All Those Who Have Achieved a World Record …

… please step forward. Not so fast, Mr. Gebreselassie!

From the guilty-until-proven-innocent-department, here's a little fact (courtesy of the People's Daily — read past the part about the Gatlin case) that I did not know about world records in athletics:

"We are very specific. Any record from 100m to 100km must have been tested for EPO. This has been the case for two years now, but it seems that not all the laboratories know about it," said [secretary general of the IAAF Pierre] Weiss.

According to the same article, the IAAF has refused to ratify at least three world record performances in 2006 because the testing laboratory failed to test an athlete's urine for EPO. You heard that right; not for a failed test, but for a failure to perform the test properly.

The section concerning world records in the IAAF Rulebook is seven pages long. Athletes are required to submit an application form, signed by numerous officials who certify the course, conditions, equipment, etc. A doping control officer also has to certify that a sample was collected from the athlete and sent to the laboratory for analysis.

The most recent record to be rejected was for the men's 25 km road race, where Ethiopia's legendary Haile Gebreselassie recorded a time of 1:11.37 in the Netherlands earlier this year. That accomplishment will not stand as a world record, thanks to bureaucratic incompetence.

Test For EPO is Bad Science

You may have missed this during the excitement of the Olympics, but last week an interesting scientific study was released in the journal Blood. Blood is the Journal of the American Society of Hematology.

The article (abstract here), as cited in Medical News Today, makes a number of very strong statements about the urinary EPO test currently being used by WADA:

• Straightforward experimental protocol of the reported study leaves little doubt that the major urinary protein that WADA test visualizes with the anti-EPO antibodies is not EPO.
• … IOC/WADA method for EPO testing is not scientifically popular or well-established. An in depth analysis of the articles behind the IOC's urine test for EPO shows these earlier publications missed critical control experiments and were not designed to exclude non-specific false-positive misidentification of other non-EPO urine components.
• … provides the grounds for blood doping corruption by IOC and WADA, abuses athletes, and obstructs Olympic "play true" principal.
• … WADA data on blood doping are invalid, and that innocent athletes could lost [sic] their Olympic medals because of IOC and WADA misconduct … Olympic champions could wrongly suffer IOC sanctions.

Of course, we've known this for a while, haven't we?

• Lagat, Offered Nothing, Says No Thanks (2 Dec. 2005)
• More On Urinary EPO Test (30 Sept. 2005)
• More Problems With EPO Test (18 Sept. 2005)
• EPO Tests Problematic (7 Sept. 2005)

How long will WADA go on insisting that there is nothing wrong with the EPO test? How many innocent athletes are they willing to sacrifice in the fight against doping? How many have been sacrificed already?

Lagat, Offered Nothing, Says No Thanks

In August 2003, Bernard Lagat (then of Kenya) tested positive for EPO as the result of an out-of-competition urine test. The IAAF suspended Lagat and informed the Kenyan athletics federation, who promptly leaked the news to the press. Lagat missed the 2003 World Championships and several other lucrative meets that summer while he was suspended. In October that same year, Lagat's B sample tested negative.

Here's what the WADA Code has to say about this situation:

If a Provisional Suspension is imposed based on an A Sample Adverse Analytical Finding and a subsequent B Sample analysis does not confirm the A Sample analysis, then the Athlete shall not be subject to any further disciplinary action and any sanction previously imposed shall be rescinded.

What's a B Sample?

There is sometimes confusion in the press about what a "B sample" is. When urine is collected for a doping test, it is divided into two separately sealed containers; one is labeled 'A' and the other is labeled 'B.' The B sample is therefore not a separate sample at all; it is just another part of the same urine sample.

The B sample is never opened, unless there is an "adverse analytical finding" (positive test result) from the A sample. The intent is to provide a backup check of the testing procedure, not to test the athlete a second time.

The SI.com article linked to here claims that the B sample was "taken on September 29." That cannot be true. The B sample and the A sample must be taken at the same time. The clearing time for EPO, in particular, is only a few days, so a second test taken two months after the fact would be meaningless.

If you're interested in reading more about the urine sample collection process, you can read the WADA Guidelines for Urine Collection.

Well, that's clear enough, then. Mr. Lagat, you're free to go.

Unfortunately, Bernard Lagat decided to get uppity about the situation. He launched a lawsuit against the IAAF and WADA, claiming loss of income as a result of his two-month suspension. The IAAF, apparently a bit nervous about the prospect, came up with a deal; SI.com reported that:

Lagat will be exonerated of any doping offense if he drops his lawsuit seeking compensation from the IAAF … "We are very pleased and we expect the athlete to accept it as well," IAAF spokesman Nick Davies said.

But why would anybody expect Lagat to take this deal? He had already been cleared of doping charges, when his B sample turned up negative. The IAAF knew this, of course; in the same SI.com article, Davies is later quoted as saying "The A and B samples didn't match and for us, he committed no doping offense and was free to compete." So even though the IAAF was already admitting that according to IAAF and WADA rules Bernard Lagat had not committed a doping offense, they still expected him to drop his lawsuit in exchange for being "exonerated?"

This week, the inevitable happened. Lagat decided to reject the deal:

Lagat's statement said he couldn't accept the IAAF compromise because it didn't contain an apology, didn't acknowledge testing methods weren't fail-safe and didn't include compensation.

As I've said before, WADA and the IFs are not going to voluntarily admit that the testing methods are imperfect. Such an admission would open them up to a long line of appeals and lawsuits like this one. My prediction is that the IAAF will next try to reach a financial settlement with Lagat, to avoid a legal judgement that highlights flaws in the anti-doping tests. For my part, I hope that Lagat does not give in; a good hard look at the urinary EPO test is critical to ensure fairness to all.

More On …

I won't be doing much blogging this weekend. I'll be doing some of that sports volunteering I talk about sometimes. So here's a little dump from my "draft post" pile that should provide some interesting reading, and tie up some loose ends that I've left dangling. I'll warn you up front that most of these stories have to do with doping, but I think that there are a few fresh perspectives on that well-worn topic.

The Canadian Centre for Ethics in Sport conducted 1081 drug tests in July, August, and September. About half were exclusively Canadian athletes. Of the 1081 tests, two resulted in doping violations: one for EPO and one for refusing to provide a sample. That's a catch rate of 0.19%, if you're scoring at home (follow up to On Doping Rates and Sample Size.)

The International Herald Tribune reports on what Bode Miller really thinks about doping in sport (follow-up to Getting the Drugs Out of My System):

In an Olympic season that should introduce Miller, the best all-around Alpine skier in the world, to a much broader audience, he has decided to start it all off by becoming the only prominent winter Olympian to be bold or benighted enough to argue for a more laissez-faire approach to doping.

The USOC now has its own official supplier of nutritional supplements (follow-up to Doping and the "Culture of Pills and Powders"). I originally spotted this in the New York Times, but the article seems to have gone away. Here's a quote I grabbed from the NYT piece:

The U.S.O.C. recently reached the agreement with Ajinomoto, a Japanese food company [Amateur: the world's leading manufacturer of Aspartame], to market an amino-acid replacement product called Amino Vital. It is a cautious step into the minefield of the supplement business, one largely unregulated by the Food and Drug Administration and the cause of untold numbers of failed drug tests.

Some former East German athletes are now suing the German Olympic Committee for damages related to the GDR's state-run doping program; here's the story from CBS News and The Scotsman (follow-up to Damages). On a related note, here's an in-depth article about the quest to erase East German accomplishments from the German record books (follow-up to Getting the Drugs Out of My System).

The Boston Globe has a story on the recent breakthrough in steroid detection (follow-up to Getting the Drugs Out of My System):

Authorities have long based their efforts to find evidence of doping through chemistry, with labs searching an athlete's blood or urine for chemical compounds known to enhance performance. But designer steroids such as THG -- the substance at the center of the Bay Area Laboratory Cooperative doping scandal -- are crafted to be invisible because authorities don't know to look for its particular chemical markers.

Speaking of beating the tests, Dick Pound is still insisting that there is no problem with the urinary EPO Test (follow-up to More on Urinary EPO Test). Then again, what else can he say?

"Of course WADA can't back down," said one European sport official, who requested anonymity. "How can they back down on a test they've used to ban people for years? If they come out and say, 'Our test has got flaws,' how many millions are people going to sue for?"

Leaving the topic of doping now, Italy is offering huge cash rewards to athletes who win medals at the upcoming 2006 Olympics — $180,000 for a gold medal. You already know that I think that this is money poorly spent (follow-up to Amateur Athlete Funding Q&A).

And finally, some Scots' dreams of an independent Olympic team died in parliament some time ago (follow-up to Not-So-United Kingdom). Since then, the Scottish governing body for soccer has decided that their organization will not have anything to do with fielding a GBR soccer team in 2012, and Scottish players will not be eligible. I'll be curious to see if any legal action results.

Getting the Drugs Out of My System

I've been doing a lot of writing about drugs, and especially steroids, lately; not only here, but over at SportsFilter, too, where I can't seem to talk about anything else. I have to stop, or soon everybody will hate me.

The most recent positive test has hit a little bit closer to home than most, and left me somewhat depressed. But aside from that, I have been collecting some news stories that I wanted to pass along. I'm going to use this post to collect some of these disjointed ideas, and then leave the topic of steroids alone for a while. (I do want to write something about Gene Doping, but that's really a different subject.)

Never Enough?

The Pittsburgh Post-Gazette ran a four-part series about anabolic steroids last week. The series was titled "Never Enough: Steroids in Sports" and covered the history of steroid use in amateur and professional sports.

I found parts one and two particularly interesting, as they covered the early history of steroid use among US weightlifters, and early regulation efforts and failures. Here are the links to parts three and four.

Need a Boost?

The Seattle Times has been running their own series on performance enhancement in sports, called "Getting a Boost." The series is in three parts, and there are also a number of supplemental articles. Some of the articles cover very well-worn ground (the dangers of supplements, the uncertainty in EPO test results), but the coverage is very broad and they've made room for some unusual perspectives. Take a look at this piece about Dr. Norman Frost, who questions whether anabolic steroids have any negative health effects, and this one, about the increase in steroid use among female athletes.

Erasing the GDR?

German track and field authorities have announced that they are going to review the validity of their national records — at least, those records that are still held by the German Democratic Republic. The investigation was apparently prompted by a request from one of the East German record-holders, who feels that the East German doping program renders her performances invalid.

Drug Pacifists?

World-class athletes from different sports and different eras, Bode Miller and Eddie Merckx have both spoken out against the current zero-tolerance policy on performance-enhancing drugs. Miller, an alpine ski star from the US, expressed support for legalizing EPO:

I'm surprised it's illegal, because in our sport, it would be pretty minimal health risks, and it would actually make it safer for the athletes …

You can follow the link to see Miller's logic on the last point, but he seems to suffer from the (common) misconception that drugs are banned because they are harmful to athletes. It's clear to me that substances are banned only when they are unfairly performance-enhancing — perhaps a subject for another day.

Taming the Italians?

IOC president Jacques Rogge (and WADA president Dick Pound) will ask Italian officials to make an exception to their tough anti-doping laws during the 2006 winter Olympics. Under Italian law, athletes caught in possession of performance-enhancing drugs could face criminal charges.

I'm not sure how I feel about this. On the one hand, athletes should obey the laws of the countries that they visit, and face the consequences if they don't. I don't see any reason that they should have special immunity from the law. On the other hand, I don't see that aggressive criminal prosecution of visiting athletes is really to anybody's benefit. My prediction is that Rogge will get what he wants.

New and Better Steroid Test?

Details are pretty sketchy, but Reuters reported on Wednesday that British scientists have come up with a new and better steroid test:

Thanks to our technique, in the future it will be much more difficult to escape detection when using performance-enhancing steroids.

I can unequivocally say that I'm all for that.

POSTSCRIPT

I knew I had forgotten one; for the medical specialists in the crowd, here's a review article I came across titled, Cardiovascular Toxicities of Performance-Enhancing Substances in Sports.

More On Urinary EPO Test

Cyclingnews.com has a detailed article on some of the scientific issues surrounding the urine test for recombinant EPO, which I have touched on briefly here and here.

The article is a summary of a report by Basque physiologist Iñigo Mujika. You can see Dr. Mujika's full report here, if you prefer; it is only a little bit more technical than the summary article.

As a sort of pre-emptive declaration of conflict of interest, the cyclingnews.com article notes that Mujika is a physiologist and trainer for one of the top pro cycling teams (Euskaltel-Euskadi). He is also a coach for Virginia Berasategui, one of the triathletes who tested positive at Ironman Lanzarote in May, but was later cleared of wrongdoing based on inconsistencies in the laboratory results. So he may have some personal interest in casting doubt on the test.

His report, however, makes extensive reference to an independent evaluation commissioned by WADA, titled Evaluation report of the urine EPO test, written by G. Peltre and W. Thormann and accepted by WADA in March 2003. If you Google the title, you can find several references to the PDF version of the WADA report; unfortunately, WADA appears to have removed it from their web site, since I can't find it there now.

Referring to the WADA report, as well as other sources, Dr. Mujika does raise some alarming points about the urine test for rEPO. Among these:

• The test is not uniformly performed at all accredited laboratories. That is, the procedure for performing the test is slightly different at different labs.
• Laboratories do not measure protein concentration in the urine in the "preconcentration phase" of the test. In some cases intense exercise can induce a condition called proteinuria, which increases the concentration of protein in the urine. This increase in protein concentration can alter the results of the test and may lead to false positives.
• The specificity of the antibodies used to bind to rEPO in the urine test has not been scientifically evaluated. It is possible that the antibodies bind to endogenous (naturally occurring) EPO, and even to other unrelated proteins. Again, this could lead to false positives.
• Despite claims by WADA to the contrary, the rEPO urine test is a quantitative test, not a qualitative tests. That is, the test does not give a simple present-or-absent result, but the test results must be subjected to quantitative pass/fail criteria. Even worse, the criteria that are used are not uniform across all laboratories, and in fact the latest criteria have not been published by WADA, which means that the test cannot be peer-reviewed.

Mujika then goes on to describe several cases where positive test results were subsequently thrown out because of questions about the test.

All of this suggests, in my opinion, that the urinary EPO test should not be used. It is clear that not enough is really known about the test and its limitations; it is also clear that many people don't care that much if the test is imperfect. The managers of the Barcelona anti-doping lab are quoted by Mujika as saying that "the only direct test available on urine has the merit of existing and is definitely needed." That's a rather short list of merits!

As I have stated before, the consequences of a false positive are very severe for the victimized athlete. Any test for EPO must be held to the same strict standards as tests for anabolic agents and other banned substances.

More Problems With EPO Test

The urine test for recombinant EPO continues to show reliability problems. Triathlete Magazine is reporting that WADA has been forced to discard two more positive EPO tests:

Of the 10 urine samples analyzed from Ironman Lanzarote, … two were positive for r[ecombinant]EPO, one was non-detectable, three were "non-qualifiable" and four were negative. The fact that four of the samples were either non-detectable or non-qualifiable is clearly suggestive of a major issue regarding the analytical procedures.

The two nominally positive tests have been thrown out by WADA.

EPO Tests Problematic

The New York Times (registration required) has an interesting article about the new test for EPO in urine samples, which is not a straightforward chemical detection and requires considerable interpretation by a skilled practitioner:

To distinguish recombinant EPO from the natural substance, the scientists used a technique that did not rely heavily on more straightforward chemical tests. To test for EPO, a preparation of urine is placed on the edge of a blotter, then subjected to the pull of an electrical field, leaving deposits in certain patterns that resemble a tiger's stripes. Some bands are more associated with recombinant EPO, some more with the natural substance. But there is considerable overlap as well. Scientists assess the patterns and the intensity of the bands. "There is a fair amount of cross-reactivity with the test, so there are certainly false positives," [Australian research scientist Nicolle] Packer ... said. "There is a lot of argument - and a lot of politics - about whether the test is good."

It should go without saying that if a positive test is going to be used to interrupt or terminate an athlete's career, invalidate past results, and ruin reputations, then the probability of false alarm (false positive rate) has to be very, very low. It doesn't sound to me like the EPO test meets that standard yet.

The story is inspired by the newest Lance Armstrong allegations, but it has broad applicability since EPO abuse for sports doping is thought to be very widespread. I found the article via Transition Game. You might also be interested in Nick's post, which is titled Dick Pound Must Go.