News for December 31, 1999

EPO vs altitude Vs hypobaric chambers

The latest, and possibly the greatest investigation (so far) into drug taking in the professional peloton again deals with the use of injecting the drug erythropoeitin (EPO) to increase riders' red blood cell count. In the current investigation, two of the highest profile medical practitioners that have worked with cyclists - Dr Michele Ferrari and Professor Francesco Conconi - have been placed under suspicion of systematically administering a large number of athletes with EPO over the course of several years.

The investigation is not straightforward of course, as scientists have still not developed a surefire test for the drug, which is produced naturally by the body in response to various stimuli. However, there has been a good deal of research being conducted into the area, and scientists from Australia and Sweden, as well as several other countries are reasonably confident of having a reliable test soon, subject of course to the all-powerful funding dollar.

However, an important ethical point has been raised several times in the past - what is the difference between injecting EPO, or training at altitude, or training while sleeping in a low-pressure "altitude chamber"? It was noted in Tuesday's news that a Norwegian skier was refused entry into the World Championships because his hematocrit was too high - not from EPO use, but from training and sleeping in a hypobaric chamber.

Head physiologist at the Australian Institute of Sport, DR David Martin, wrote to cyclingnews commenting on the difference between the above cases:

"1) Injecting EPO is illegal whereas living in simulated or actual altitude environments is legal.

2) When an athlete is exposed to actual or simulated altitude a number of physiological responses to the novel environment take place including an increase in the production of the hormone EPO. It is important to note that at moderate altitude some athletes have a big increase in circulating EPO concentration whereas others do not. The basic goal of training is to use a variety of external stimuli (exercise, environmental conditions, nutritional therapies, etc.) to produce a physiological adaptation. Injecting EPO bypasses the stimulus - physiological response association and this is the problem because the stimulus - physiological response association and the genetic and environmental factors that influence this relationship is essentially what training for sport is all about. Although not all athletes will have the same EPO response to altitude, all athletes will show the same EPO response to injecting EPO.

3) The increase in EPO that naturally occurs when an athlete is exposed to altitude is similar to the increase in EPO we recently identified following completion of a six day stage race - approximately 20-40% (1999 Tour Down Under, N=21). When athletes are injected with EPO resting concentrations will increase by over 100% and the increases will persist for much longer.

In summary - as a sport scientist working with elite sport I am constantly trying to make sure that the teams I work with are not at any disadvantage when they compete against the best athletes from other countries at big events such as the Olympics. My colleagues and I can now read many scientific studies published in reputable journals suggesting that some moderate altitude exposure protocols are beneficial for the elite athletes. The use of a simulated altitude chamber is safe, legal and potentially effective. Many of the coaches and athletes I work with would consider me unethical if I did not do everything in my power (legally of course) to ensure that they were not at a disadvantage at major competitions because they did not use altitude effectively."

The key point is that injecting EPO bypasses the training stimulus, and the same goes for taking any other drug. Also, it is easily possible to increase athletes' EPO concentrations beyond their natural limits using an injection. However, an altitude chamber does not do this, although it does make it a lot easier for athletes to increase their EPO levels - just not beyond their natural limits. It probably costs more than a few ampoules of EPO or a trip to Mexico (depending on who you are).

So, on the one hand we have the issue of training stimuli and natural (or should we say legal) recovery from training, producing improvements in performance while on the other, drugs are used, again to help recovery but doing this independently of other adaptations, and presumably at a greater rate. Altitude chambers currently lie within the realm of vitamin supplements, carbohydrate drinks, massage, stretching, sleep, and correct eating. They accelerate or magnify the response to training stimuli. Drugs such as EPO artificially elicit a response from the body that is not reproducible in another way. The line is there but it is subtle, and the powers that be could conceivably shift it so that altitude chambers become off-limits, in the same way that other technological advancements in cycling have been banned.

Italian doping: Ferrari investigated

The public prosecutor Giovanni Spinosa in the north Italian city of Bologna has opened a formal criminal case against Dr. Michele Ferrari, who is suspected to have administered Erythropoietin, EPO, to a number of cycling stars from several countries. As revealed recently, the investigators have found notes on huge variations in the blood values of the cyclists, in one case as much as 16.5 percentage units in a very short time. "Such unsuitability can only be explained by the taking of various substances", said professor Plebani from the University of Padua.

Ferrari has also worked with Professor Francesco Conconi in Ferrara, who is also being investigated. Conconi is alleged to have given EPO to 22 top Italian athletes in various sports from 1992 to 1995, while running a program to find a method to detect the use of EPO. Cyclists and cross country skiers were the dominant sports but also athletics, canoeing and swimming were involved.

Dutch stars to talk about doping

Three former Dutch professionals, Peter Winnen, Maarten Ducrot and Steven Rooks - the latter who rode for the PDM team more than a decade ago, will give a frank discussion about their respective teams' medical programs on the Dutch TV documentary, "Reporter", this evening.

The three riders will speak about their almost daily doping regimes. Rooks is perhaps the highest profile of the ex-professionals, winning the mountains jersey in the Tour de France in 1988 as well as coming second overall that year. Ducrot won a stage of the Tour in 1985, while Winnen came second in the Tour de Suisse and third in the Tour de France in 1983. The three are "coming clean" in order to make more of today's professionals aware of the health risks of doping, as well as better medical control for teams.

Strazzer signs

Italian cyclist Massimo Strazzer, who rode with Mobilvetta this past season is moving to new Italian outfit, Alessio-Banca S.G.M. for next year

Canada's cyclist of the century

The Canadian award for their "Cyclists of the Century" went to Alison Sydor and Steve Bauer, who shared the honor. The top five list:

1. Alison Sydor and Steve Bauer
3. Torchy Peden
4. Jocelyn Lovell
5. Willie Spencer