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  Full Statements regarding Frankie Sheahan.
 
 

Irish Medical News - August '03
Inhaled salbutamol not performance-enhancing – GP expert
A leading GP asthma expert has stated that there is no evidence that salbutamol taken by inhalation is performance-enhancing for athletes. Co Wexford GP Dr Reggie Spelman, author of the ICGP’s asthma guidelines, said this was acknowledged by the International Olympic Committee medical commission and salbutamol by inhalation was not prohibited by the IOC.
Writing in IMN this week, Dr Spelman says the IOC has outlined that salbutamol is classed as an anabolic agent but permitted by inhalation. For salbutamol, the IOC definition of a positive test under the anabolic agent category is a concentration in urine of 1000ng/ml or 1ug/ml of non-sulphated salbutamol, and the aim of testing for urinary salbutamol levels is clearly intended to differentiate between those using the prohibited oral route and those using the authorised inhaled one.
He said it was absurd that an athlete could be banned and lose his or her livelihood under the anabolic category for taking a prescribed medication which is acknowledged by the IOC to have no performance-enhancing properties.
International rugby player Frankie Sheahan, who suffers from asthma, was recently given a two-year ban for allegedly having excessive levels of salbutamol in his system, and his appeal against the ban is due to be heard this week.

 
 

Martin Johnson and the PRA raise concern over Sheahan hearing......28/07/03
The Professional Rugby Players Association (PRA) expressed extreme concern at the implications for asthmatic sportspeople in regard to the upcoming appeal of the Ireland player Frankie Sheahan. The Munster hooker is fighting to save his career after receiving a two year ban in July for having the banned substance Salbutamol in his system.
Damian Hopley, CEO of the PRA expressed concern over the implications for all rugby players in the UK of Frankie Sheahan’s ban being upheld. In a statement he said “There has been huge interest in this case amongst our membership, all of whom are very concerned for rugby players in England if this severe ban is upheld. Asthma should not be a barrier to participation in sport at any level. There are several asthmatics playing in the Zurich Premiership, and this treatment of Frankie has set a very dangerous precedent.” Frankie has suffered from asthma for over 25 years and the Judicial Tribunal accepted that he was an asthmatic, that he required medication and that he inhaled this medication containing Salbutamol.
England captain and PRA Executive Management Board member Martin Johnson added that “the regulations regarding the use of inhalers in rugby union have to be clarified in order to bring transparency and consistency to the issue of asthma medication.” Hopley concluded “we would not wish for any asthmatic who is obliged to use an inhaler to undergo the turmoil that Frankie has had to endure.”

 
 

UK National Asthma Campaign
"Exercise induced asthma is a recognised medical condition but yet some of those running natiobnal and international sports display apppalling ignorance. This isn't a rare condition. When it comes to asthma among teenagers, the Republic of Ireland has the 5th highest level in the world. Athletes with asthma like Frankie Sheahan are an important role model for Ireland's children with asthma and cases like this send out negative messages. People with asthma should be encouraged to reach their sporting potential and not have to worry about being accused of taking drugs to enhance their performance, in the current climate where asthma is widely misunderstood. It is important to stop cheats but we have to do it without discriminating against people with asthma who have shown the courage and determination to overcome the condition"

 
 

O'Gara and Wallace strike out on Sheahan's ban

Last Friday evening Frankie Sheahan was in Thomond Park sitting between Munster colleagues Anthony Foley and Peter Stringer watching his colleagues play their seasonal opener against Rotherham. For Foley and Stringer there is just a fortnight to go before they will be named in the Ireland World Cup A week before that squad is named Sheahan will appear before an ERC Appeal panel for a meeting that will ultimately decide his chosen future as a professional rugby player.

On the afternoon of Monday September 1st, Frank Sheahan and his legal team will present his appeal to the decision of an earlier ERC Tribunal that handed the Munster player a two year ban for having Salbutamol in his system after the Heineken Cup semi-final. It's an anxious time for Sheahan and his family who have however been buoyed by the level of support they've been receiving from all quarters.

Bodies such as the Munster Supporters Club, Irish Rugby Union Players Association, Cork Constitution, Munster Players and Management and the Irish Asthma Society have weighed in behind the asthma sufferer and colleagues in the Munster team including several asthma sufferers such as Ronan O'Gara, David Wallace and Peter Stringer have all expressed their disquiet at the treatment meted out to their colleague.

David Wallace played in the game against Rotherham on Friday evening and admitted afterwards that he was never aware of any danger in using a Ventolin inhaler. "To be perfectly honest I would have been like Frank in that I'd take puffs of my inhaler whenever and as often as I felt I needed to. I wouldn't have known that I could be in danger of exceeding limits and I can honestly say that there probably would have been times in the past when, if I'd been tested I could have found myself in the same situation that Frank now finds himself in. The point is that people like us, asthma sufferers, don't take Ventolin for the hell of it. We have to take it. And from what I've read it seems ERC took no notice whatsoever about Frank's condition."

Ronan O’Gara is another who suffers from asthma and the out half who is currently suffering from a wrist injury voiced his concern at the decision and the manner at which it was arrived. “I just think it’s unbelievable really. Frankie and I have player together since we were 10 years of age and he always had to use his inhaler before and during matches. I have seen him in distress many times as a result of his asthma, and i know that, like myself, it would be unsafe for him to play without using an inhaler. I was with Frankie after the Toulouse game and witnessed his terrible cramping as a result of his severe dehydration. There seems to be no logic in the decision that the ERC tribunal arrived at. How can they ignore his condition and deny him his right to earn a living. I think this is a grave injustice and I hope that this wrong can be righted in the appeal, not only for Frankie’s sake, but for the sake of all asthmatics".

 
 

The Asthma Society of Ireland
The Asthma Society of Ireland wishes to express its concern that the ban imposed on rugby player Frankie Sheahan recently may send out wrong and worrying signals to tens of thousands of people living with asthma. The fact that the ban was imposed as a result of a positive test for the commonly-used beta2-agonist reliever inhaler – salbutamol – has alarmed many asthma sufferers, particularly those involved in sport. Since news of the ban emerged, various people from high-level athletes, various sports people, parents and coaches have contacted the Asthma Society of Ireland’s asthma line to voice their concerns. And all of them want to know one thing – is it safe to keep using their reliever inhalers in sport? Relievers (beta-2 agonists) such as inhaled salbutamol are a safe and effective therapy for use in asthma and are permitted in most sports when prescribed by a physician for an asthmatic. Asthma should not be a barrier to participation in sport at any level. However, it is vital that people with asthma know that reliever inhalers are safe to use and that they are an important component of their asthma management plan. Their use should NOT be discontinued without medical advice. The Asthma Society of Ireland encourages people with asthma to keep active and to participate in sport – competitive or otherwise – at whatever level they can. The Asthma Society therefore calls on the governing bodies in Irish sports to enter this debate, and to give clarity and consistency regarding the use of asthma medication in sport. Anyone with concerns about the management of their asthma in sport should contact their doctor in the first instance. The Asthma Society of Ireland’s Asthma Line (1850 44 54 64 or 01 8788511) is also available for advice. Dr Pat Manning, Consultant Respiratory Physician, Chairman of the Medical Committee of the Asthma Society of Ireland. www.asthmasociety.ie

 

Munster Supporters Club
The Munster Supporters’ Club, through their Chairman Declan O’Connell, have pledged their full and unconditional support to Frankie Sheahan in his bid to overturn the recent ERC ban imposed on him. “Frankie has won 76 caps for Munster and has been instrumental in the magnificent rise of Munster Rugby over the past seven years. He is an integral part of Munster Rugby as he is an inspiration not only to his peers but to the thousands of young rugby players throughout the province”, said Declan “We have enormous respect for Frankie as a player and as an individual, both on and off the field. The feedback from our supporters throughout Munster and further afield has been that of anger and annoyance at the terrible manner in which Frankie has been treated by the ERC tribunal”. “We are concerned that the ERC tribunal in ignoring the evidence submitted on Frank Sheahan’s behalf, have jeopardised his career, threatened his livelihood and tarnished his good name. “Frank Sheahan is an asthmatic. The rules and regulations of rugby and indeed all sports bodies should be such as to ensure that asthmatics are allowed use their inhalers to enable them to compete on an equal footing with non-asthmatics. Frankie Sheahan’s suspension has very serious consequences for all asthmatics involved in Rugby and Sport in general. We would not wish for any asthmatic who is obliged to use an inhaler to endure the appalling circumstances that Frankie and his family now find themselves in. It is the wish of the Munster Supporters Club that Frankie’s legal and medical team will succeed in overturning this grossly unfair and penal ban at his appeal on September 1st. “It is our fervent belief that for justice to prevail his suspension must be lifted forthwith”, concluded O’Connell.

 

 Irish Players' Union back Frankie over appeal.

The Irish Rugby Union Players Association (IRUPA) said, that Frankie Sheahan has “the full and unconditional support” of the Association in his efforts to vindicate himself and clear his good name. “We are very concerned with the methodology employed by the tribunal and find the situation to be totally unsatisfactory”, said IRUPA in its statement. Niall Woods, Chief Executive of IRUPA stated: “The decision of the independent judicial tribunal was a major surprise in the light of the legal and medical evidence presented at the tribunal”. “I would like to stress that this is not just a matter of a player being banned from playing rugby. This is a player’s whole livelihood, his sole source of income, his whole life. Frankie chose to play professional rugby he did not choose to be an asthmatic”, said Woods. IRUPA in its statement says it is optimistic that Frankie Sheahan will be successful in his appeal against the two-year ban imposed on him and he can resume his rugby career as soon as possible. IRUPA will be seeking a meeting with the IRFU, the employer of Frankie Sheahan and all the members of IRUPA, to impress upon it its extreme unease with all the circumstances surrounding this matter.

 

Cork Constitution support Sheahan.
The President Billy Dowling and the Executive of Cork Constitution F.C. wish Frankie Sheahan every success in his forthcoming appeal before the ERC. Frankie who has been with the Club from underage is one of our most respected and popular members. We know him to be an honest individual in his dealings with the Club over many years. We are pleased to be able to state he is receiving huge support from members and particularly playing members at this time. Frankie Sheahan’s suspension has serious consequences for Cork Constitution, and all other clubs, Munster and Irish Rugby. It also has very serious consequences for all asthmatics involved in sport. We hope that for the sake of all asthmatics involved in sport and particularly those involved in the game of rugby football that Frankie Sheahan’s good name will be vindicated. We further hope that the position with regard to the use of Salbutamol Inhalers by all sportsmen and women alike will be clarified. We would urge both the IRFU and the Irish Sports Council to clarify their position in this regard at the earliest opportunity. We would not wish for anyone who is obliged to use inhalers to have to endure the appalling circumstances which Frankie Sheahan and his family now find themselves in.

   
 

 Frankie's Official Statement.

Frank Sheahan is an asthmatic. He uses a Ventolin inhaler which contains Salbutamol to help treat his condition. This fact is well documented and was accepted by the Judicial tribunal. At the first hearing in ERC headquarters, it was pointed out to the Judicial Tribunal that Frankie required medication to treat this asthmatic condition and inhaled this medication. The Judicial Tribunal accepted that Frank Sheahan was an asthmatic, that he required medication and that he inhaled this medication containing Salbutamol.

On Frank Sheahan's behalf, it was pointed out that the subsequent level of Salbutamol in the urine is not relevant or applicable to the Rules of the Competition because of his condition and medical requirements and that there is no cut-off point or level outlined in the competition rules or the IOC regulations, provided that the medicineis inhaled.

If the Salbutamol levels found in the urine sample were a relevant factor, medical opinion offered on behalf of Sheahan that it was present as a result of inhalation, was accepted by the medical experts retained by the ERC (including members of the International Olympic. (It should be noted that one puff of a Ventolin inhaler is equivalent to 100,000 (one hundred thousand) ng/ml of Salbutamol).

Professor Kenneth Duncan Fitch, the renowned Anti-Doping Expert, retained by the ERC confirmed that when research findings indicate the approach taken in the current list of prohibited substances and prohibited methods is scientifically flawed, prompt action to correct the position should be taken and that this is exactly the position that currently relates to Salbutamol readings in excess of 1000 ng/ml.

He went on to say that he would consider it a gross injustice to any athlete found with a Salbutamol concentration in excess of 1000 ng/ml in his urine to be charged with a doping violation without investigating whether the Salbutamol was inhaled. Professor Finch had tests carried out on the residue of the “A” sample in an IOC accredited Laboratory in Barcelona, which confirmed that in Frank Sheahan's case the Salbutamol in the urine had been inhaled.

Finally, in relation to the divergence in the level of prohibited substance found in the players sample, from the quarter final and semi final, Perry Leary, a Professor of Pharmacology, an acknowledged expert in this area, gave evidence on behalf of Frank Sheahan in which he stated that the humidity differential (a maximum of 57%) between the Leicester and Toulouse games, coupled with the severe dehydration experienced by the player immediately and for some time after the game, had a direct bearing on the levels found in the sample provided. The ERC medical team agreed with this evidence.

The IOC’s regulations are 1,000ng/ml which goes for all sports, but we believe that Rugby, and particularly Frankie’s position on the team, is much tougher than most, and is more comparable to a marathon runner than a sprinter for example, therefore having higher levels. Also, Frankie’s dehydration was so severe that we believe this contributed to the high levels. It is also worth noting, that an IOC accredited laboratory in Barcelona confirmed that in Frankie’s case the Salbutamol in the urine had been inhaled.

When Frankie was drug tested in Toulouse, he had had 8 puffs of Ventolin inhaler, and his Salbutamol level was 1,650 ng/ml. The reason the independent judicial tribunal banned Frankie was that they "cannot with conscience conclude that the player has satisfied us, on the balance of probabilities, that he administered himself with only eight puffs of Ventolin containing Salbutamol for the purpose of properly treating and/or preventing his asthma and/or exercise-induced asthma."

Frankie got drug tested 2 weeks previously in Leicester, England, and his Salbutamol level was only 80 ng/ml. However, in Toulouse, Frankie was extremely dehydrated after the match, and took him up to 8 litres of water and 2 hours waiting before he could urinate, and when he did urinate he found it extremely difficult and the urine was very yellow and extremely concentrated. Frankie also believes that he sweated approximately 7/8 litres during and after the match. The PH levels as a result was 5.0 exactly.

   
 

Brendan Quinn of sports-drugs.com and former president of Irish Pharmaceutical Union......

I have followed the case from the start: the arguments are very well put, and as a sporting (GAA football) asthmatic myself, I can see the need for Salbutamol usage well over the normal standard "2 puffs four times daily" dosage. I used 10 puffs last week over 4 hours after intensive training in the heat!

As a Pharmacist I am also acutely aware of person to person variation, and the constant updating needed in Drugs rules, as new data is discovered. Little data has been produced on the possible "concentration" of drugs during dehydration, in much the same way as gravy thickens as the liquid evaporates, and as someone who got a first class honours in Chemistry among my subjects, the Barcelona argument that the "inhaled" molecule metabolites are different from the "oral or other" metabolites appears to be solid.

Remember too, that if an athlete suddenly needed NEBULISED salbutamol (still inhaled, but each nebule at 2.5mg to 5mg contains the equivalent of 25 to 50 puffs of a standard inhaler! Surely the manufacturers would have data on residual blood and urine salbutamol after such treatment. There is therefore reason to believe that the bar for salbutamol has not yet been set at the right height.

 

Shelagh Finlayson, Asthma Manager, Ontario Lung Association......

It was upsetting to learn that this Canadian born athlete has been banned for two years from playing international rugby. This ban was imposed upon him for a doping offence caused by the prescription drug Ventolin, used to control his asthma. Mr. Sheahan has had asthma all his life and has previously reported his use of Ventolin.

Unfortunately, he has admitted this year he failed to fill out the necessary documents that technically left him open to a doping offence. The Lung Association supports the use of Ventolin for athletes to prevent symptoms of asthma caused by exercise. This medication is generally taken ten minutes prior to exercise and can be used again if symptoms occur. Ventolin is an approved drug by the International Olympic Committee and it is surprising that the European Rugby Cup Tribunal does not recognize the need for this medication prior to or during exercise for people suffering from asthma.

The Lung Association encourages all people with asthma to exercise. It is very common for athletes to take Ventolin to enable them to perform optimally and without symptoms, The Lung Association is a registered charity that provides information and funding for research to improve lung health. We focus on the prevention and control of asthma, chronic lung disease, tobacco cessation and prevention, as well as air quality and its effects on lung health.

We are writing this letter in support of Canadian born Munster hooker, Frankie Sheahan who is appealing this decision. It is our hope that the two-year ban from play will be lifted.