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Letters to Cyclingnews - October 1, 2004
OK, no disrespect intended to Michael Rogers, who was clearly the class of the field today, but let's not pretend that the Elite Men's World Time Trial Championship means the winner really is the world's best time trialist. The World's ITT has become a complete sham and the title means almost nothing except that it comes with a pretty jersey. Want proof? Look at the results of arguably the most important ITTs run in 2004: those in the Grand Tours (excluding prologues), the Olympics and the GP des Nations:
Giro stage 13 1 Serguei Gontchar (Ukr) 2 Bradley McGee (Aus) 3 Yaroslav Popovych (Ukr)
Tour stage 16 1 Lance Armstrong (USA) 2 Jan Ullrich (Ger) 3 Andreas Klöden (Ger)
Tour stage 19 1 Lance Armstrong (USA) 2 Jan Ullrich (Ger) 3 Andreas Klöden (Ger)
Vuelta stage 8 1 Tyler Hamilton (USA) 2 Victor Hugo Peńa (Col) 3 Floyd Landis (USA)
Vuelta stage 15 1 Santiago Perez (Spa) 2 Alejandro Valverde (Spa) 3 Roberto Heras (Spa)
Vuelta stage 21 1 Santiago Perez (Spa) 2 Francisco Mancebo (Spa) 3 Carlos Sastre (Spa)
Olympic TT 18 August 2004 1 Tyler Hamilton (USA) 2 Viatcheslav Ekimov (Russia) 3 Bobby Julich (USA)
GP des Nations 19 September 2004 1 Michael Rich (Ger) 2 Uwe Peschel (Ger) 3 José Ivan Gutierrez (Spa)
Now let's look at the results from the World's ITT
1 Michael Rogers (Australia) 2 Michael Rich (Germany) 3 Alexandre Vinokourov (Kazakhstan) 4 Gustav Erik Larsson (Sweden) 5 David Zabriskie (USA) 6 Marzio Bruseghin (Italy) 7 Marc Wauters (Belgium) 8 Fabian Cancellara (Switzerland) 9 José Ivan Gutierrez Palacios (Spain) 10 Uwe Peschel (Germany) ... 25 Bradley McGee (Australia)
OK, at least Rich, Peschel, Rogers, and maybe Gutierrez are arguably among the world's finest time trialists. But let's get real -- any ITT that does not feature, at a minimum, Armstrong, Ullrich, Gontchar, Klöden, Perez and Hamilton isn't going to be crowning the true champion of the discipline. Just another indicator of how far the World's have fallen in stature. Blame the riders for not valuing the World's or blame the UCI for shunting them to the end of the season. Whatever. The fact is, the quality of the field is so diluted that the title "World Time Trial Champion" is virtually meaningless.
I imagine selection for worlds is a very large responsibility. Trying to put the best team on the road doesn't always mean putting the strongest or most experienced riders on the team. It is my understanding that for the elite RR and TT the spots are always filled up with people who qualified automatically. And if these automatic riders turn down their nomination then it comes down to who is still riding their bike and is willing to travel to the race. For the Juniors and Espoirs it is a season long battle and a goal of many athletes to have the opportunity to race in early October.
I believe that currently the U23 squad is selected first by automatic qualification and then the rest of the squad is filled by one person who is very far form impartial, and has a lot to gain from the selection certain riders over those who may deserve to go more. This year there were no automatic spots in the RR, which left an entire team to be decided by one man. This man chose a team that would make his program based out of Belgium look good. He put his own standing above the bottom line of putting together the best team for our country. He chose his own riders because that would make him look good. At the same time he left the National Champion off the team! I think that Ian MacGregor took this injustice in stride and without disrespect towards the US cycling federation. However something MUST change, we cannot allow one person, with there own agenda to select the entire team representing the US.
Uhmmm... Maybe he did do it. I can't believe the overwhelming opinion in the previous letters stating that there is no way Tyler tried to pull one over on us. We see 15 second sound bites of Tyler at the Tour and we think we know him. Of course Tyler seems nice. Why then aren't we hearing emphatic support from Armstrong, Hincapie, Julich, Landis, Rodriguez, Vaughters, etc? All we hear is that they were surprised. Remember how Armstrong talked about really wanting David Millar to come over to Postal a couple of years ago? God aren't we glad that didn't happen. I'm assuming Armstrong didn't know at the time that Millar was capable of doping.
Maybe the reason why the UCI waited so long to report their findings is because Tyler is a hero. How is it in the best interests to the UCI to bring down one of the most popular figures in the sport? It isn't! Maybe the tests are flawed, but maybe they aren't. Certainly most of us idiot, gear-head readers aren't experts.
Maybe Tyler just got fed up with being hurt and having bad luck during the last couple of years and figured just this once he'd give a go at the dark side.
Let's hope everything comes out in the wash and Tyler is cleared. Let's also remember that good people do dumb things.
Tyler Hamilton #2
I, as everyone else, hope Tyler Hamilton is innocent. But I think it's a big mistake to start criticising the tests and to start defending Tyler Hamilton based on what we feel his real character is. Almost everyone who has been caught using illegal means has proclaimed their innocence, has claimed that the tests are invalid, and have had die hard fans to support them. Marco Pantani is prime example of this and of the tragic consequences of not facing up to the facts. Blood doping is a very dangerous practice and should be illegal. If we want racing to be clean and safe, we have to abide by the testing and the results.
Tyler Hamilton #3
Geez! No one is more disappointed in the positive findings of Tyler Hamilton than I am, but proclamations of testing errors or corrupt officials does nothing but make everyone's job harder.
There is a very slight chance that the testing procedure made a mistake. There is also a very slight chance that Tyler has a rare condition in which the results of the test could report an actual medical condition.
But the overall probability is that Tyler succumbed to the pressures of becoming a star. That makes him a cheater and he deserves to lose his position as painful as it is to the rest of us.
If elite sports are to become something to which you might want your own children to aspire, we have to support the drug testing even when it returns results we don't want to hear and which we don't like. Only the worst truth is going to make athletes believe that they will no longer get away with cheating.
Thomas H. Kunich
I have never read so much sycophantic fawning, nationalist drivel as on your letters page about Tyler Hamilton.
Just read it and am clearing up my puke now...
Tyler is an American - Americans never take drugs, Americans never cheat to win Gold medals, he is too honest and professional, he is a chimera, they mixed up the samples, it must be some horrible mistake, they are just out to get him because he is American - yeah right...
Which is more likely? That the IOC, UCI and WADA ask some body who knows nothing about blood testing to come up with some test, never check it and decide to implement it despite the likelihood of being sued for multi millions if it turns out to be unreliable, and decide to pick on Tyler Hamilton because he is an American. How many other US athletes tested positive in Athens? Zero.
Or that the IOC, UCI and WADA spend a load of money inventing a test by a group of blood experts based on a previous check used to help stop people dying from complications in blood transfusions, who rigorously test the method to the point the lawyers are prepared to say it is safe to implement but they don't publicise the results so they don't help cheaters get around the test and it looks like Tyler is probably another lying cheat following a line of lying cheating pro cyclists.
Don't remember anyone standing up for his team mate Oskar Camenzind saying oh no he is Swiss, he is too professional, he's an Olympic champion, he could never cheat and take EPO...
Tyler Hamilton #5
One simple question: What was his hematocrit? In the range of normal for the general population, or elevated? If he was clean, one can expect that it would be in line with his off-season readings.
Tyler Hamilton #6
I'm not sure what to believe about this situation. But as someone who trains others on the process of testing for drugs and alcohol in the trucking industry, I take issue with the following paragraph from the recent IOC statement:
"The fact that the analysis of the B sample was not conclusive does not challenge the accuracy of the analysis of the A sample; the method used during the Olympic Games in Athens was authorized by the World Anti-Doping Agency after validation by the international scientific community in accordance with an established set of criteria."
If the analysis of the B sample does not challenge the accuracy of the analysis of the A sample, why do labs even bother with a B sample? This statement is preposterous, and appears to be an effort by the IOC to avoid liability. Of course mistakes can be made in analysing the A sample - that's why the whole "split sample" process was created in the first place.
Duncan M. Granger, MS, CEAP
Tyler Hamilton #7
I wish Tyler the best; however, if there is transfused blood in his body, it can be detected for up to 55+ days after the transfusion.
His actions will be speak loudly if he gets a lawyer to answer and fight for him in the courts. If he is innocent, this will be the wrong route to take.
He needs to immediately have another blood sample drawn with the proper authorities observing and participating in the retesting, and have it tested under their supervision.
This is the only way that he will ever clear himself and regain his status without question. To get a lawyer is the wrong way to go for him to prove his innocence. If he is truly innocent, then have another sample drawn and tested immediately.
In the world of media that we live in, this will be the only way to answer the world court and clear his good name. This is what I would do if I were in his situation. This would also clear everything up for him with his Team (Phonak) and his sponsors.
Tyler Hamilton #8
I have known Tyler for at least the past 10 years and have worked with him during part of that time. For me, he is the nicest rider that I have ever worked with. Honest to a fault. I do not believe that this man can do anything wrong. I know that there are incredible differences in the human body, from one person to another, like people who have their hearts on the right side of their chest, extra ribs etc. My best Polish rider (double Olympic medallist) who is now 53 years old, has a natural hematocrit level of 54! We all know that there is plenty that we don't know about the natural physiology of the human body. It has become very easy so destroy people's lives and reputation without taking into consideration that positive drug tests CAN be wrong at times.
I am so sorry for him and his family over this incredible situation. I am in total shock and disbelief over this.
Eddie B (Borysewicz)
Tyler Hamilton #9
In his letter dated September 23rd, Patrick McGlynn says "there is no way Tyler is guilty". How can anyone possibly know this except Tyler himself? And perhaps the donor and the doctor who administered the transfusion?
I agree, I am extremely cynical, but I also consider myself a huge fan of cycling AND a fan of Tyler Hamilton. I am a fan of David Millar too, and Richard Virenque, and... It's just a little naive to think someone innocent just because "they work so hard" or they're "such a nice guy".
I wont be so foolish to dare tar everyone with the one brush - I accept there may be completely clean pros out there, however I believe it's that the majority of professional cyclists do or have used substances or techniques that are prohibited. The only surprise to me is that more don't get caught!
But finally let me say this; despite my cynicism and opinion (which I accept is mostly based on hearsay and presumption) it does not in any way diminish my love or respect for the sport and it's riders - nor do I consider the majority of said infractions as cheating. It is the most beautiful and tough sport in the world and the use of banned substances by professional riders is an unavoidable fact! It continues to amuse and annoy me when people are "so shocked" when so and so gets caught.
Wake up and smell the coffee (now no longer banned).
I am afraid to say that American fans may well be fooling themselves in relation to Hamilton's failed dope tests. There has been much discussion about this matter on European message boards and posters fall into 2 clear camps - those who are Hamilton fans, now reluctantly accepting the findings, and those, like myself, who were relieved that he had been caught.
There is undoubtedly a huge doping problem in our sport, from humble domestiques coerced into the practice for survival to top riders greedy for success in the hardest sport of all - Millar springs to mind. Then there are riders like Hamilton who do not have that natural class of say, Bettini, Petacchi, Zabel or Ullrich - for riders like Hamilton success comes less often, at best sporadically or occasionally. Cycling Weekly carried an interview with Hamilton a week before the news broke, it's main theme being Hamilton's rollercoaster year..... I had witnessed Hamilton's dismal performances throughout this year and when he won the Olympic TT, I was one of the few pundits in Britain who saw the parallel with Millar's peformance at the Worlds in 2003. At least Millar had the pedigree of being a top class rider against the clock - but Hamilton?? To beat Ullrich, Rogers, Ekimov, Bodrogi etc was just too unlikely. Time Trialling is not called the "race of truth" for nothing.
You have to be realistic and face the truth that American athletes are not the angels you would like to believe, in fact the evidence suggests that cheating is probably more widespread amongst American competitors than those from any other country.
Tyler Hamilton #11
I hate to be a wet blanket here folks, but has anyone actually considered that there may be some shred of truth to the test results? It is a possibility. Like the rest, I'd love to see Tyler's name cleared, but even more so, I'd hate to see any rider, or athlete for that matter, get away with such charges on the basis of being a popular "gentleman," or for having a nice dog. Let the tests, and re-tests, and Phonak examinations, etc., run their course, but don't be so naive as to think that a person who competes for money in a seemingly notoriously drugged up sport would not be above gaining any advantage possible. Including blood doping.
Tyler Hamilton #12
Denial is a common reaction upon the receipt of unexpected bad news, whether in work, life, or sport, and the bigger the shock the stronger the denial. It seems to me that the correspondents who would believe that Tyler Hamilton must be innocent, and therefore everything else must be flawed, are suffering from a classic case of it.
I greatly admired Tyler's courage in last year's Tour, and I would like to believe he is innocent, but 3 positive samples in 3 valid tests, performed in 2 different laboratories, makes that very difficult. The erroneous freezing of the 4th sample, whilst it might let him keep his Olympic medal, is akin to Scottish law's "not proven" verdict: in other words "we think you did it but we can't prove it".
Patrick McGlynn suggests that the test was "hastily developed so that [it] could be rolled out for the Athens Olympics". Can I ask on what basis he makes this suggestion? In Dr Ashenden's interview he mentions an article published in Haematologica 10 months ago. This hardly seems to me like it's a "hastily developed" test. Mr McGlynn concludes by saying it would be "devastating to American cycling" if he were suspended. I think it would be more devastating to allow a rider who has committed such an offence to go unpunished, especially if it is proven that he was guilty. What would happen next time a rider (prominent or otherwise) was found guilty? "Oh, you can't punish me because you didn't punish him!"
Joy Davis suggests boycotting Hamilton's sponsors' products if they have the temerity to drop him. If he is banned for two years - which should be considered at the very least highly likely - would she really expect them to continue to ask him to endorse their products out of a perceived sense of injustice?
And Bridgette Fleming asserts that the officials are corrupt, and they are going to target innocent sportsmen. So presumably that's the IOC AND the UCI, with their scientists in Athens AND Lausanne, who are corrupt then?
The letters go on, with the writers standing steadfastly behind their man, refusing to believe in anything other than his complete and utter innocence. They bring to mind the reaction to Marco Pantani's exclusion from the 1999 Giro, when his supporters suggested any possible reason for a high haematocrit reading other than that he was using EPO. It is indicative nowadays that, whereas a high haematocrit reading may not get the rider suspended by the UCI, his team will often sack him unless he can prove he DIDN'T take EPO.
To the correspondents who suggested that Hamilton might be a chimera I would say that there is one simple way to prove this. He has said that he will fight this until he has spent his last cent. I suggest he put himself in a Big Brother-type environment, where can be constantly monitored to prove that he hasn't had any more transfusions, for the next 90-120 days, after which time any transfused blood cells would have expired, and he can retake the test. An innocent chimera will record an identical reading, a guilty blood doper will not.
And finally, John Spevacek PhD questions the test's likelihood of producing a false positive because only 25 people were used for the initial report. Well, consider now that there are some 3000 samples sitting in the IOC Athens laboratory. Currently only one has returned a positive. Coincidentally, another sample from that same athlete, taken a few weeks later and treated in a different laboratory, has also returned a positive - in BOTH its A and B samples. So that's three CONSECUTIVE positives, which Dr Spevacek would like to believe are all false. What are the probabilities now? And I would also point out to him that he has misunderstood Dr Ashenden's quote about "mystery antigens". It's not "invalid science" but good anti-doping tactics: you do not reveal all the weapons in your arsenal. What would be the point of publicly listing all the antigens they are testing for? It would be tantamount to saying "If you can do this and this and this then we can't catch you."
As things stand at the moment, I cannot see Tyler Hamilton being anything other than guilty. And cycling has had enough high-profile cases already that it should be no surprise.
Tyler Hamilton #13
Bye and large, all the "chin music" regarding Hamilton is just that; chin music. There are two realities. One being the immediate impact of any sanctions the UCI might place on Hamilton and the other the impact on the sport in general over a period of time.
As regards the first it is obvious that barring any unforeseen and apparently unlikely development Hamilton will be suspended and his career placed in jeopardy. One way or the other, the tests that Hamilton failed will be by far and away the most quantitative measure of his guilt or innocence. There can be no conclusive proof that he hasn't doped. The practical impact for Hamilton and Phonak is obvious.
The impact on the second reality is more difficult to predict. It is the impact of the ongoing doping scandal that continues to gather over our sport like the dark clouds of a violent thunderstorm. Ultimately, the sport will thrive due to its immense appeal or it will be drowned in the downpour.
For me, it is increasingly the latter. I had the good fortune of watching the 2003 TDF through the Alpe d'Huez stage. We rode much of the course, followed the race and rode the Alpe. It was an experience of a lifetime. I can't imagine the disappointment I would have felt upon returning home to find out that the results I witnessed "live" were changed due to the disqualification of one of the favorites, or even Armstrong himself. We have been planning to return to Europe to watch the Giro in '05. I am not sure I am willing to risk hard-earned dollars and vacation time necessary to watch an event conducted under such a cloud.
The problem is, it no longer matters whether Hamilton is guilty or not. The on-and-on doping scandal suggests that doping is endemic to the sport. The notion that an athlete goes into a dark alley and scores a banned substance from some thug and self-administers it in a vacuum is ridiculous. Doping controls and the efforts to circumvent them involve sophisticated concepts in physiology and pharmacology. Doped athletes must be carefully monitored to avoid detection and to regulate their performance and to monitor the serious potential side effects of overuse and misuse of performance enhancing products. They can't do this themselves. It is obvious they get help to secure, transport, use, and monitor the use of these products. There must be a fairly large, and fairly organized system involving criminals, other team personnel, sponsors, and medical professionals. Such a conspiracy must involve a substantial amount of money, as the drugs, and the means to cover up their use, do not come cheap.
How long do the pros think that sponsors will continue to shell out the money to support a team on the pro tour? Mapei has taken their 10,000,000 euros annually from the sport. Other sponsors will surely question the wisdom of supporting cycling. Only so many superstars of the sport can fall before the sport is tarnished beyond repair, much like the image of boxing will never recover from the scandals in that sport. Maybe fans from all over the world who go to the Tour Prologue in '05 should wear a black armband and turn their backs on the riders as they leave the starting gate. The people who control cycling's purse-strings should deliver an ultimatum. Clean it up or close the wallet.
Tyler Hamilton #14
All the unwavering support for Tyler has prompted me to ask this question: How well do the supporters know him?
Please understand that I have always liked him as a rider, but he is just that - a pro cyclist that I receive a handful of info about each year. Some post race comments or an interview perhaps. That's it. All too often we think we "know" all about a person in public life just because we watch them play their sport or see their movies or watch their "Here's how my life changed and everything's wonderful now" piece on Dateline. We really know very little about these people, yet make statements about a particular person's honesty and integrity, how they would never do something, etc. How can we know unless we went to college/high school with that person or worked side by side for months at a charity or were a teammate/mechanic on the same team?
Many of the people who reach the top ranks of their profession are driven by a succeed-at-any-cost mentality. They are the most likely candidates to look for any advantage over their competitors. And they often learn to present the persona that is most advantageous to their careers. They just might not be the "solid citizens" we make them out to be.
Anyway, I hope everything works out for Tyler and his family.
OK listen up guys I'm going to make this short and simple. First of all there are an incredible number of doping tests administered at the Olympics, it takes time for these to all be analyzed and some medalists do not actually get their rightful medals for years after the event. Only this summer was Canada's Becky Scott given her gold medal from Salt Lake. This only goes to show how heinous a crime doping is, not how unreliable anti doping measures are.
Second Tyler has 3 blood tests that have shown the same method of doping, one of which is from a month prior. As much as I love Tyler, even more so than Lance, that is still pretty conclusive. Doping is always dangerous and this method was harder to detect, this was the first time the test was used, so why wouldn't Tyler use it over more popular methods? Frankly the fact that a man who returned 3 positive tests in about a month still has an Olympic gold from that time is disgusting. It's obvious that the IOC has cannot persecute Tyler in this case, and that is unfortunate.
Tyler may have been an inspiration, but he was a fraudulent one. Some of you may think him Innocent despite the fact he already has three strikes but I find it abhorrent that you think its all right Just because it's Tyler. Other cyclists have been suspended for drug use and athletes of other sports as well. Tyler is not being singled out he is being added to the pile of known cheats as an ever increasing warning that you will be caught. You can gripe about Eddie and Fausto all you want, why not gripe about cycling in general? The only way we stop the injustice of doping is through the persecution of every one known to be and the development of tests for every known method of doping.
It saddens me that the resolve of the cycling community against doping is so quickly dissipated as soon as we don't like what we are finding. Attack the new test if you will, it is a new test and needs to be strengthened by criticism. Still Tyler should be suspended, if not banned, because he has failed 3 blood tests for performance enhancement during large competitions. Jan Ulrich was suspended for failing one out of competition test for NON performance enhancing narcotics!
As sad as it is to discover this monument to mental toughness and audacity is fake, lets not compromise principle. "The first principle is that you must not fool yourself - and you are the easiest person to fool." These words from Richard Feynman should be hung over ever one of the letters supporting Tyler as a constant reminder to not jump to conclusions so quickly just because you want them to be true!
The Hard Man from Marblehead isn't dead, he never was.
Tyler Hamilton #16
Of the three "properly implemented" tests that have been conducted on Tyler's blood, all three returned positive for a mixed blood population. That seems incontrovertible to me. I hope Tyler does as he said he would do .. spend his last dollar to prove his innocence. If he doesn't make a credible effort to do so, then that speaks volumes.
I remember Greg LeMond's comments earlier this year about the prevalence of doping in the peloton. In light of the developments with Tyler, maybe he is onto something.
On the one hand, I hate to see Tyler go down if that's what happens, but on the other hand I'm glad that anti-doping efforts are catching up to the cheaters. I can't wait for a good autologous test to be implemented.
Tyler Hamilton #17
I read with amazement all the letters in support of Tyler Hamilton. Whether or not Tyler is guilty - and the evidence looks pretty bad at the moment - how silly to have such blind faith in someone I imagine none of you have every met. Its not difficult for a media personality to make out he's honest and upright and Hamilton's denials should be considered worthless - remember Virenque? Taking the biscuit was Bridgette Fleming (Niceville, FL Wednesday, September 22, 2004)'s letter which asserts that somehow Hamilton being found guilty proves that the testers are corrupt. With such blind faith what's the point of testing? We all have to allow for the possibility of error but the logical explanation at the moment is that Hamilton is guilty - only an irrational person, or someone who knows Tyler an awful lot better than these idolizing fans - could come to a different conclusion. As it is, it seems to me he's enormously lucky to keep his medal but of course its essentially worthless because - unless something is revealed - he's plainly guilty of cheating. I wouldn't be surprised if OJ Simpson-style he hires a lot of lawyers and scientific experts (Lance's pal Dr Ferrari perhaps?) and gets off, making a mockery of the whole testing business in the process. But as far as I'm concerned the test was accepted and validated and he's a cheat.
With regard to Timothy Shame's remarks on autologous transfusions and the 1984 United States Olympic team: these transfusions were not illegal in 1984. There was no violation to penalize. In the Hamilton incident, most interesting to me is that such a long period expired between the Athens test and the public disclosure. How many others have tested positive without any disclosure ever having been made? Would the Hamilton result have been revealed at all if he had not participated in the Vuelta?
Tyler Hamilton #19
I was giving Tyler Hamilton the benefit of the doubt until he said he was "100% innocent." O.J. was 110% not guilty. From now on, I will not believe anybody that says they are anything less than 200% not guilty.
When cyclists talk about their innocence they usually talk in terms of, "in ten years I have never had a positive."
Even with the mishandling of the IOC B sample it looks like there is guilt, no matter what kind of math you use.
In a world where the godfather of the peloton puts his fingers to his lips to signal omerta what more will we learn more about these practices?
Tyler Hamilton #20
Over the past few years, I've been drawn to the sport of cycling because Lance Armstrong's amazing accomplishments. I'm almost a little guilty to admit it: I jumped on the Lance bandwagon. But ever since the 2003 tour when Tyler Hamilton battled a broken collarbone en route to a solo breakaway stage win and a fourth place finish, I've found another hero in cycling. Routinely weighing in near 130 pounds for races, Hamilton has a body type very similar to mine. It's a body type that doesn't fit well in traditional American sports like basketball and football, but in cycling it's an advantage. Lance was the reason that I started watching cycling; Tyler was the reason that I got on the bike. I believe that Tyler is innocent, but if he is found guilty, it will certainly come as a blow to the many American cycling fans that have only just started to love this sport. My point is that I don't believe the American fanbase of cycling can withstand the downfall of one of its heroes, especially one that just won Olympic gold. Say it ain't so, Tyler. Say it ain't so.
While I do not know whether Tyler Hamilton blood doped or not, I would like to think that all athletes do not engage in any kind of doping. However, since people are known to cheat, various tests have and will continue to be introduced to detect and prevent this kind of behavior. Further, as many have pointed out, homologous blood doping can cause serious infections in the recipient (i.e. HIV/AIDS, hepatitis, etc.).
With the above in mind, I would like to make some observations about the flow cytometry-based test used to detect homologous blood doping. I have read the two papers by Margaret Nelson and co-workers (1, 2) that established this test. Briefly, the test uses a panel of antibodies against many (>10) red blood cell (RBC) antigens. When any of these antibodies reacts with the RBC antigens the RBC-antibody complex will react with a second antibody that is tagged with a fluorescent dye. The fluorescent tag makes the cell visible to the detector in the flow cytometer. The idea is that the presence of the RBC antigens varies in any population of humans and thus a homologous transfusion can be detected in a person receiving one unit of blood (450 ml; probably the lower limit of blood needed to improve performance). Further, since the half-life of transfused RBCs is about 30 days and the sensitivity of this test is very high, Nelson et al (2) suggest that their test can detect evidence of transfusion for 3 half-lives or 90 days. In short, the test sounds like an excellent way to detect homologous blood doping. Further, similar tests are used to monitor blood of individuals who are sensitive to blood transfusion.
However, review of the both papers by Nelson et al (1, 2) reveals that while the authors have clearly shown that false negative results are rare and can be eliminated by increasing the size of the antibody screening panel, they have not clearly addressed the potential for false positive results. In their first paper, Nelson et al (1) showed two samples (one in each table) out of twenty that might be false positives. They did not clearly address these samples and only marked the results with asterisks. In their second paper, Nelson et al (2) tested 25 patient samples, all of which were supposed to have been transfused with 1-3 units of blood. The authors determined that three patients did not receive scheduled transfusions. Again the authors showed that they have an excellent test with high sensitivity that can differentiate between transfusion and no transfusion - low rates of false negatives. Unfortunately, the authors did not test a large panel of blood from non-transfused people. There are no data that address the possibility of false positive results.
Every test used to screen people for the presence of some substance (disease agent, drug, blood antigen, etc.) must not only have high sensitivity (few false negatives), but it must also have high accuracy (few false positives). Imagine having a test for HIV infection that is very sensitive, but also gives high numbers of false positives. Such a situation would lead to people not trusting the test. It would not be adopted. The flow cytometry blood doping test may fall into this category. The false positive rate is not known. It is amazing to me that a test has been adopted to screen people after being used on only 45 samples and that virtually all of these samples were known to be positive. How can one trust a test that has not been tested on a large (>1000) sample that includes many negatives?
A second objection to the test is that it is done without proper controls. In their 2003 paper, Nelson et al (2) report the blood types of the patients in the study. Thus one is able to compare the before transfusion results with the post-transfusion results. Have the testing authorities obtained "clean" blood samples from athletes to compare with competition testing samples? Were proper controls run? Without proper controls, no test is valid.
My final concern with the work done to establish this test is that to determine the ability to detect mixed RBCs over time the authors did not do a test over time, rather they simulated the effects of time by diluting the sample two-fold three times (dilutions of 2-, 4-, and 8-fold). They did not sample transfused patients over a period of weeks or months following the transfusion. So while they showed that they have a very sensitive test, they did not determine what happens to the ability to detect transfused blood in a person over 90 days.
In summary, the flow cytometry test for transfused blood is highly sensitive, but its accuracy has not been shown in a refereed publication. The possible lack of proper controls leaves the test results highly suspect. The fight to eliminate doping from our sport is jeopardized by the use of unproven tests to accuse competitors of doping. False or unproven accusations hurt the fight against doping.
Finally, I am surprised that WADA, USADA, IOC, and UCI and others have adopted such a potentially flawed and certainly highly complex test to determine the possibility of homologous blood doping. I suggest that the agencies adopt a test that is much better, easier to perform, is widely performed, and is accepted in virtually all courts. The test would be DNA testing. The use of mitochondrial DNA markers would detect all but mother and sibling donors of blood. The use of nuclear DNA markers would detect all non-self donors.
1. Nelson, M., Ashenden, M., Langshaw, and Popp, H. 2002. Detection of homologous blood transfusion by flow cytometry: a deterrent against blood doping. Haematologica 87:881.
2. Nelson, M., Popp, H., Sharpe, K., and Ashenden, M. 2003. Proof and homologous blood transfusion through quantification of blood group antigens. Haematologica 88:1284-1295.
David R. Nelson, Professor, Cell and Molecular Biology
The new blood test #2
John Stevenson should go back to Dr. Michael Ashenden for some more answers.
If Dr. Ashenden has such a deep scientific interest in minor blood types, how did he miss the article in BMC Genetics in 2001, 2:10, "RHD positive haplotypes in D negative Europeans" by Wagner, Frohmajer, and Flegel from Ulm, Germany? In this article, the authors screened 8442 D-negative blood donors (looking for information about the D blood group gene) and found one chimera who would have failed Ashenden's test. This innocent 24-year old had 6% D-positive cells and 94% D-negative. The article is online at http://www.biomedcentral.com/1471-2156/2/10 ; click on Figure 7 for pictures of the flow cytometry data from two blood samples collected three months apart. That already suggests a false positive rate of more than 1 in 10,000, and that's with testing for only one antigen.
If Dr. Ashenden really said, "the only way that can happen is if the person whose blood you're looking at has had a transfusion - that there is someone else's blood there," Mr. Stevenson should ask him how he overlooked enormous numbers of papers on using flow cytometry to detect maternal cells in offspring and fetal cells in mothers, papers describing the establishment of "foreign" lines of blood cells after transplants and transfusions, several papers showing natural chimerism in unsuspecting people who were tested for other reasons, and at least one paper showing an 8% rate of blood chimerism in twins.
Mr. Stevenson might also want to find out what Dr. Ashenden's evidence is for stability of minor blood group antigens. Do we know that the antigens he tests for are expressed on red cells regardless of the health status of the individual? Has he done any testing to make sure that some of them don't appear or disappear under physical stress? If he didn't do that kind of testing, why not?
There are well-known standards in the US for evaluating positive drug tests in truck drivers, pilots, and other transportation workers. If the screening test is positive, a confirmatory test is done by a more reliable method. If that one is positive, the individual has a chance to talk with a specially-trained physician about any legitimate medical reason that may exist for the positive result. Only after that can the positive result be reported to the employer. Mr. Stevenson might want to find out why Dr. Ashenden would deny athletes the same rights and consideration that truck drivers get.
Dr. Ashenden also appears to have violated international conventions governing medical research on non-consenting subjects. What does he have to say in his defense?
There may be fair and valid ways to use this test, but Dr. Ashenden has a lot of questions to answer before I'll be convinced that he has found them.
Disclosure: I do medical review of positive drug tests on transportation workers.
Mary Arneson, MD
The new blood test #3
It seems to me, based on what I have read and on the letters that proceed mine, there are three scenarios that Tyler could be involved in. The first is that he is doping. The second would be that at some point in his life he has acquired some sort of duality in his RBC antigen makeup. The third would be that recently he has had some surgical intervention that introduced RBC's different than his own. In regards to scenario two, I would think that if he has acquired two set of RBC's at some point he would be in some state of equilibrium with those two sets. Blood cells have a life of 90-120 days so new blood cells introduced would slowly die-out leaving a different ratio of blood types. This being the case, could he not test his blood with this same method to produce results that are similar all of the time? And would this not show that he did not go through some homologous blood transfusion? In regards to scenario three, there would be a paper trail.
I would like to see Tyler cleaned from these accusations as much as the next guy.
The new blood test #4
I am disturbed to find Tyler caught up in a dope test fiasco. Like most everyone else I hope he proves to be innocent.
I am even more disturbed to find that there is a debate about the effectiveness of the dope test itself. I don't know how, in our current situation, any test could be put out there without great confidence by everyone involved that there would be no room for doubt of the results. In our doping crisis, dope tests are becoming the only remaining support for the whole house of cards. We fear everyone is doping, so we anxiously look to the test labs to provide some confidence in the process, the riders, the whole sport, even while we suspect that unethical team doctors are working to subvert the tests. We look to medicine be the salvation of cycling as much as it is the source of its crisis. Therefore we need and expect that the tests themselves have been subjected to the highest standard. There is too much at stake.
In this light, I was alarmed to read the following comment in cyclingnews.com attributed to Dr Ashenden of "Science and Industry Against Blood Doping".
He said they will not reveal all the details of new tests, moreover, "Dick Pound [head of the World Anti-Doping Agency] has said that we don't have to announce a test before we start using it," says Ashenden. "Athletes will know when it is developed because they will be caught. If an athlete chooses to carry on using a particular form of doing when they know we are bringing in a test, they will be caught."
This approach is flat out wrong. In order to restore confidence to the cycling world, dope testing has to be open, transparent, and extensively validated by professional peer review like any other medical standard. This essential process cannot be discarded in an effort to keep ahead of the team docs. Cycling cannot tolerate any doubt in the integrity of the process, even less than we can tolerate doubt in the integrity of athletes.
The test development process must be improved. It's true that the development of tests is in the hands of scientists, but its management is not. I would be much more comfortable with the anti-doping process if it were managed by a professional medical body rather than a quasi-political or commercial body like the UCI or IOC. They need to turn over this process to more independent groups before it's too late to repair the damage to the credibility of the tests and our best hope for recovery.
The new blood test #5
I have a few comment on Tyler's positive test. First, in a clinical lab, the mishandling of a sample is grounds for loss of accreditation or worse. How can anyone trust any result from a test where they mishandled a sample. Is anyone even sure that the first sample that came back positive was even Tyler's? Did they mislabel the sample?
Second, the described test uses serum that has antibodies that react with the minor blood antigens. Sera is by definition polyclonal, meaning that there are a mix of antibodies. This means that there might be antibodies in the sera that react with something other than the desired antigens. Technology exists to make monoclonal antibodies that react very specifically and only with the desired antigen. Biochemical researchers have moved to monoclonal antibodies because of the higher degree of confidence that can be ascribed to their specificity. Why would the WADA/UCI/IOC trust a method that clinical labs and researchers are moving away from when rider's careers are at stake?
Third, the report in Haematologica discusses less than 30 blood samples. Clinical trials for a diagnostic product used in a hospital require 10-20,000 repetitions for approval, how could this test get through with less than 30? Extensive testing of several thousand samples must be done to determine the false positive rate. In addition, multiple repeats on a single sample must be done to verify the reproducibility of the test in a standard sample. These are required to validate the testing procedure. There seems to be a veil of secrecy surrounding the validation of this test, and no one is willing to share data on the validation of this test. Has it even been done? The veil of secrecy makes the whole testing protocol suspect.
Finally, what really needs to be measured is a change in someone's blood sample from test to test, not whether a specific antigen is present at one time. Has Tyler Hamilton failed this test every time his blood has been tested? Were all the results the same? What really needs to be done is to have the same lab test every professional cyclist 2-3 times from blood drawn through random sampling. This will establish a baseline result for each rider. In competition testing can then be performed and compared to the baseline results for each rider. Riders that show a deviation from their own baseline can be accurately described as doping. This is how hematocrit testing is performed. Someone who consistently has high values is allowed to compete with a level over 50 while others are not. Why should this test be different?
These are just a few thoughts on the science of this test, ultimately, much more information must be released about the test before anyone should accept these results as being accurate.
Dale Christensen, PhD
The new blood test #6
I read your comments and observations with great interest, and in case what
you say is in fact plausible, my question is: if such situation would be the
case with Hamilton, why has this not been recorded in his medical files. I would
have thought that such out of the ordinary situation regarding a professional
sportsman's blood would be immediately and heavily documented in his medical
profile, especially since it concerns an individual who knows that he will be
subjected to intensive screening...
I am just a little bit worried of all those instant reactions which first of
all target the researchers and anti-doping labs, while starting from the assumption
that a caught rider is per definition not guilty... However "unbelievable" it
may seem that this or that professional rider proves to be a cheat, (look ar
David Millar, his supporters couldn't believe it either, and they too claimed
the tests were at fault) one needs to take a step back, shrug off the supporter's
approach and adopt an impartial and objective attitude, as people do in the
anti-doping labs: one looks at a bottle with a number and investigates its contents,
and then checks and double checks. That's it. I don't believe some famous names
are being singled out.
Sarah Ulmer - pure pursuiting poetry! A world record, world title, and of course Olympic Gold! Rider of the year.
Rider of the Year #2
I have to take the commentary about Gunn-Rita Dahle being named Rider of the Year to task. Yes, her palmares are impressive. But we have to exclude the women from this award, or Jeannie Longo would have won it ten times..... If she were a man, she'd be the hands-down Best Rider of All Time in everybody's book. But I'm still voting Rebellin.
Raymond F. Martin
Jonathan Smith asks if there's another profession where someone can say "I've signed with so and so for next year and am continuing to work here." Well, if an employee in industry is on a fixed-term contract which has a designated end date, he is quite entitled to sort out his future employment before the conclusion of that contract without having to terminate his initial contract. This is valid both inside and outside the sporting arena, but to give a specific sporting parallel, European football players whose contracts are up at the conclusion of a season (typically end of May) are free to sign a "pre-contract agreement" with another club from the 1st of January of the year the contract expires. This does not prevent them from completing the season with their original club.
Tyler, USPS and Bruyneel #2
Jonathan Smith, Formula 1 has such situations where a driver can continue to race for a team to finish out the season (sometimes for half of the season) and yet already have a contract to drive for another team next season. The driver knows that he needs to perform regardless during the present season, or he may find himself not too well thought of, performance-wise, next season at his new team, and maybe even be relegated to test driver.
There has been a constant theme of the lack of crowds at the Olympic Road Race in letters to the editor. The men's road race was 40 degrees Celcius (as well as the added concrete glare) & standing in the sun watching a group of cyclists fleetingly zip past each 30 minutes would test the resolve of even the most ardent fan.
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