Thursday, 6 February 2014

Drug cheats and doping at the Sochi Winter Olympics


Another Olympics, another statement from International Olympic Committee that this time there will be the "most stringent anti-doping programme" ever [1]. Whilst technically true, the sophistication of the anti doping programme set up at the Games itself, does not prevent all doping at the Games nor, more importantly, what happens before the great event.

So what are the differences between doping at the Summer and Winter games? To some extent there is less variety of doping in the winter sports. There are very few raw power events (perhaps pushing the bobsleigh at the start being one of the exceptions). So anabolic steroid abuse is less likely to distort the results. Also there is a higher preponderance of activities in the winter games where - assuming a minimum level of brawn - skill and co-ordination are the deciding factor in winning medals. Again drugs might help, but they are unlikely to be a major distortion, at least not until “smart” drugs that improve mental ability start to live up to their hype [2]. Even sports where drug abuse might be expected, such as ice hockey, seem to have rather low levels of steroid abuse compared to similar sports [3].

Of course the authorities are not complacent. Their concerns over the recent discovery of a muscle growth factor being offered by Russian scientists to an undercover German journalist is proof of that [4]. Incidentally whilst it makes sense to ban growth factors I remain somewhat sceptical about their efficacy. And as for the claimed undetectability [4] that is really, as ever, mostly a factor of how good out-of-competition testing regimes are. What I am more concerned about is their safety. Here I am four square with WADA; it is personally and professionally immoral and unethical for a coach or scientist to offer a drug to an athlete that has never been tested on a human being, in even the most basic phase 1 clinical trial.

Still, in a sense these are all side shows. Because some winter sports do indeed have a history of drug abuse every bit as tainted as the East German athletes of the 1970s or the Tour de France of Lance Armstrong and his ilk. Step forward cross-country skiing. This is one of the most aerobic sports there is, and so subject to all the same EPO and blood doping abuses that figure in cycling. More oxygen in the blood translates to more gold in the medal. In fact there is an argument that blood doping and EPO became prevalent earlier in this sport than any other. The current drama relates to the Russian biathlete (shooting and skiing) team. Their European champion, Irina Starykh has just failed a drug test and been pulled from the team. Another Russian and a Lithuanian failed tests at the same time. This follows on from three other Russian biathletes testing positive for EPO in 2009.

But we should not dwell only on the misdemeanours of the host nation. Drug testers can now detect blood transfusions from a donor matched to the same main blood types (A, B, O). However, in the days before these tests there were persistent rumours of some European nations sending “ringers” to the Winter games; these would have been weaker members of teams specifically selected for elite competitions, not for their performance, but because they could double up as compatible blood donors for the “team leader”.

The most bizarre story concerns the Austrian ski team. To quote from my book [5]: “Equipment consistent with the use of blood transfusion was confiscated from the Austrian team at the winter Olympics of 2002 and 2006. In 2002 the Austrian ski federation’s defence was that that the needles, tubes and transfusion bags were needed so that they could withdraw blood and then expose it to a magnetic field and ultraviolet radiation prior to reinjecting into the body. This, it was claimed, was an effective cold prevention remedy in common use at many spas. The authorities were not impressed; the IOC banned the athlete’s coach, the Norwegian Walter Mayer, from attending the 2006 and 2010 Olympics.  The 2006 story was worthy of a Hollywood movie, or perhaps more appropriately a reality TV police show. The Austrian team were based in the quiet Italian mountain towns of San Sincario and Pragelato. Mayer was spotted, despite his ban. During a subsequent police raid on the team’s accommodation bags of used syringes were seen being thrown out of the window. Some athletes and coaches promptly fled. Meyer was caught when he crashed into a police roadblock in the Italian Alps. In 2007 six skiers were given lifetime bans from competing at the Olympic Games; in 2011 Mayer was sentenced to a fifteen month jail sentence for supplying banned substances.”

And the Finnish cross county ski team provided probably the greatest coup ever for the drug testing authorities. Again quoting from my book:

Six members of the Finnish ski team were found guilty of taking hydroxy ethyl starch (HES) at the 2001 World Championships. HES is a plasma volume expander that dilutes blood samples and hence allows someone to appear to have a lower number of red blood cells. This can mask EPO and other blood doping offences, but in particular it ducked a rule that had just been introduced forbidding someone from competing when their red cell number was too high. HES is not a medical pill that could be taken by mistake. Instead it is a fluid that needs to be intravenously injected. The Finnish skiers knew exactly what they were doing; what they didn’t know was that WADA had secretly introduced a test for HES. The positive results led to the International Ski Federation banning the skiers for two years”.

One final caveat. The Winter Olympics also have us the genetically enhanced man who was suspected of blood doping, but in fact turned out to be completely clean [5]:

“Eero Mantyranta, a Finnish cross-country skier who won golds in the 1960 and 1964 Winter Olympics was found to have abnormally high levels of the protein haemoglobin in his red blood cells. High haemoglobin levels allow athletes to carry more oxygen and are a benefit in endurance sport. Mantyranta, like all his family who were tested, achieved their high haemoglobin levels by having a genetic mutation in the protein in their body that responded to the hormone erythropoetin (EPO). At normal levels of EPO the effect on their body was as if they had much higher levels. A stronger EPO effect means more haemoglobin and therefore more oxygen to their cells.”

Enjoy the games!

References






Tuesday, 17 December 2013

Jonathan Tiernan-Locke, Team Sky, blood doping and biological passports


With Team Sky rider Jonathan Tiernan-Locke facing an anti doping hearing, the biological passport system is going to be big news in the UK (though it should be noted that Sky stress the anomalous findings were all taken before he joined their team).

So I took a look back at all my blogs. The word “passport” arises 34 times. What does this mean in a sporting/doping context? The athlete biological passport aims to detect doping indirectly via looking at the variations in biological markers in blood or urine. The only current validated system in use is the “blood passport” that tests for blood boosting and EPO abuse. As it is clearly inappropriate to comment on an allegation under review, I thought I would instead link to all my previous blogs that mention the passport system; sort of a “greatest hits” of my writing on this system. Happy reading! 













Saturday, 16 November 2013

University of Essex students talk about drugs in sport


I had my annual discussion with my final year sports & exercise science undergraduate class about the ethics of drugs in sport. Last year they surprised me with how much they thought elite athletes should be role models and not even dabble in recreational drugs (see [1]). Maybe this was a result of a 2012 post-Olympic glow because the class of 2013 included a number of more libertarian individuals who favoured a laissez faire “anything goes” policy. We had an interesting debate around what was the meaning of “natural” versus unnatural sport; kind of an Essex version of the differing philosophies of human enhancement pronounced by Michael Sandel or Julian Savelescu – see for example [2].

Some of the students suggested that the spectacle of sport itself was by definition enhanced if times were quicker and the distances thrown longer. I pointed out that it was all relative and maybe it mattered how you achieved your goals. I also noted that if it was only about absolute times, not relative performances, there was no point in watching women’s sport as they were always going to be slower than the men. I am not sure I won this debate (they were tough arguers!), though it was perhaps noticeable that the female students were more anti doping, on average, than the men (I think not surprising given the greater concerns over women’s health with steroid doping).

Anyway, as always, I was left with much food for thought after this session. Let’s hope they argue as well in their essays on the scientific future of doping I am about to mark!

[1]  Cooper, C. E. (2013) Run, Swim, Throw, Cheat: The science behind drugs in sport, OUP, Oxford.  Preface to the paperback edition

[2]  Savulescu, J., and Bostrom, N., (Eds.) (2009) Human Enhancement, Oxford University Press.   See introduction (Savulescu) and Chapter 4 (Sandel). 

Sunday, 27 October 2013

Jodie Marsh, steroids and bodybuilding


The interview I did with Jodie Marsh – glamour model, turned reality TV star turned natural bodybuilder  – has finally turned up on TV. I am not sure how easy it is to find, but the TV channel is TLC. Here's the link to the program details: http://www.uk.tlc.com/shows/jodie-marsh-on-steroids/ Apparently TLC repeat their shows all the time so if you can access this channel you still might be able to catch it.

I don’t know how the show has been edited, but the director spent most of the interview trying to persuade Jodie to get me to say how dangerous steroids were to health (clearly the “angle” they were taking as she doesn’t take steroids herself). I stuck to the scientific line – the sex side effects (e.g. cliteromegaly for women and gynaecomastia for men) are, at least in part, somewhat manageable by careful regimens and taking additional drugs (e.g. tamoxifen). But the long-term adverse effects are much less easy to control, and potentially far more serious. These include adverse cardiovascular effects and liver cancer [1-3], and for women the sexual side effects may not be readily reversible. The problem is that, perhaps for obvious reasons, it is difficult to get the information to present careful long term follow up studies at the high doses of anabolic steroids bodybuilders use. So we don’t have good data, though what we have certainly does not suggest a sound safety profile.

Actually, bizarre as it was to be discussing enlarged clitorises and man-boobs with Jodie Marsh, she was a charming intelligent woman and much more interested in getting at the scientific truth than her director. The only pain in the interview was that the cameraman thought it was a good idea to have us standing together for the whole one hour pre-record. Normally given the size difference (see attached photo), I would have expected to be perched on a table so we could take face-to-face. Instead I loomed over and cricked my back. Still all for the sake of entertainment!

References

1. Hardt, A., Stippel, D., Odenthal, M., Holscher, A. H., Dienes, H. P., and Drebber, U. (2012)Development of hepatocellular carcinoma associated with anabolic androgenic steroid abuse in a young bodybuilder: a case report, Case Reports in Pathology 2012, 195607.

2.  Socas, L., Zumbado, M., Perez-Luzardo, O., Ramos, A., Perez, C., Hernandez, J. R., and Boada, L. D. (2005) Hepatocellular adenomas associated with anabolic androgenic steroid abuse in bodybuilders: a report of two cases and a review of the literature, British Journal of Sports Medicine 39, e27.

3. Angell, P., Chester, N., Green, D., Somauroo, J., Whyte, G., and George, K. (2012) Anabolic steroids and cardiovascular risk, Sports Med. 42, 119-134.