that still, because that’s what I’ve worked for my whole career.”
Voluntary Provisional Suspension
“I voluntarily signed a provisional suspension. FINA sends a form with the analysis of the B Sample results. They send a form [that says] ‘you can accept a provisional suspension.’ My first reaction to that was ‘Hell no, why would I do that? I’m not going to punish myself for something I didn’t do.’ But then later, I was like, ‘well, the best chance for me to actually compete at World Championships and at the Olympics is if I do accept this provisional suspension.’ Because if hypothetically I get actually suspended, if I wouldn’t have signed the form, then the suspension would start on the day of the verdict. [But by signing the form, it begins] the moment that I withdrew myself voluntarily from competition, so before World Championships.”
Not an Admission of Guilt
“When I sent the letter to accept the suspension from FINA I very clearly stated that it’s not a mea culpa. The letter was written in English and I clearly stated that. So I’m training but I’m voluntarily out of competition.”
Telling the Truth
“The Dutch Federation wrote a statement that I was not fit for competition. So the media made out of that that I was sick and went home. So I was in the plane and a lot of people were texting me and I answered them with an emoji with a crying face. Most people didn’t respond to that because it was clear I didn’t want to talk about it. It was very painful for me to talk about World Championships or watch it because I felt I might do really good. With the Dutch relays we had really good chances. I mean they still did really well, but it was really painful to see I couldn’t compete with them.”
Timing of the Announcement
“First I had to wait for the analysis of the B sample. That came about December 20. Before that I already wrote a statement because the chance that the B sample is negative if the A sample is positive is 1 in 1000. I wanted to prepare for what would happen if it was positive. I prepared to give an interview for the Dutch television. Then the letter came. It was terrible to receive the letter because even though I knew it was going to come, I still had hope. After that letter, all the hope was gone.
“I took time to think about signing the letter. I signed the letter in January, but it’s dated before because that’s when I voluntarily withdrew myself out of the competition. On December 7th.
When would you need to finish hypothetical suspension in order to qualify for World Championships?
“I seriously still have no clue about what might happen, what could happen. So I don’t really want to speculate about that because I just don’t know. There’s not much to say about it. We have a trial in April and another chance in June, so I guess June is the last time I can qualify for World Championships.”
Are you still training?
“I’m still training with the same group, with the same coach as I did before everything happened. That hasn’t changed. It’s just a big waiting game; that’s the hardest thing about it. Every day I’m waiting to receive an email from FINA and it doesn’t come. That’s hard. I have to take it as it comes. Right now I’m just going to train.”
Sanctions
“I still hope [the sanction] will be zero.”
Very interesting the Chinese believe their equipment to be accurate to 9 significant figures. Cannot imagine the cost for that equipment to become 1 significant figure more accurate than required especially in such a small magnitude.
I think we won’t know what really happened in this case, too.
Tulobuterol (INN) is well-known from decades. Any labs (?) can buy it for research use (https://www.scbt.com/scbt/product/tulobuterol-41570-61-0 e.g).
Medicines containing Tulobuterol can be found in Asian countries (listed above plus Bangladesh) and in Venezuela, but not only in transdermal formula (controlled and long lasting) but also in aerosol inhalation type (DS 0,1%). There’re different patches (0,5-1-2 mg) for children and adults (and indications: asthma, COPD etc.) and the pharmacokinetics is not so simple in human beeings.
Generally the main problem is that the rules must be clear and precise. The procedure of the drug tests must be homologue. The time, amount etc.taking… Read more »
This is actually insane.
That level is crazy. What is the margin of error on a result of a billionth of a gram?
This is total FINABULLPOOP! Poor Kira WE STAND UNITED BEHIND YOU!!!!!