Doping in XC skiing

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Mar 4, 2013
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python said:
ever since the sundby asthma-gate broke out, i've been keeping an eye on both the main stream scandinavian media and the less official forums and reader comments...here's what surprised me, actually stunned me -- the virtual lack of any discussion regarding the finer details of what may look as a sophisticated doping scheme. the stress is on SOPHISTICATED as opposed to random, amateurism of the poor soles swallowing any crap and injecting themselves with own blood...

before i get misunderstood, a disclaimer here is due. i am not insisting on the existence of a deliberate doping program in norway. just calling for some attention to the common features of what we have learned from a sophisticated cycling doping. here are some.

1. they are always supervised by and act in accordance with the expert doctors. needless to remind, that in the case of sundby-gate, the medics role in administering the drug to the healthy was not only admitted and vigorously defended, but the entire fiasco was spuns as a doctor mistake.

2. well calculated drug dozes and administration timing so that by the time of giving a doping sample, the drug is either cleared from the system or falls below the detectable threshold. thus beating the test (i explained it in the point 4. here viewtopic.php?p=2018684#p2018684) the scientists call it a drug's half life.

for instance, as we now know from the cas document on sundby, his clearance of salbutamol was VERY fast. almost gone just several hours after 'eating' it. his personal studies proved it ! it is unimaginable that the highly professional norwegian team docs (mind you - the doctors that followed his asthma for many years by their own admission) would be blind to his fast salbutamol clearance. too bad for them, when administering the illegal nebulizer, they likely miscalculated.

3. combining anti-asthma with other drugs to stay undetectable and still being a ped. this principle is so subtle and cutting edge that only a team of various specialization experts can apply it right. very curiously, and this went over the heads of almost everyone, the danish researcher quoted above hinted at it black on white when interviewed about sundby. what the dane meant but did not elaborate is - the combination of short acting beta agonists (salbutamol) and long acting (formoterol) with trace dozes of sympathomimetics or corticosteroids and various other agents shown to affect athsma...

the mechanism of doping would be similar to the one used by the russian wada lab chief rodchenkov turned wada whistle blower. he said he experimented with and invented a cocktail of 3 quick acting anabolic steroids that would be in such small quantities that individually were undetectable yet delivered a triple punch. this is the micro-dosing cutting edge that requires a direct feedback from a sophisticated laboratory.

All very good points Python. While you are "not insisting on the existence of a deliberate doping program in Norway, just calling for some attention to the common features" you do touch the unmentionable, which is a delibarate "doping" program, though hidden behind arguments of preventative treatment and every limit pushed to its maximum or beyond.
The fact is, if you believe nothing was wrong with the Norwegians in the 90s, than listen and be comforted by the explanations from the Norwegian Ski Federation and its team doctors. However, if you believe something was wrong even in Norwegian XC-skiing in the 90s, maybe convinced by the clearly suppressed anger from the late, antidoping legend Bengt Saltin, than you should be really worried. Because, the leading positions in Norwegian XC-skiing is still dominated by the 90s people, so be it team doctors or the top dogs.
 
Jan 3, 2016
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MrRoboto said:
Blaaswix said:
Kowalczyk skied with a broken foot!
Probably not the best example, as she used a relatively powerful painkiller to get through that.
I think it's a good example. Taking a painkiller to get through an event because you have an injury. As long as it gives no other advantage.Taking a medicine, regularly, for an illness you don't have because your doctor thinks you might benefit from it, in ways that aren't fully clear, is very different.
 
Sep 25, 2009
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Blaaswix said:
MrRoboto said:
Blaaswix said:
Kowalczyk skied with a broken foot!
Probably not the best example, as she used a relatively powerful painkiller to get through that.
I think it's a good example. Taking a painkiller to get through an event because you have an injury. As long as it gives no other advantage.Taking a medicine, regularly, for an illness you don't have because your doctor thinks you might benefit from it, in ways that aren't fully clear, is very different.
to summarize, regarding the sundby doping case, Blaaswix believes that justyna's use of pain killers in sochi was well justified, while MrRoboto seems of the opposite opinion.

who's argument makes more sense ?

to begin with, and to put it bluntly, i am far from convinced that justyna was squeaky clean during her long career. but was her use of a pain killer in sochi comparable to the norwegian use, or per wada - abuse, of the asthma meds ?

lets consult the available PUBLIC sources.

what emerged is that justyna had a real broken bone. it was documented by making a real mri medical image public. pls, note it was intended to be private. what she did was to expose herself and her doctor and the image producers to doubts. none EVER followed. which means most certainly she had a broken bone. how did she treat it ?

again, she made it a public knowledge that she used a LOCAL pain killer injection (that was NOT on a banned list) to numb her bone fracture for 3 hours. btw, wada never challenged her version. if anyone is aware of an opposite fact, pls link to it...

and how does her story compare to the sundby fiasco ?

your millage may vary, but he chose to use what wada considered an illegal method (the nebulizer). while both martin and justyna appeared to use their medications to address their own medical troubles, martin was has tested positive for a banned substance while justyna in sochi never used a wada banned substance.

end of the story.

i could go into the more damaging issues of the banned drug used on the healthy norwegian athletes, but i tried to keep apples=apples.
 
May 19, 2011
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Blaaswix said:
I think it's a good example. Taking a painkiller to get through an event because you have an injury. As long as it gives no other advantage.Taking a medicine, regularly, for an illness you don't have because your doctor thinks you might benefit from it, in ways that aren't fully clear, is very different.
Fair enough, I misread the context a bit.

Still:
As long as it gives no other advantage
...well, that's a good question, isn't it.
 
Feb 15, 2015
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Here's the committee that will check the use of asthma meds:

Leder: Katharina Rise
Fungerende avdelingsleder ved Oslo statsadvokatembeter (i permisjon fra Riksadvokatembetet).

Kjell Larsson
MD, professor, Unit of Lung and Airway Research. Karolinska Institutet.

Lars Pedersen
Dansk overlege, Ph.d. (spesiallege i lungesykdommer). Sitter i Anti-Doping Danmarks TUE-komité.

Katja Mjøsund
Lege (spesiallege idrettsmedisin), PhD. Leder av den finske TUE-komiteen. Medlem av WADAs TUE ekspertgruppe. Tidligere topputøver (orientering).

Reidun Førde
Lege og professor ved Senter for medisinsk etikk, Universitetet i Oslo.
Very Nordic.

https://www.nrk.no/sport/granskingsutvalget-er-klart-1.13133860
 
Mar 4, 2013
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kosmonaut said:
Here's the committee that will check the use of asthma meds:

Leder: Katharina Rise
Fungerende avdelingsleder ved Oslo statsadvokatembeter (i permisjon fra Riksadvokatembetet).

Kjell Larsson
MD, professor, Unit of Lung and Airway Research. Karolinska Institutet.

Lars Pedersen
Dansk overlege, Ph.d. (spesiallege i lungesykdommer). Sitter i Anti-Doping Danmarks TUE-komité.

Katja Mjøsund
Lege (spesiallege idrettsmedisin), PhD. Leder av den finske TUE-komiteen. Medlem av WADAs TUE ekspertgruppe. Tidligere topputøver (orientering).

Reidun Førde
Lege og professor ved Senter for medisinsk etikk, Universitetet i Oslo.
Very Nordic.

https://www.nrk.no/sport/granskingsutvalget-er-klart-1.13133860

Kjell Larsson has published numerous articles together with Kai Håkon Carlsen. Especially this article is problematc since it is probably an essential part of the research that the Norwegian Ski Federation is embracing, when medicating all XC-skiers with asthma medication due to preventive reasons.
It's really mind-boggling that they couldn't produce more independent experts. It's against core values concerning ethics in scientific research and academic values.

Delgado, L., K. H. Carlsen, and K. Larsson. Asthma-like conditions in athletes. In: European Monograph - Diagnosis, Prevention and Treatment of Exercise-Related Asthma, Respiratory and Allergic Disorders in Sport. K. H. Carlsen (Ed.), 2005, pp. 67-72
 
May 13, 2011
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Who is the political fixer on the committee who will make sure that the report will say what the Norwegian government / ski federation wants it to say?

Clearly Larsson is the science advocate who will ensure that Carlsen's viewpoints on asthma not being performance enhancing will be represented.

Sorry, the committee is not unbiased and therefore is useless.
 
Mar 4, 2013
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kosmonaut said:
http://www.expressen.se/sport/langdskidor/svenske-specialisten-ifragasatts-i-norge/

When the Swedish expert member of the commission prof Kjell Larsson being put under pressure by journalists about his connections with Kai-Håkon Carlsen, he answers:
-Jag vet inte vilken roll Kai-Håkon har i det här och jag vet inte vad det eventuellt skulle betyda att jag skrev några artiklar ihop med honom för 10-15 år sen.
(My translation) - I don’t know which part Kai-Håkon plays in this and what it might mean that we wrote some articles together 10-15 years ago.

However, it turns out they’ve had a professional relationship since 1996 and with last article published as late as 2013. The most compelling thing is the close research work together in the same sensible area he is going to investigate. Someone should inform his employer Karolinska Institutet. They can’t afford another debacle concerning ethics in scientific research, after the Macchiarini scandal.
This is a list of the research:

Lazarinis N, Jørgensen L, Ekström T, Bjermer L, Dahlén B, Pullerits T, Hedlin G, Carlsen KH, Larsson K (2013)
Combination of budesonide/formoterol on demand improves asthma control by reducing exercise-induced bronchoconstriction
Thorax, 69 (2), 130-6
PubMed 24092567

Carlsen KH, Anderson SD, Bjermer L, Bonini S, Brusasco V, Canonica W, Cummiskey J, Delgado L, Del Giacco SR, Drobnic F, Haahtela T, Larsson K, Palange P, Popov T, van Cauwenberge P, European Respiratory Society, European Academy of Allergy and Clinical Immunology (2008)
Exercise-induced asthma, respiratory and allergic disorders in elite athletes: epidemiology, mechanisms and diagnosis: part I of the report from the Joint Task Force of the European Respiratory Society (ERS) and the European Academy of Allergy and Clinical Immunology (EAACI) in cooperation with GA2LEN
Allergy, 63 (4), 387-
Allergy, 63 (4), 387-403
PubMed 18315727

Carlsen KH, Anderson SD, Bjermer L, Bonini S, Brusasco V, Canonica W, Cummiskey J, Delgado L, Del Giacco SR, Drobnic F, Haahtela T, Larsson K, Palange P, Popov T, van Cauwenberge P, European Respiratory Society, European Academy of Allergy and Clinical Immunology, GA(2)LEN (2008)
Treatment of exercise-induced asthma, respiratory and allergic disorders in sports and the relationship to doping: Part II of the report from the Joint Task Force of European Respiratory Society (ERS) and European Academy of Allergy and Clinical Immunology (EAACI) in cooperation with GA(2)LEN
Allergy, 63 (5), 492-505
PubMed 18394123

Delgado, L., K. H. Carlsen, and K. Larsson.
Asthma-like conditions in athletes. In: European Monograph - Diagnosis, Prevention and Treatment of Exercise-Related Asthma, Respiratory and Allergic Disorders in Sport. K. H. Carlsen (Ed.), 2005, pp. 67-72. [abstract]
S.D. Anderson, V. Brusasco, T. Haahtela, T. Popov, L. Delgado, K-H. Carlsen, K. Larsson
Asthma-like conditions in athletes
Eur Respir Mon, 2005, 33, 67–72

K. Larsson, K-H. Carlsen, S. Bonini
Anti-asthmatic drugs: treatment of athletes and exercise-induced bronchoconstriction
Eur Respir Mon, 2005, 33, 73–88

Carlsen KH, Larsson K (1996)
The efficacy of inhaled disodium cromoglycate and glucocorticoids
Clin Exp Allergy, 26 Suppl 4, 8-17
PubMed 8809433


Year 2005 EAACI - European Academy of Allergy and Clinical Immunology, did put togehter an international Task Force: Recognizing and diagnosing exercise related asthma, respiratory and allergic disorders in Sports
with following members:
EAACI: Bonini S. (Italy), Canonica G.W. (Italy), Del Giacco St. (Italy), Delgado L. (Portugal), Galatas J. (Greece), Haahtela T. (Finland), Popov T. (Bulgaria), Van Cauwenberge P. (Belgium);
ERS: Anderson S.D. (Australia), Bjermer L. (Sweden), Brusasco V. (Italy), Carlsen K.H. (Norway), Drobnic F. (Spain), Larsson K. (Sweden), Palange P. (Italy);
IOC: Cummiskey J, (Ireland);
Observer: Khaltev N, (WHO)

Addition:
Kjell Larsson has ties to four of the big medical companies that produces asthma medication (2008):
[translation]
The last 5 years had economical compensation for lectures/member in Advisory board/educational activities arranged by: AstraZeneca, GlaxoSmithKline, Boehringer Ingelheim och Pfizer. Also had financial research support ("unrestricted grants") from AstraZeneca, GlaxoSmithKline och Boehringer Ingelheim.
https://lakemedelsverket.se/upload/...ner/Clean REVIDERAD Jävsdeklarationer KOL.pdf

As of 2016 Kjell Larsson is contact person regarding medical questions for Boehringer Ingelheim:
http://www.boehringer-ingelheim.se/muc/contacts/KjellLarsson.html
 
Sep 25, 2009
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what do people think a commission appointed by the norwegian ski fed is supposed to find ?

think about it...will the organization that staunchly fought wada in cas and immediately upon finding that sundby was guilty announced he will be compensated...will such an organization be interested in exposing its secret kitchen ? anyone still naive to think the 'investigation' is anything more than a deflection or essentially a cover up would imo depart common sense. or at best forget the norwegian record of never fulfilled promises in the aftermath of the svt documentary...in fact we were flooded with the usual deflections and half truths...'poor accuracy, bad devices, unclear rules etc..'

one only needs to carefully read the cas document on sundby to find the same old stamps used by their ski fed to absolve their darling of any guilt. the international 'commission' free of skeptically minded experts like morten hostrup is bound to produced a 'well-balanced' verdict along these lines - some problems, no evidence of deliberate bad intentions etc..some lessons to learn'

yet we will be told over and over 'we have nothing to hide'. sure, sure...just like the failed attempt at hiding the sundby acquittal:
http://www.aftenposten.no/100Sport/langrenn/Dette-skjedde-i-kulissene-da-Norge-fikk-astmaanfall-821418_1.snd
 
May 13, 2011
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It would be interesting compare the number of Norwegian skiing TUEs for asthma to the number from the Fancy Bears Rio hack.

Clearly the Norwegian asthma epidemic is not normal.
 
Jun 22, 2010
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Random Direction said:
It would be interesting compare the number of Norwegian skiing TUEs for asthma to the number from the Fancy Bears Rio hack.

Clearly the Norwegian asthma epidemic is not normal.


Of course it's not normal. It's a great way to abuse the rules and dope. Now that we have confirmation of athletes that don't have asthma using the meds, then it's a no brainer.

The TUE's from RIO aren't normal either. Look at the sheer number of them and what the athletes are able to use. That's ridiculous.
 
Mar 4, 2013
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Some interesting read:
https://www.theguardian.com/sport/2016/sep/14/wada-hacking-abuse-debate-theraputic-use-drugs
Tucker points to the high use of corticosteroids [cortisone], which are given to athletes to help them breath better yet can also be performance-enhancing. “If they were banned, unfortunately you would end up discriminating against people with asthma,” he says, “but, if you define asthma as a breathing disorder which prevents you from accessing your maximum capacity, you could argue that EPO should be legal because people don’t have high blood values too.”
Symbicort, wellknown asthma drug throug Marit Bjørgen, is a corticosteroid. Further on:
Then there is the rumoured widespread use of cortisone, especially in cycling, to reduce weight while maintaining power, something Tucker calls the “holy grail” in the sport. “It’s an anti-inflammatory but it works because it negates the inflammatory pain that you normally get when you exercise and so there is no signal to back off.”
The last bit is interesting since there’s been a lot of fuzz around how much less body fat the Norwegian XC-girls have compared to other skiers. Also interesting in the perspective of how much training hours the Norwegians, and especially Johnsrud Sundby, are able to put in compared to other skiers.

If still in doubts about the performance enhancing effects with asthma medication, listen to former professional German cyclist Joerg Jaksch in this article.
http://cyclingtips.com/2016/09/jaksche-on-skys-tue-controversy-we-used-the-same-excuse-in-my-era/
Asked what the benefits were [with corticosteroids], Jaksche said that there were clear boosts.
“The effect was extreme. Cortisone reduces inflammation in your body, number one. It is also a little bit pushy as it is a hormone. So it causes a certain hormone rush.
“On one hand you are at [race] weight and you are more willing to perform, and then on the other hand it is a strong pain killer and an inflammation killer. So your recovery is shorter and the pain you are going through is less.
“It makes you very skinny. It burns fat. If you do it at the beginning of the Tour, you are going to lose another one to two kilos in the first week. You are going to suffer less. You are going to be less tired as your recuperation is faster because of the anti-inflammatory effects. It is the old school of doping.”
Finally, the now infamous Norwegian asthma expert Kai-Håkon Carlsen admits a few things:
http://www.dagbladet.no/sport/slar-...-a-bli-mobbet-og-stemplet-som-dopere/62762756
Kai-Håkon Carlsen er klar på at Hostrups funn ikke er knyttet til utholdenhetsidretter - som for eksempel langrenn.
- Hans forskning er korrekt, men er knyttet til kraft og spenst og med høye doser, forteller Carlsen.
- Det er der forskningen hans viser at det kan være prestasjonsfremmende, men ikke når det kommer til utholdenhet og oksygenopptak.
Translation: Kai-Håkon Carlsen states that Hostrup findings aren’t relevant for aerobic sports like XC-skiing.
- His research is correct, but it concerns power and elasticity together with high doses, says Carlsen.
- In those cases his research shows that there is performance enhancing effects but not when it comes to endurance or oxygen uptake.
So he admits that Danish scientist Hostrup are correct with the following statements
http://www.tv2.no/a/8560242/
Det er utøvere som sprintere og hekkeløpere i friidrett, svømmere og syklister på korte distanser som har størst utbytte av astmamedisin
– I langrenn får du effekten når det er spurter, sier Hostrup
Translation: It’s athletes like sprinters and hurdlers in athletics, swimmers and cyclists in short distances that gains the most through asthma medication.
- In XC-skiing you will have benefits in the finish.
Come on doctor Carlsen and Norweigan Ski Federation. Time to stop insulting our intelligence. Look how many races Northug and Bjørgen has won by dropping everyone with a stunning finish. In championships and Olymics there are four medals in sprint distances. To succeed in sprint is crucial to if you’re going to be successful in the different Tours throughout the season. I’m fed up with the Norwegian lies, smokescreens, dishonesty and whatever it takes mentality in bending the rules and ethics of the sport. :mad:
 
May 19, 2011
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Random Direction said:
It would be interesting compare the number of Norwegian skiing TUEs for asthma to the number from the Fancy Bears Rio hack.

Clearly the Norwegian asthma epidemic is not normal.
Obviously it isn't normal, but I don't think you'll learn anything from that. A better comparison would be skiers from other nations. Especially Sweden, Finland and Russia. Your airways are sensitive to cold air (for different reasons), so it's not really a surprise that people who compete and train a lot in cold weather use (and abuse) asthma medicines the most.
 
Sep 25, 2009
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MrRoboto said:
Random Direction said:
It would be interesting compare the number of Norwegian skiing TUEs for asthma to the number from the Fancy Bears Rio hack.

Clearly the Norwegian asthma epidemic is not normal.
Obviously it isn't normal, but I don't think you'll learn anything from that. A better comparison would be skiers from other nations. Especially Sweden, Finland and Russia. Your airways are sensitive to cold air (for different reasons), so it's not really a surprise that people who compete and train a lot in cold weather use (and abuse) asthma medicines the most.
you can confidently take the russians out of the comparison. it's a well known fact they dont typically apply for the asthma tue's. i do recall posting an official statistic not long ago here. page up, it was a pittance...the reason is, as was pointed out several times before, their system of talent selection from the very young age weeds out any asthma or the breathin anomaly sufferers. the old-fashioned soviet selection system still in play to this day.. you dont deserve a state investment if you can't breathe freely as a youth. obviously, had their understanding of the asthma pharma been up-to-date or even 1/4 of the norwegian, they would likely dominate the sport with or without the real doping. this is not to say, they dont have ANY tue's for asthma. for instance, legkov was revealed by kramer recently. but as far as i know, he's the only one publicly known.

regarding the sweeds and the finns, i get a feeling they do have a high number of the tue at the elite level. quite possibly comparable to the norwegian team - perhaps 30-50%. the big difference being - and this is based on their national team medics comments - they were stunned by the news that healthy, non-asthmatic skiers would be offered a nebulized salbutamol routinely. stunned ! particularly the finns after their past doping fiasco had changed the ethics completely. so they say.
 
Sep 25, 2009
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some questions to those better informed:

1. who were the fis doping panel members that acquitted sundby ?
i seached the fis site and archives and except for the 2-page press release there's nothing. no pdf/text of the acquittal award nor the names of those who passed the desicion. i'd hope for those of us looking into the case closely, the fis would be more transparent...

2. does anyone have the complete list of the members on the fis doping panel ?

either my research skills are falling, or the fis prefers not to make them public ? i did find that the panel is headed bya certain mr patrick smith of canada. that's it. one can also find some names by reading the OLD AWARDS but there's no assurance these people are still active or valid.

why am i digging ? well, i feel there are some very strange moments in the case.

like, for instance, a person well know to be suffering both acute and chronic asthma from the early age and throughout his sporting years -yes-he did NOT have a therapeutic use exemption. a negligence like this by a mature professional blows my mind. not only he'd get it with utmost ease, but he'd be NEVER needing to whine to cas about a guilty verdict 'threatened his livelihood'. with the tue he could legally nebulize himself to his eyeballs and no one would peep. a case of negligence or an elementary arrogance rooted in the norwegian impunity ? and if it was a case of negligence, i want to understand why fis overlooked it, b/c there are very strict wada rules addressing the negligence directly.

and all this ties into trying to understand if there were/are sufficient grounds for suspecting fis in favouritism...
i did look into the absence of leaks and the lack of sundby's provisional suspension as a potential charge of favours. looks like the fis acted within the rules in that regard as unprecedented as the 'tightlipness' may have been when the 1st ever norge got popped.

so pls help.
 
Mar 4, 2013
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python said:
some questions to those better informed:

1. who were the fis doping panel members that acquitted sundby ?
i seached the fis site and archives and except for the 2-page press release there's nothing. no pdf/text of the acquittal award nor the names of those who passed the desicion. i'd hope for those of us looking into the case closely, the fis would be more transparent...

2. does anyone have the complete list of the members on the fis doping panel ?

either my research skills are falling, or the fis prefers not to make them public ? i did find that the panel is headed bya certain mr patrick smith of canada. that's it. one can also find some names by reading the OLD AWARDS but there's no assurance these people are still active or valid.

Good questions, and I can't recall it has been mentioned in any media either. I only found the different committes under FIS-ski.com when I searched the site earlier this summer. In the document "FIS anti doping rules" following is stated about the FIS doping panel:
8.1.1
The FIS Council shall appoint a standing panel consisting of a Chair and
other experts with experience in antidoping ("FIS Doping Panel")
that serves as the responsible body to hear and adjudicate all violations of these Anti
Doing Rules, except where the Results Management is conducted by a
National Ski Association according to article 7.4
. The Chair shall be a lawyer.
Each panel member shall serve a term of two years.
The Canadian lawyer Patrick Smith seems to have been chairing the panel for quite some years. He was re-elected this summer. The only document I've found with names of the panel members was from 2011 in the Veerpalu case. http://blogs.fasterskier.com/worldcup/files/2011/09/Veerpalu-FIS-decision.pdf
Besides Smith also Norwegian Sverre Seeberg and Czech Roman Kumpost.

It seems FIS want's to keep the members of the panel out of publicity.
 
Mar 4, 2013
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kosmonaut said:
Another non-approved yet still completed study with Kai-Håkon Carlsen as medical director.

NRK this time: https://www.nrk.no/sport/ny-avsloring_-eliteutovere-ble-medisinert-uten-godkjenning-1.13140639

Elite athletes, nebulizers, the works.
Scandalous. Not much credibility left, if any, concerning dr. Kai Håkon Carlsen.

And today XC officials from Finland, Russia says they take skiers with breathing problems out of competition instead of medicating them.https://www.nrk.no/sport/syke-utovere-far-startnekt-_-ikke-medisin-1.13137602
German spokesmen says: of course we only treat skiers with diagnosed asthma with asthma medication, otherwise it would be a health risk.

I wonder how the attitude against the Norwegian skiers will be this winter; from spectators, from sponsors and from other countries skiers.