My
title indicates that I think these championships might take up more than one of
my blogs! Indeed the Sunday Times/IAAF doping story has already messed up my
holiday. I was pestered by well meaning journalists while visiting Yorkshire.
Fortunately I was for the most past saved by dodgy mobile phone signals and an
absence of Wifi. I did, however, make an exception to talk to Radio 5 live
Drive and Radio 4 pm in the BBC radio car parked in the local pub car park.
What could be more surreal?
It
has been hard commenting on the leaks given the fact that the various
protagonists (IAAF and the Sunday Times/ ARD/WDR) have access to the data but have released only a very limited
amount into the public domain. The IAAF has indicated they will eventually
publish a “prevalence study” sometime in the future. Whether this will go so
far as to make comparisons between countries and whether it will also be
possible to compare individual sporting events remains to be seen. These of
course are the highlights of the leaks, but realistically might be excluded in
an academic type report.
So
what can be said and how does it relate to the upcoming World Athletics
Championships in Beijing? Well, starting with a selfish note, I am pleased that
the 1500m final in the women’s 2005 World Athletics championships is finally
getting the “recognition” it deserves [1]. In the opening pages of my book I
note that, far more than Ben Johnson’s 100m run in the Seoul Olympics, this
race deserved the moniker of the dirtiest race in history [2]. My comment that
the first five athletes to cross the line were alter found guilty of doping
(admittedly in later tests) has now been backed up by anomalous blood readings
taken at the time of the events.
It
is worth noting that the winning time in this infamous race was over a second
slower slower than when the clean athlete, Kelly Holmes, won the 1500m Olympics
title a year earlier. This brings me to my first substantive point. An
anomalous blood reading does not mean someone is necessarily doping. And even
if they are doping it does not mean that they won the race because they were
doping. Although there is good evidence in the scientific literature that increasing
your total haemoglobin levels increases athletic performance, there are
sparingly few results in elite athletes (where performance effects of ergogenic
aids naturally become smaller in size). Even the studies that have been done rarely
use a proper randomised placebo controlled design. There is no control for the
placebo effect. The importance of this cannot be underestimated; a placebo effect
is likely to be doubly powerful when taking a banned substance as these are
assumed to be especially powerful. Interestingly a recent randomised blind
trial on elite cyclists surprisingly showed no effect of altitude training and
suggested previous positive results might be mostly down to placebo [3]. “Unfortunately” it will be almost impossible
to do a similar study using EPO or blood doping due to ethical constraints
surrounding giving people potentially harmful drugs. Worse still the definitive
study would involve giving someone the drug and actively telling them they are
getting a placebo [4]; even using microdoses of EPO this would be a real ethical
minefield.
My
second substantive point relates to the success, or not, of the blood passport
program introduced in athletics by the IAAF in 2009. Clearly this has resulted
in a significant number of suspensions. But has it affected the number of
people doping? In cycling there seems to be a clear effect [5]. This was shown
by the drop in the number of cyclists showing abnormally high or low levels of
young red blood cells called reticulocytes (a recent blood transfusion will
likely give a low number and an injection of a high dose of EPO a high number).
The blood doping expert Michael Ashenden was reported in the Sunday Times as
saying that “despite the
introduction of the biological passport, analysis of the data shows nearly 70
athletes with suspicious blood test results still escaped censure” [6]. This my
be so, but it would be very interesting to see his detailed analysis of whether
there was any change at all from 2009-2012.
The
relevant data outlining the effect of blood doping on the performance of elite
athletes is hidden from the average scientist in the secret files of doping
athletes and their coaches. Still my “not too controversial” personal view is
that blood transfusions and high dose EPO genuinely provide a performance
benefit in elite athletes. I am currently less convinced that micro dosing of
EPO, of the type designed to fool the biological passport, is as effective. It is
unlikely to create a situation where a clean athlete cannot win a race against
a doper. It is also possible that just by forcing the athletes to change doping
strategies to avoid detection, you make that doping less effective.
In
the worst-case scenario portrayed by the Sunday Times 30% of successful athletes
had anomalous blood readings and so might have been doping; but this still means
that 70% of athletes with “normal” blood readings managed to beat these dopers.
Doping is best seen as one part of a complex set of factors that lead to a gold
medal. It is only occasionally in sport that we see situations where it is
inconceivable that a clean athlete could beat a doper – the most notable being
the period in the 1970s and 1980s when female athletes were dosing with large
amounts of anabolic steroids. The Tour de France in the Armstrong years may
well be another example.
My
final point relates to one I was questioned by on BBC radio recently. Should
athletes reveal their own passport data? Even the athletes themselves are
divided on this [7, 8]. But I feel the cat is out of the bag now. Anyone with a
normal score is going to shout it from the rooftops. Those with anomalies will
be shamed for not revealing them – unless they have a really clear explanation
to hand. Anyone not revealing their scores will be assumed to be hiding their
data because they are doping. My major concern is that the internet will fill
up with well-meaning and not so well-meaning amateurs who will be able to
“prove” that someone is doping from their passport score.
We
have seen this effect with performance data in cycling for a number of years
now. The most recent example was the accusations of doping against Chris Froome
in the Tour de France in the complete absence of any analytical doping data [9]
or any intelligence about dodgy practices garnered from fellow team members
[10]. Another example: the UK 400m runner Roger Black is one of those now
calling for athletes to reveal their passport data [7]. Yet I remember him
telling me he was once confronted by a member of the public who said he could
tell he was cheating just by looking at some of the times he had posted. As
Paula Radcliffe [8] said you can never prove you are not doping.
I
suspect blood passport scores such as reticulocyte count, red cell volume and
haemoglobin concentration will soon become as well known to the world of online
sport comment as performance measures such as peak power, VO2 max
and lactate threshold are now. In the conclusion of my book I said “When it comes to making practical and
ethical policy there is a devil in the scientific detail that is absolutely
required if we are to make informed moral and political choices.” In athletics
and doping the time of science is upon us now.
