Are more dope cheats eluding the net?

WADA testing figures 2014 report (part 1)

Are dope cheats getting away from the anti-doping net more than they were able to in the past? Is testing for EPO and human growth hormone (hGH) adequate and effective around the world?

These are some of the questions that crop up as you glance through the 2014 anti-doping testing figures released by the World Anti Doping Agency (WADA) on Wednesday, July 22.

Not that these questions did not arise in the past, but now, with more and more reports asserting how easy it has become to avoid detection for EPO and related substances, and how difficult it is to get an hGH candidate among dope cheats the scenario has become more alarming.

If you thought the endurance athletes in athletics, cycling, triathlon etc were being tested for erythropoietin (EPO) regularly in the anti-doping domain, you would be wrong.

Despite more sophisticated testing and larger volumes of samples the anti-doping machinery reported lesser number of adverse analytical findings in 2014, according to the statistics released by the WADA on Wednesday.

This could be attributed to dope cheats being wary of getting caught and resorting to less and less doping practices or, conversely, they being smarter and avoiding getting caught. Recent reports suggest that the latter could be more logical.

Drop in adverse analytical findings

WADA reported that its accredited laboratories tested a total of 1,86,739 samples in Olympic sports  in 2014, resulting in adverse analytical findings (AAFs) of 1440 (0.77%) and Atypical Findings (ATFs) of 406 cases (0.22%) together constituting 1846 total findings which turned out to 0.99 per cent of the samples tested.

(Atypical findings (AAFs) mostly relate to higher thresholds of endogenous steroids, like testosterone and nandrolone, and the need to further study the cases.)

From 1,76,502 samples in 2013, over 10,000 samples lesser than in 2014, the laboratories had reported 1710 AAFs (0.97%) and 1716 ATFs (0.97%) in Olympic sports, making up a total of 3426 findings that amounted to 1.94 per cent.

In all, WADA laboratories tested 2,83,304 samples in 2014, turning up 3153 AAFs and 713 ATFs totaling 3866 findings that came to 1.36 per cent. The corresponding figure in 2013 was 5962 findings from 2,69,878 samples working out a percentage of 2.21.

The figures for erythropoiesis-stimulating  (ESA) agents including EPO, and those for human growth hormone are most revealing.

EPO tests come to less than 11%

Only 28811 EPO tests were done in 2014, constituting under 11 per cent of the total samples. There were 50 AAFs from in-competition tests and 11 from out-of-competition testing for this class of substance from urine testing.

Blood tests for ESA were limited, with 1752 samples turning out just five positive cases.

The position with regard to testing for hGH was disturbing. Only 6075 tests were done that turned up just one positive, at the Warsaw laboratory.

This prompted former chief of the Australian Sports Anti Doping Authority (ASADA), Richard Ings, to Tweet “Only 5,700 hGH and 32,000 EPO tests across an entire globe in a whole year across every spot. Leaving the front door wide open”. In another tweet, Ings said “Net with holes”.

For the Indian reader it could be of interest that the National Dope Testing Laboratory (NDTL), New Delhi tested no blood sample for ESA (including EPO) and did 107 urine samples for this class of substance including four out-of-competition samples and came up with two AAFs amounting to 1.9%.

A few 2014 cases are pending to be taken up rather late in 2015 and it could not be confirmed whether there was an EPO positive there yet to be presented by NADA before a hearing panel.

(Testing for EPO used to be a combination of blood and urine testing when it was introduced in 2000. Blood samples were screened first and then confirmation obtained through urine sample testing, rather an expensive process. In 2003 WADA approved a stand-alone urine test for EPO. However, even now some organizations seek both blood and urine testing.)

EPO, used primarily to treat anaemic conditions in kidney disease, has been misused in sports as a performance-enhancing drug because of its capacity to boost red blood cells which in turn helps improve oxygen supply in muscles. Endurance athletes love it and the drug has long been associated with doping in cycling, especially Tour de France. Lance Armstrong is all too fresh in memory.

Costly affair

EPO testing is costly. The Australian anti doping agency ASADA puts the cost at US$940 for an in-competition ‘stand-alone’ EPO test. Depending on where the laboratory is situated, it could be cheaper.

Of late there has been much debate about EPO and micro-dosing. The BBC’s Panorama programme which made the allegations against American coach Alberto Salazar, had its reporter, Mark Daly micro-dosing with EPO, and improving his endurance considerably without getting detected.

More recently, a French study, which had the permission of WADA, according to reports, had eight athletes being injected with EPO and growth hormone, among other things, in small amounts. They never tested positive but showed remarkable improvement in performance.

The detection window in EPO being very limited, experts are suggesting that micro-dosing could be found out only for a few hours after administration and if such methods had to be detected then testing had to be done at night, probably middle of the night.

Night testing in a restricted way has been allowed by WADA, according to reports, but there is no knowing how effective it has been.  France doesn’t permit night testing and there could be others that could raise an objection or two.

There is no clue about who all among the athletes have benefited from micro-dosing with EPO and may be continuing to benefit as they go about winning laurels.

Last year one of Kenya’s most successful woman marathon runners, Rita Jeptoo was caught doping with EPO and banned for two years.  Her positive test hit Kenya badly. The focus on marathon runners became more intense, from a doping sense that is.

Short detection window

Just like EPO, growth hormone testing has also been problematic for the testers in the sense an acceptable test took time in getting approved while an alternative method had to be discontinued after being introduced for a brief period at the time of the London Olympic Games.

The detection window is so limited that growth hormone administered the previous night would not be detected next morning, researchers have said. Spontaneous secretion of growth hormone is reported to become normal 48 hours after administration of the hormone and thus any athlete who is tested a few days after the administration can easily escape.

The key here lies in catching the culprit out of competition, based on ‘intelligence’ or a suspicion generated by any abnormal improvement.  Since 2010 there have only been around 15 cases reported for hGH (WADA figures). In 2014, just one athlete was caught.

As the WADA President, Craig Reedie recently advised anti-doping authorities to concentrate on substances specific to the sports or events concerned in a bid to tighten controls, it is clear that more and more targeting would be required to concentrate on possible EPO users.

In India, for example, there has been much talk of hGH use for the past decade but nothing has been found out so far. In India, NADA conducted 14 in-competition tests and 190 out-of-competition tests for hGH in 2014, with of course no sample turning up positive.

(continued in part 2)