However, the most damning item in her training bag was a small inhaler Torres used to keep her asthma in check. Now, new research from a Danish research lab may have finally set the record straight, vindicating the asthma medication that seems to have been falsely accused as a performance-enhancing substance.

During the Olympics, all asthma medications containing beta2-agonists, such as salbutamol (also known as albuterol), were on the official World Anti-Doping Agency (WADA) list of banned substances, due to their known ability to relax the smooth muscle cells in bronchial airways.

The thinking was that athletes who didn’t have asthma might be able to use salbutamol to further relax the muscle linings of their healthy lungs, kicking their breathing capacity into overdrive and gaining a crucial advantage over other competitors.

Asthmatics were exempt from this rule, of course, provided they could verify the inhaler was a medical necessity. That’s what Torres did some 18 months before the Beijing Olympics, petitioning the International Olympic Committee for a Therapeutic Use Exemption for Proventil — an albuterol-based asthma medication — which was then granted.

Starting this year, WADA lifted the ban on salbutamol, since research had yet to demonstrate that the drug enhances performance when taken as directed. The new doping rules simply state that all athletes must have a salbutamol level less than 1,000 nanograms per milliliter detectable in their urine sample when screened before competition (.pdf), which shouldn’t be a concern for athletes following the dosing guidelines of prescription inhalers.

The problem is that athletes might be tempted to take much more than the prescribed dose, squeezing every last possible benefit out of their now-approved meds.

A research team led by Jimmi Elers at the Respiratory Research Unit at Bispebjerg Hospital in Copenhagen was curious: Although taking a few puffs of salbutamol hasn’t shown a performance boost in past studies, what would a dose that’s, say, 40 times higher than normal do to lung function? And with higher amounts of the drug running through their bodies, would the over-the-top dose cause athletes to hit the upper limit enforced by the new WADA standards when they’re forced to undergo a urine-screening test before competition?

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Authors: Brian Mossop

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