One of the most notable performances at this summer’s Sydney Olympic Games took place far from the athletic fields and arenas. At a quiet laboratory miles away, an international team of scientists and technicians, equipped with over $3 million of advanced equipment, worked non-stop to assure the future health of the Olympic movement. Their mission — to screen out athletes who use drugs to enhance their performances.
IPictured from left to right are: David Okrongly, vice president, methods development; Dan Papale, Advia 120 support specialist; Marty Sorette, staff scientist; Pat Frank, marketing manager; and Greg Colella, director of systems engineering.
In the past decade, blood doping has emerged as a special concern for those responsible for policing competition. Once done through transfusions, blood doping is now more sophisticated. Athletes take injections of synthetic erythropoietin (EPO) in hopes of boosting their numbers of oxygen-carrying red blood cells, thereby improving stamina and performance levels.
But at Sydney, there was good news for honest competitors. Scientists introduced a new testing protocol that targets EPO blood dopers. The procedure combined analyses of urine and blood tests. Two standard Advia 120 hematology systems, developed by Bayer Diagnostics and equipped with the latest software, played a crucial role in the combination testing.
Since 1997 laboratories around the world have been using the Bayer Advia 120 Hematology System to detect and monitor the treatment of microcytic and macrocytic anemias and leukemias and also to enhance platelet transfusions. The Sydney Olympics marked the first time the technology was used to test for EPO blood doping in international competition. The test protocol was developed by international sports medicine experts and was validated only months before the games.
A history of cheating
The use of performance-enhancing drugs by Olympic athletes has a long history. Fifty years ago, Soviet weightlifters were the first to use anabolic steroids to build muscle. That was followed by the use of other steroids, stimulants and hormone injections. More recently, Olympic sharpshooters, archers and figure skaters turned to banned beta blockers to slow their heartbeats and calm themselves before events. Five years ago, one company from Latvia made a tidy profit retrieving human growth hormone (hGH) from cadavers and peddling it to athletes looking for an edge.
Perceptions of cheating persist. A recent survey of Olympic coaches and athletes by the Office of National Drug Policy revealed that they believe as many as 90 percent of their fellow athletes use performance-enhancing drugs.
The EPO attraction
For doctors, EPO can play a significant role in the treatment of anemia and dialysis patients. For athletes, the synthetic form provides an unfair advantage. Increased EPO levels produce more of the red blood cells that carry oxygen to an athlete’s muscles. Since oxygen helps keep muscles from tiring, EPO doping is especially helpful to athletes who compete in endurance events such as distance running, cycling and cross-country skiing.
Nearly half the field of the 1998 Tour de France bike race dropped out after EPO doping charges became public. French cycling star Richard Virenque felt peer pressure to engage in doping. “I was the black sheep. If I strayed from the flock, I was finished,” he said.
Aside from the ethical issues, unsupervised high doses of EPO can drive athletes’ blood counts so high, they risk clotting that can lead to strokes, heart attacks and death. In fact, abnormal EPO levels have been linked to heart problems and the deaths of nearly two dozen racing cyclists in Europe since 1987.
Science fights back
In late August, just two weeks before the Sydney Games opened, the International Olympic Committee authorized the new combination blood and urine tests to detect EPO doping. The new test protocol was more than three years in development. Experts from China, Canada, France, Norway, Australia and the United States took part.
The combination procedure requires less than an hour. When a sample indicated that a red blood cell count was out of range, an athlete would then take a urine test. That test definitively shows the presence or absence of excessive EPO.
The advancement didn’t please everybody. Just before the games began, China withdrew 40 coaches and athletes from its team. News accounts reported high EPO levels were detected among that country’s rowing teams and female distance runners.
“We are very pleased to see that the information our product is capable of providing can also be used to protect the health of Olympic athletes,” said David Okrongly, Ph.D., vice president, methods development for Bayer Diagnostics. “Other tests merely focused on levels of EPO in the blood or urine. What’s different about this test is that it looks at the bottom-line production of red blood cells triggered by an EPO injection.”
A benchtop Advia 120 unit can store results from up to 10,000 patients or athletes, although Olympic testing covers only a fraction of that number. Medal winners gave urine samples at doping-control stations immediately following their event. Selected non-medalists also were tested. Random testing also took place in preliminary events and among teams.
Because the Advia 120 system tracks both accelerated and decelerated production of red blood cells, it shows spikes in parameters when compared to baseline markings. “I think the IOC took a very conservative approach. I see the new Advia 120 protocol as a major step forward that holds great promise for the future,” Okrongly said.
Of the eight Sydney Olympic athletes who tested positive for drugs and were disqualified, not one involved EPO blood doping. Like Okrongly, Larry Bowers, Ph.D, senior managing director at the U.S. Anti-Doping Agency attributes that to the conservative parameters set for the testers by IOC. “I think the Advia 120 is a powerful advance. To get its full impact, we have to come up with parameters that will more clearly identify individuals using EPO.”
Ideally, Bowers said, EPO doping tests would be administered without notice to randomly selected athletes during training periods outside scheduled competitions.
“I think trying to make doping a pure police enterprise is not a good way to address the issue. To get drug-free sports, we need to emphasize testing and the importance of integrity in athletics. We need a change in attitude,” Bowers said.
Nicholas Borgert is a freelence writer based in Charlotte, N.C.
