Taking The Doping War Into The Shadows
Feb 12, 2010 - Craig Lord
As the Winter Olympic Games get underway in Vancouver this evening, biathletes, cross-country skiers and others will doubtless be aware of talk that a new blood test is in the pipeline, one designed to protect the innocent and ensure that cheats do not prosper. Why would SwimNews wish to raise this matter? The link between the race pool and the piste may not be all that close but the anti-doping controls that apply to each of those worlds are a perfect match under World Anti-Doping Agency (WADA) rules - and it is from the world of swimming and FINA that the latest lines of inquiry stem.
After its January meeting in Bangkok, the FINA Bureau issued a statement on matters agreed and gave a hint of where debate and discussion were going on several fronts. On anti-doping, world swimming bosses had this to say:
That reference to plasticizers gave rise to a little consternation in anti-doping circles, first and foremost because the "news" was a little premature: there is work to be done yet before the declaration "we have an approved and legally binding test in place" can be made. But if you put the three things on FINA's list together, you get heartening news on two fronts: the threat to the blood-doping cheat is very real and it is so because scientists and doctors working with FINA and swimming are among those leading the war on deceit.
Blood samples from athletes limbering up in Vancouver could, for example, be tested retrospectively for the presence of tiny particles passed into the body during transfusion, unnecessary in healthy athletes unless they intended to cheat with blood doping, according to leading doctors and sports administrators close to the IOC and related international sports federations.
Homologous blood transfusions, from a donor to a doping athlete, have been tested for since 2000 but there is as yet no accepted method for detecting autologous transfusions, which involve reintroducing an athlete's own blood after it has been manipulated to increase red-cell count and thus boost the level of oxygen carried from lungs to muscles and increase aerobic capacity and endurance.
Now, a test that identifies the presence of plasticizers, tiny trace elements that may be passed from plastic intravenous bottles and tubes used in transfusions, in the blood stream is in the pipeline five years after WADA promised to find a detection method.
Plasticizers are harmless to human health but their presence could prove that an athlete in peak condition at a major event such as the winter Games had, within a certain timeframe, undergone a blood transfusion.
The question would then be: why would a supremely fit, young athlete have needed such intervention? The answer, in sporting terms, is likely, say anti-doping experts, to be twofold: the athlete wanted to cheat; and the athlete would have needed expert medical advice in order to do so. In other words, a professional such as a doctor, nurse or "self-appointed scientist", as one leading anti-doping doctor put it, would have to have been involved in the deceit.
While there is work to be done before the plasticizers test is added to the official list of WADA weapons - in common with other methods used by WADA-accredited laboratories, the test must be reliable, legally binding and consideration must be given to the question of whether there are legitimate circumstances in which plasticizers might be present - anti-doping experts are excited enough by the new line of attack to have discussed taking retrospective action against any found to have cheated should the new methodology gain approval.
The threat of retrospective testing, allowed under WADA rules, is likely to make any prospective cheats who may be heading to Canada this month think twice, while blood tests from Rome will also be tested, FINA has stated. The Rome tests, even if "positives" are found, could not result in any sanctions being imposed or cases even opened until any test had been approved. Meantime, anti-doping agencies will surely know who to place on their "must remember to visit more often" lists.
After the Olympic Games in Athens 2004, WADA promised that there would be a test for autologous transfusions, while anti-doping experts noted that any test method would be kept secret in order to avoid tipping off cheats. The plasticizers theme is just one of a variety of potential weapons being discussed among doctors and anti-doping experts.
SwimNews has learned that coagulation of blood, or blood thickening, also holds further potential as a way of detecting cheating. A source said: "Blood doping can lead to premature clotting. There have been deaths in cycling. One of the things we're looking at is to count coagulates. No-one is doing that. It may be very helpful to do so but these academic processes don't always lead to a test that stands up to scrutiny."
The plasticizers test is far from being oven-ready. One leading doping expert close to the world of winter Olympic sports told SwimNews: "I was surprised to see that reference in FINA's paper. As far as how it all works, nothing has been decided in this respect. One of the opportunities open to sports bodies is to think ahead on how to frame strategies. One of the questions raised is 'are there levels of plasticizers that may come from plastic IV bottles and tubes and can you in fact find these in the bloodstream. This is not going to be done tomorrow and then find application in Vancouver. The thing must be validated and accepted by the scientific community and has got to withstand legal scrutiny - and that could be miles down the road."
It could also be sooner than some hope. And the best policy for anti-doping bosses is not to reveal agendas and timetables to the rogues out there who watch and wait and plan their strategies according to the level of threat posed by WADA and national testing agencies, among other folk at the helm of the war on doping in sport.
One senior Olympics source indicated that testing for plasticizers on existing samples provided in world-championship competition was in fact not that far off, while provision was being made to make sure samples were available for many years to come: "Our understanding is that FINA will retest blood samples from its world championships in Rome as part of the process that leads a testing method being validated. As such, there would be no sanction as yet should plasticizers be found in any samples from Rome because the test would have to have been validated."
The test may be some way off but heartening to hear that experts engaged by FINA are at the heart of research, discussion and debate when it comes to finding news ways to catch cheats and keep sport clean.
One source heading to Vancouver noted, in relation to work on the plasticizers test, noted: "It's very good news that FINA is taking a lead on this, going to the expense of it all in the knowledge that they will help add another line of attack on the doping front. The discussion is that a test will certainly not be used in Vancouver but will be something that will be used retrospectively ... that once they have an ability to sanction they will go back to those samples [from Vancouver] and retest."
Any test for plasticizers successful enough to be included on the WADA list of banned substances and methods would take the doping battle a big step closer to the supply chain of banned substances and methods and the link between those, such as rogues doctor, other medical workers, sports scientists and coaches, who help athletes to cheat but rarely go punished. Though provision exists in swimming rules, for example, to punish coaches of athletes suspended for doping, China, the scourge of the race pool in the 1990s with more than 40 steroid positives, remains the only nation of late to have actually banned both athlete and coach.
Dr. Andrew Pipe, a Fellow of the Canadian Centre for Ethics in Sport, the domestic anti-doping body established in the wake of the Ben Johnson scandal in 1988, said: "As doping strategies become more complex, there have to be health professionals or self-styled scientists involved in [the cheating]. We have to remove these people. We are talking about Machiavellian-Pigamalion-Rasputin types who are behind procedures such as blood doping. They ... don't carry the can. All of us in the medical profession deeply wish that our perverted colleagues are removed from sport."
A senior official in international sports governance, approving of Dr Pipe's stance, added: "There were doctors and medical personnel overseeing these kinds of things in relation to Nordic sports back at the 2002 and 2006 winter Games. You and I could not do a transfusion ... it would take some training, and it isn't just about the physical act of transfusion but you have to be able to store blood in secure medical situation, you need refrigeration. You need expert advice." Any sport with an aerobic component is a potential playground for rogues, Dr Pipe noted. At the winter Games in Vancouver, cross-country skiing and biathlon, in which endurance plays a big part in performance, are among those sports in which blood-doping cheats would prosper if undetected - and assuming that their health held up.
The risks inherent in blood doping are life-threatening. Beyond contamination, the simple act of increasing the red-cell count makes blood thicker, which can also make it clot more readily, raising the risk of heart attack, stroke, and pulmonary embolism.
Cyclists are among athletes known to have died after blood doping, while Russian investigators concluded that 19-year-old New York Rangers prospect and Russian hockey player Alexei Cherepanov was engaged in blood doping for several months before he died on October 13, 2008, after collapsing on the bench during a game in Russia. But those who would have played a part in the teenager's death were never pursued.
"They rarely are," said one source. "But when they are it highlights where the fight has to be taken to. Balco was a highly regulated and coordinated programme. It was systematic in nature. This is not Marion Jones simply looking up some info on the internet. It was a very sophisticated, co-ordinated pattern of doping use. In almost all doping cases now you need supply and knowledge of the doses and the procedures.
"Whether or not someone is using drugs in an alley is far less consequential than finding the suppliers abnd the chain. That's why Balco was so significant. There were a dozen athletes found to be part of the programme but it was less about them than it was about having this very sophisticated, savvy group of people who could upset the entire balance of competitive life across many sports. Jones was terrible but the really bad thing is that such savvy people behind her got to upend sport completely. That's the death of fair sport."
And with that in mind, sports governors are extending discussions aimed at taking the fight ever closer to the suppliers and dealers who sit in the shadows behind athletes and rarely get called out.
The blood (and biological) passports system in swimming, long overdue, coupled with the kind of official eight-year retrospection on test samples offer great potential, though the detail of what ought to be registered needs a bold approach. Blood and urine test results and the establishment of longitudinal profiles for athletes goes part way to achieving results that would justify the necessary investment.
In swimming, some very athletes, Ian Thorpe among them, have long been calling for stricter anti-doping measures and blood passports, while individual nations, such as the US and Germany, and stand-out solo projects, such as the ADN Project in Italy, have taken their own worthy stance.
World-class butterfly aces Milorad Cavic (SRB), Olympic and world medallist and European champion, and Evgeny Korotyshkin (RUS), world s/c record holder - both coached by Andrea Di Nino - are members of the Positivo alla Salute (Positive Health) project and already have a biological passport. Time for officialdom to catch up. It now looks as though FINA will turn intention into action at last soon.
But measures being considered do not go far enough, as yet, some say. Why not, for example, oblige all athletes and teams to register in a swimmer's passport every professional who has worked with or treated that individual? There was a time when each border control required a stamp in a travel passport. That would be a useful mechanism for the occasional doctor who would not normally treat a particular athlete but had to do so under prevailing conditions. Medical confidentiality would have to be observed at all times , of course - but the moment, the name of the doctor and date of the contact would be recorded. Failure to register any professional, from coach to sports scientist, masseur, nurse and doctor, ought to carry the prospect of sanction.
Some might say that such measures go to far but they are hardly intrusive and they would go further in the battle against bad practice. One world-leading swimmer was singled out in a private conversation among doctors and journalists that I was a party too not long ago as having been on a list of "unofficial patients" visiting a doctor with a dark record in sport and doping. Transparency (and obligatory transparency at that) would protect that athlete from speculation and provide one more line of attack in the war on cheating.
An anti-doping passport ought to be a record not only of test results but the journey through a career, a document that could be, with each passing great result and upon retirement, be held in the air by a swimmer able to say " ... and all of that I did clean".
In the case of a positive test, investigators ought then to be given authority to interview all professionals listed in the passport of the athlete suspected of cheating. As noted above, no swimmer is able to cheat with blood doping without assistance.
There is provision in the FINA rule book for imposing sanctions on officials linked to athletes who test positive. On coaches, China takes a leading stand (then again, it does have rather more reason, and cases, to do so). There are other cases where coaches have been sanctioned, including that of Sam Riley (AUS), who took a prescription headache pill given to her, inadvertently, by coach Scott Volkers (the pills belonged to his wife). His punishment was more severe than the warning received by Riley.
In the past decade, several leading names, including Olympic and world champions in the race pool, were suspended for doping but no coach nor doctor nor maker or supplier of a substance was pursued. It has long been the case that no doctors or officials from pharmaceutical companies or sources inside hospitals or traders on banned substances have been taken down by an international sanction when a swimmer has tested positive, even in cases where national authorities have actually removed medical staff from their posts following questionable practices (such as being present when a sample is being provided but failing to notice that the athlete in question provided a sample that belonged to another human being).
The German doping trials of 1998-2000 made criminals of a token group of doctors and coaches in cases that marked the tip of an iceberg of cheating and criminality.
Athletes cheat in a variety of ways and arrive at the point of cheating down different roads: some have no idea or find themselves cogs in a systemic (not necessarily state) wheel (GDR and China), others are convinced by Pigmalion rogues of the what they represent as the truth of what is actually a lie - that "all cheat, so it's ok for you to do so" - while others simply decide to cheat and seek out the help they need.
Regardless of how an athlete arrives at that dark place, it is time for those who trade in and supply banned substances and methods and work with swimmers (and others) in pursuit of ill-gotten gains to be called out of the shadows and face the consequences.