Alarming diagnosis for French cyclists: 60% of the racers tested have biological disorders
This article was written by Jean-Louis Le Touzet and Philippe Rochette.
The status of the French peloton's health is alarming. The comprehensive longitudinal control of the cyclists' health instigated by the French Federation at the request of the Minister of Youth and Sport has produced its first results. Some have said it means that "half of the professional peloton should be taken off the job". As the season is about to start, Liberation has learned of the first conclusions of the epidemiological study including, at the moment, 200 French cyclists, or about half of the professional and Elite category. This medical study of the cyclists with four thorough examinations each year was initiated following the doping affair of the 1998 Tour de France. The study includes two approaches: a physiological exam (endurance test) and a biological phase, with hematological, biochemical, and immunochemical tests. According to the coordinator of the study, Dr. Gerard Dine (hematologist and director of the Biotechnological Institute at Troyes), it appears that 60% of the racers who have undergone the longitudinal control to date have "cases of serious biological disorders that should be the object of scientific study".
According to the first versions of the report, which is not yet finished even though nearly all of the professional peloton has undergone the control, 60% of the racers have biological disorders and "an anomaly in iron metabolism". In 90% of these cases, "an excess of iron has come to light", which indicates repeated use of EPO (erythropoietin) "which we associate with injected iron supplements". In 65% of these cases, the first conclusions not "a serious disturbance of lipid metabolism which also arises from foreign substances"; in this case, injections of corticosteroids and other hormones. Among the racers affected by this problem, 40% have indications of liver or pancreatic damage. The iron levels found among the professionals are astounding: they are greater than 500 ng/l (nanograms/liter) in 90% of the cases, and a normal subject has iron levels lower than 100 ng/l. Levels of 1000 ng/l were found in more than 20% of the professionals. The report also notes that levels as high as 1200 ng/l and even 2000 ng/l.
One of the consequences of these levels is the risk of developing liver or lymphatic cancer. According to a source working with the fight against doping at the Ministery of Youth and Sport, "these results confirm the importance of looking at a population at risk, whose profiles are, at a minimum, not normal. It is up to the doctors to do something. No one else can."
Further, the official is "surprised and concerned by the status of the peloton's health. Honestly, I thought that cyclists were in better health. Especially since the peleton had warning and a chance to make adjustments before the season began. Either the doctors didn't know these facts, or they did know, in which case the absence of any response is surprising. And other parameters are worrisome, with levels that lead one to believe that anabolic steroids are being taken."
For Dr. Guillaume, the physician of Francaise des Jeux, "for the moment it is out of the question to make major changes. The kinds of problems that were found, we knew they existed but maybe we didn't appreciate their importance. We didn't have a global picture at any one instant. The results of this first longitudinal control prove that these anomalies last some time. We can't stop everything just because of these first results. The season will start. We'll know more in three months."
Iron, a dangerous substance. Cirrhoses, cancers ... two physicians analyze the consequences of an overdose of iron.
This article was written by Eric Favereau and David Dufresne with comments from Pierre Laton, chief of endocrinology at the Cochin Hospital, Paris.
An overload of iron is anything but harmless. It can have serious long-term consequences for the patient, because it acts directly on the liver, and can lead to cirrhosis or cancer. In humans, there is even a disease that is characterised by an overload of iron: hemochromatosis. It is a genetic disease, and it must be treated by repeatedly bleeding the patient; but sometimes its progress cannot be stopped, and cancer may follow. In the case of elite athletes, this iron overload immediately brings to mind the use of EPO, augmented with iron injections. EPO increases the level of red blood cells, and a supply of iron is needed for this increase. The two go together.
The second issue is the serious disturbances of lipid metabolism. This condition could arise from a diet that is too rich in animal fats. Another possible cause would be the use of corticosteroids, but it would have to be large doses.
The third issue concerns the anomalies in liver and pancreatic metabolism. There are several possible causes, but in this cases the most likely is secondary effects of taking certain drugs, which have toxic effects upon the liver and pancreas.
Whatever the cause of the problems, it is the high iron levels that should be taken most seriously, judging from the preliminary results.
Comments from Riccardo Iacoponi, biologist and nutritionist, consult to the Italian Senate on the anti-doping law that is currently under consideration:
The body can absorb a maximum of 2% of ingested iron. Taking EPO results in proliferation of red blood cells that are rich in iron, and allows more iron to be incorporated. The problem occurs when the subject stops his or her athletic activity.
The excess of red blood cells break down in the liver and release their iron. This substance is very toxic at these levels and can affect any organ.
This phenomenon, which specialists liken to hemochromatosis, a fairly rare disease (see above). can be associated with certain accidents which, accoring to Iacoponi, may have been the cause of the health problems suke care to do it gradually and to take care of themselves as if they had hemochromatosis."
Prevention is the right approach
Reported by Jean-Louis Le Touzet
Daniel Baal, president of the French Cycling Federation and vice-president of the UCI, coments upon this first epidemiological study of the peloton.
How do you react to the numbers?
At this time, nearly all of the professional racers have undergone this thorough testing. According the the information at my disposal, we are now becoming aware of the seriousness of the doping problem. These preliminary results support our preventive and medical approach. From the evidence, it did not make sense to continue to impose sanctions. We were not making any progress and we still had very few positive results. That said, I am nevertheless very surprised by the consequences for the racers. Many people have said to me "Why are you attacking the use of EPO? It's not a dangerous drug!"
Is it necessary to stand down half of the peloton, as certain doctors have suggested?
First, contra-indicating cycling is not a good way to take care of the racers. It would be dangerous to draw conclusions too hastily, because we have to judge the results over time. What we see from the first tests is that riders are taking legal and illegal products in a disorderly manner. This is why we have decided to stop two racers from competing, for their own good. Right now, our concern is to take care of the racers. We are acting in the interests of public health.
Thanks to Heather Williams for providing the complete translation.
Newcomers to the team will be French neo-pros Franck Pencole, Jérome Neuville, Fréderic Finot and Frédéric Delalande. The sports director is Roger Legeay and the team lineup for 1999 will be: Sebastian Hinault, Anthony Langella, Frederic Moncassin, Olivier Perraudeau, Francois Simon, Cédric Vasseur, Frédéric Delalande, Frederic Finot, Jérome Neuville y Franck Pencole (all French), Chris Boardman, Swede Magnus Backstedt, German Jens Voigt, Italian Eros Poli, Australians Marcel Gono, Henk Vogels and Stuart O'Grady and finally, New Zealand's Christopher Jenner.
The team lineup for 1999 is Mario Aerts, Koen Beeckman, Sebastian Demarbaix, Peter Wuyts, Geert Verheyen, Rik Verbrugghe, Paul Van Hyfte, Kurt van de Wouwer, Christophe Detilloux, Fabien de Waele, Wim Feys, Thierry Marichal, Chris Peers, Jo Planckaert, Andrei Tchmil, Jean Denis Vandenbroucke and Manu Lhoir (all Belgian) and Frenchmen Jacky Durand and Thierry Laurent.
According to Vicent Lavenu, the team will be looking to consolidate this year and achieve solidarity. They will cut the number of races by 30 per cent and will not ride the Giro. The team will aim for the Tour, the Vuelta and all the World Cup races.
He said: "doping in cycling is a serious problem. It can't be solved by digging here or there, without having evidence". The last words from Pantani are clearly in reference to the search that occurred at the house of national selector, Antonio Fusi.
He continued: "We have reached our limit. We are treated like criminals, but this is not the way to solve the problems. The ideal thing would be a serious investigation organized and financed by the International Olympic Committee. Doping in cycling exists and has always existed, but to bring it out, we need real methods. The cyclists can't do anything else. Before coming to the training camp, I underwent all the medical tests imaginable. We submit to all sorts of controls and it seems to me, that there is nothing else that we can do".
About the information published on the French newspaper 'Liberation', about the extent of doping in cycling, Pantani said: "I have read absurd things, figures which are out of this world. Evidently that person (Ivano Fanini, team boss for Amore Vita), whom I consider has little credibility, needs some publicity".
About his program in 1999, Pantani said: "Until the Giro d'Italia I will do my whole Spanish program, more or less like last year. I probably will not go to Romandie, because last year it was cold and wet. I'll be happy to run into Richard Virenque at the Giro."
Peter Zvedenyk (known as "the Russian") took B grade after determined work from a select group. They brought back a two-man break, which at ten minutes to go had looked good, in the last lap.
C grade saw Andrew Hall take command of the remnants of a dying break with twenty-five minutes remaining. His co-escapees worked even turns to survive by a dwindling margin of some thirty metres. Of note was the effort of Blackburn's Mitchell Vervaart, at 15 years of age riding gears restricted to a tiny 83 inches (40x13), he not only contributed but finished a strong second.
Track devotee Justin Doveston took the money in D grade with a characteristic burst of speed when required, at the finish.
A Grade: 1. Robert Tighello 2. Warren Knevitt 3. Michael Varski 4. James Taylor Started: 37 B Grade: 1. Peter ZZvedenyk 2. C. Boone 3. D. Toce 4. N. Witkamp Started: 55 C Grade: 1. Andrew Hall 2. Mitchell Vervaart 3. A. Conquest 4. L. DiMartino Started: 52 D Grade: 1. Justin Doveston 2. D. Vervaart 3. A. Cameron 4. L. Brown Started: 31
At around 25 kms, a strong group of 9 riders formed with Maarten den Bakker, Edward Farenhout, Rene Lems, Joh Talen, Perry Bothof, Björn Schilperoord, John den Braber, Heerco Gorter and Ron Verwey. This group rode fast and also cooperated well together. Rob Sienders tried to get across to them but was unsuccesful. In the finale, there was a further attack out of the top group. 3 riders - John Talen, Edward Fahrenhout and Heerco Gorter - created a gap and were pursued by Perry Bothof and the professionals Maarten den Bakker and John den Braber. The rest of the top group was gon and sat up to the finish.
The chasing 3 could not close the gap and the final sprint was easy for John Talen, who was clearly faster than Edward Farhenhout and Heerco Gorter
1. John Talen (Batavus/Banklotery/Big Star Jeans) 2. Edward Farenhout (Giant) 3. Heerco Gorter (de Volharding) 4. John den Braber (AXA Cyclingteam) 5. Perry Bothof (WV Breda) 6. Maarten den Bakker (Rabobank Wielerploeg) 7. Rene Lems (Visser & Smit Hanab/De Mol) 8. Björn Schilperoord (Visser & Smit Hanab/De Mol) 9. Ron Verwey (de Volharding) 10. Rob Sienders (De Hoekse renners).
Standings after Round 2:
1. John Talen (Batavus/Bankgiro Lotery/Big Star) 40 2. Edward Farenhout (RTC De Hoekse Renners) 38 3. Perry Bothof (WV Breda) 30 4. Bjorn Schilperoord (Visser & Smit Hanab/De Mol) 30 5. Jordan vn Scheers (Visser & Smit Hanab/De Mol) 21 6. Gerhard Klijnhout (RTC De Hoekse Renners) 21 7. Barry vd Ham (WV Willebrord Wil Vooruit) 21 8. Maarten den Bakker (Rabobank Wielerploeg) 20 9. Robert Reyers (Visser & Smit Hanab/De Mol) 20 10. Rene Lems (Visser & Smit Hanab/De Mol) 19 11. Heerco Gorter (UWTC de Volharding) 18 12. Ruud Zijlmans (WV Breda) 18 13. John den Braber (WV Westland Wil Vooruit) 17 14. Rob Sienders (RTC De Hoekse Renners) 16 15. Ron Verwolf (GRC Jan van Arckel) 16 16. Ron Verweij (UWTC de Volharding) 12 17. Leon vn Strien (PRC Delta) 12 18. Dennis Lems (Visser & Smit Hanab/De Mol) 11 19. Corne Castein (GRC Jan van Arckel) 11 20. Allard Epping (UWTC de Volharding) 10 21. Arno Hartog (GRC Jan van Arckel) 10 22. Cor vd Stel (Visser & Smit Hanab/De Mol) 10 23. Edwin Hofstee (RTC De Hoekse Renners) 10 24. Edy vn Liempd (Visser & Smit Hanab/De Mol) 10 25. Ellen de Weert (Visser & Smit Hanab/De Mol) 10 26. Erik vd Velden (Visser & Smit Hanab/De Mol) 10 27. Frank Klarenbeek (Visser & Smit Hanab/De Mol) 10 28. Gert Lunenborg (Visser & Smit Hanab/De Mol) 10 29. Gijs Nederlof WV Woerden) 10 30. Henk Kortland (WV Avanti) 10 31. Hymen vn Doornspeek (Visser & Smit Hanab/De Mol) 10 32. Jan Gommers (WV de Zuidwesthoek) 10 33. Jan Pieter Spruit (PRC Delta) 10 34. Jeanet Harder (PRC Delta) 10 35. Jeroen Dubbeldam (Visser & Smit Hanab/De Mo) 10 36. Johan Tromp (GRC Jan van Arckel) 10 37. Lennart Maris (Visser & Smit Hanab/De Mol) 10 38. Marco Scholten (Visser & Smit Hanab/De Mol) 10 39. Marco Verhoef (Visser & Smit Hanab/De Mol) 10 40. Marco vd Velden (Visser & Smit Hanab/De Mol) 10 41. Michel Kooyman (Visser & Smit Hanab/De Mol) 10 42. Peter vn Vliet (WV Avanti) 10 43. Piet vn Stek (Visser & Smit Hanab/De Mol) 10 44. Rene vn Vuuren (Visser & Smit Hanab/De Mol) 10 45. Robert Karremans (RTC De Hoekse Renners) 10 46. Robert vd Wardt (Visser & Smit Hanab/De Mo) 10 47. Vincent Ruinaard (PRC Delta) 10 48. Jorrit Noppen (Visser & Smit Hanab/De Mol) 9 49. Michel Klop (WV Pedaalridders) 8 50. Richard Visscher (WV Spartaan) 7 48 more riders classified with 5 points