The case revolves around an anti-doping violation involving Danish football player Jesper Münsberg, who tested positive for salbutamol, a prohibited substance under World Anti-Doping Agency (WADA) regulations. The dispute centered on whether the elevated salbutamol concentration in Münsberg’s urine sample, which exceeded the 1000 ng/mL threshold, resulted from legitimate therapeutic use under his Abbreviated Therapeutic Use Exemption (ATUE) or constituted a doping violation. Münsberg, a semi-professional player with asthma, held an ATUE permitting inhaled salbutamol (Ventolin) for medical purposes. However, his urine sample showed a concentration of 2400 ng/mL, prompting WADA to appeal a prior decision by the Danish National Olympic Committee and the Danish Football Union (DBU) not to pursue sanctions.
The Court of Arbitration for Sport (CAS) upheld WADA’s appeal, ruling that Münsberg failed to prove the elevated levels were due to therapeutic use. The panel found that his excessive intake—admitting to at least 12 puffs on the match day—was driven by anxiety to perform rather than medical necessity, disqualifying it as legitimate therapeutic use under his ATUE. While Münsberg argued that his high dosage was due to a cold and aggravated asthma symptoms, the panel concluded his usage exceeded medically justified limits. The decision emphasized that athletes bear responsibility for understanding anti-doping rules, including dosage limits for permitted medications.
The panel also considered mitigating factors, such as Münsberg’s non-professional status, lack of doping incentives, and ambiguous medical instructions ("as required"). His doctor’s vague prescription and insufficient guidance contributed to the violation, but the panel ruled this did not absolve Münsberg of negligence. Notably, the case highlighted ambiguities in WADA’s 2008–2010 regulations, which were later clarified to specify maximum therapeutic doses. The panel acknowledged these ambiguities as mitigating circumstances but maintained that Münsberg should have exercised greater diligence.
Ultimately, the CAS imposed a six-month ineligibility period, a reduced sanction reflecting the lack of intent to enhance performance and the regulatory ambiguities. The ruling reinforced strict adherence to anti-doping rules while underscoring the need for precise medical documentation and athlete education. The case serves as a reminder that therapeutic exemptions do not grant unlimited discretion and that athletes must ensure compliance with dosage limits to avoid violations. The decision also highlighted the evolving nature of anti-doping regulations and the importance of clear communication between athletes, doctors, and anti-doping authorities.