[Cevtriat-l] Doping... Deu no Sportscience

To: TRI <cevtriat-l@xxxxxxxxxx>, cevciclo-l@xxxxxxxxxx
Subject: [Cevtriat-l] Doping... Deu no Sportscience
From: Roberto Landwehr <robland3@xxxxxxxx>
Date: Mon, 23 Apr 2001 11:29:20 -0600
Doping Disaster for Finnish Ski Team: a Turning Point for
Drug Testing?
Stephen Seiler
Institute of Sport, Agder University College, Kristiansand, Norway.
Email: Stephen.Seiler@xxxxxx
Sportscience 5(1), sportsci.org/jour/0101/ss.html, 2001 (1750 words)
Reviewed by Carl Foster, Department of Exercise and Sport Science,
University of Wisconsin-LaCrosse,
LaCrosse, Wi 54601, USA
A recent doping scandal at the world cross-country skiing
championships may mark a turning point in the war on illegal drug use
in sport.
Six Finnish skiers tested positive for hydroxy-ethyl starch (HES),
a plasma volume expander and masking agent against EPO use. The
athletes knew the drug was on the banned substance list, but neither
they nor the doctors and coaches who assisted them knew that the World
Anti-Doping Agency had developed a urine test for HES.
KEYWORDS: banned substance, blood doping, cross-country skiing,
EPO, ergogenic, HES, hydroxy-ethyl starch
In late February, the World Nordic skiing championships in Lahti,
Finland, became the latest battleground in the war on doping in sport.
For once, it was the drug testers who had the bigger guns. Actually,
they had a hidden gun.
In endurance sport, we are all aware that the central target of this
battle has become use of erythropoetin (EPO). Hemoglobin boosting has
been rampant in cross-country skiing for years, both via natural
(altitude training), semi-natural (altitude houses), and illegal methods
(EPO use now, blood transfusions previously). Blood testing initiated in
1997 (see various articles at this site) has had some impact, but with
an upper limit of 18.5 g/dl, and still no
accepted method in place to directly detect EPO administration,
eradication of
EPO use has remained a pipe dream.
This year, the International Ski Federation (FIS) reduced the
acceptable "safe"
hemoglobin limit to 17.5 mg/dl for men, thereby raising the chance of a
test. In fact, some athletes reach this limit after altitude exposure.
Some athletes, via their doctors, quickly learned that by combining
EPO administration
with the use of plasma volume expanders such as Dextran 70 and the newer
(hydroxy-ethyl starch, a chemically modified form of corn starch), they
could achieve performance enhancing combination of elevated total blood
volume and high hemoglobin, all while holding hemoglobin below the legal
limit. HES is a very large molecule (450,000 Daltons)--five times larger
than the more familiar Dextran, which exercise physiologists use in
studies of plasma volume.
The molecules of HES and other plasma volume expanders are so large
that the stay in the blood. As osmotic agents, they hold extra fluid in
the blood, thereby elevating plasma volume and total blood volume. These
agents are unique on the banned substance list, in that they enhance
performance and mask the presence of another banned substance.
HES must be delivered intravenously via a drip bag and a large-gauge
cannula. In other words, HES infusions aren?t something that athletes
are likely to pull off alone. The disadvantage of this product is that
the starch is only partly broken down by the body. The large molecule is
slowly cleaved into smaller sections by the liver. A part is excreted
via the urine, another part via the bile, but a last part remains in the
circulation for weeks and is slowly deposited in the tissues,
particularly the skin.
HES was officially placed on the banned substances list 1 year ago.
Often, substances are banned before they can be detected, and HES was no
exception. The Finns were informed, apparently by international sources,
that HES could not yet be detected in urine samples. Their head coach,
two national team doctors, and 6 team athletes therefore chose to
systematically use HES in the two weeks prior to the world
championships. Meanwhile, the new World Anti-Doping Agency (WADA) and
its certified drug-testing labs had
purposefully not announced that they had a detection method for HES in
place prior to the world championships. This method was the hidden gun.
For once it was the drug testers who had a secret.
The first Finnish skier to test positive was medallist Jari
Isometsaa. This unexpected positive created panic in the Finnish team,
some of whom responded desperately by faking accidents and illness. For
example, Jani Immonen had the incredible "bad luck" to ruin a ski
binding in one race and break a ski pole in another. Meanwhile, Finnish
spokesmen claimed that the one positive test was an isolated incident.
Jari Isometsa tried to protect his team by claiming that his actions
were in cooperation with a foreign doctor unknown to the Finnish
support crew. When "accident prone" Janne Immonen tested positive two
days later, systematic doping was suspected. Yet, even after they knew
that HES was being detected, they chose to start the men?s 4 x 10-km
relay with HES-injected athletes.
To make bad things worse for the Finns, a physician?s bag containing
used needles and drip bags was found at a gas station near the Helsinki
airport. The bag turned out to belong to the Finnish cross-country team.
In this story, we might call this bag "the smoking gun".
When two more male skiers from Finland?s gold medal relay team and
two female skiers subsequently tested positive, Finnish skiing was
finished. National heroes Mykka Myllala and the ageless wonder 42-year
old Harvi Kirvesniemi, who earned a bronze medal in the Lake Placid
Olympics of 1980, tested positive and ended their careers in the worst
possible way.
I was visiting the German Sport University (GSU) in Cologne when the
first positive test was announced. Besides being perhaps the world?s
largest sports science and sports education program (6000 students), GSU
is the location of one of the world?s 24 WADA-certified drug testing
The man I talked to had just returned from the WADA laboratory in
Helsinki. Hidden
away on the seventh floor of an 11-story academic building, high
performance gas
chromatography and mass spectrometry are the big guns in an impressive
arsenal of detection methods. Eleven combination HPCG/mass-spec machines
sat in one room! The chemicals in the urine are transferred and
concentrated into
organic solvents. Under high temperature 2-microliter liquid samples
become gaseous
and are pushed through 17 to 60 meters of super-fine separation tubing
to detect banned substances. With eleven HPGC units running, each with
their own heating units designed to raise solvent temperatures to 300°C,
even the special cooling system in the room is not enough to stop it
becoming a sauna.
The lab technicians work in T shirts, but the serious looks on their
faces tell you that they
know what is at stake. By virtue of its structure, each chemical
compound moves through the tubing at a different, highly reproducible
speed, making separation possible. Separation by HPGC and exact
identification by mass spectrometry comprise a "finger-printing" system
that can detect the majority of banned substances. A few others are
revealed using other methods such as liquid chromatography (HPLC). In
the Cologne lab alone, 10,000 human urine samples and 4,000 horse urine
samples are tested annually.
The Cologne lab boasts the largest collection of reference samples
of banned substances in the world. These samples are the key to the mass
spectrometry identification system and are protected by an impressive
system of security measures. All of the WADA labs are subject to
unannounced double-blind sample testing and regular inspection for any
irregularities in laboratory procedures, chain of evidence, and so on.
Had I been a competing athlete with an urge to take a chemical
short-cut, this lab tour would have scared me straight.
Any athlete who claims that their positive test is a mistake should
keep this in mind that the Cologne lab has never produced a single
false-positive test in all the double-blind control tests performed over
the last 10 years. Not one. So much for the B samples.
Although hardly noticed outside of northern Europe, the demise of
Finnish skiing may well represent a breakthrough in the war on doping.
The Ben Johnson episode in Seoul in 1988 kick-started a build-up in drug
testing technology that has continued for more then a decade. In 2001
the technology and organizational structure for year-round testing in
and out of competition is at last beginning to accomplish its mission.
The Finnish scandal also gives hard evidence to strengthen or refute
several suspicions that have been whispered for years. First, while the
former East German and Soviet sports machines have been disassembled, we
have suspected that systematic drug use by isolated national sports
organizations is still happening.
By "systematic", I mean one or more athletes, doctors, and perhaps
coaches working together. In the case of the Finnish incident, it
appears that only a small group within the national team was cheating.
So, we should not persecute those Finnish skiers who were and are clean.
But, Finnish endurance athletes have been suspected since the days of
Lasse Viren and old-fashioned blood replacement techniques in the 1970s.
In international cross-country skiing, the Finns have displayed an
uncanny capacity to be best when it counted.
At times their performances in major championships have born little
resemblance to performances during the season. We training theorists and
exercise physiologists could not understand how an athlete training 25
hours a week and competing 20 times in three months could suddenly raise
his capacity 5% in one week. Our suspicions are now strengthened. There
was no training magic. On the other hand, the fact that a Finnish
laboratory reported the positive tests on the home team helps refute the
claim that the entire drug-testing program is corrupted by sports
organizations in an effort to hide positive tests that would cast a bad
light on the sport.
Finally, this drug scandal reminds us again that, without doctors
and physiologists, much of the drug problem in sport would not exist.
Two Finnish doctors gave their blessing and their assistance to the
offenders. The guilty athletes are now banned from their sport for
cheating. National team sport physicians and top athletes private
doctors are in a powerful position to influence athletes regarding all
things pharmaceutical. When they directly aid an
athlete by providing a banned substance, they are "an accessory to
doping." War history
buffs know that one key to winning a war is cutting off supply lines.
Drug testing is beginning to win battles. When national governments
criminalize a doctor?s
assistance of an athlete using a banned substance, and take away their
medical licenses, we could move a big step closer to winning the entire
editor@xxxxxxxxxxxx · Homepage · ©2001
Edited and webmastered by Will Hopkins.
Published April 2001.
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