Cycling reform report anti doping thoughts

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This week the “Cycling Independent Reform Commission” report was released this week and has caused a lot of fall out in cycling.

 

The Commission was tasked to investigate both the governance of the cycling and it’s anti-doping effort, by the incoming UCI (cycling governing body) Chairman Brian Cookson in late 2013.  The report did not make happy reading for the previous administration with bad practice exposed, favouritism to star riders (Lance Armstrong for example) and debatable effort to clean up the sport.  There were also some suggestions how to improve the drug testing effort for cycling.  Below I have included my thoughts on this – as originally commissioned for The Conversation website.

You can read about many of the drugs mentioned in the report following this link here.

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This week the “Cycling Independent Reform Commission” released a report into the often murky world of professional cycling. The report was commissioned by the Union Cycliste Internationale (UCI, the association that oversees competitive cycling events internationally) and focused on governance of the sport and doping between 1998 and 2013.

That cyclists were doping through this period is no big surprise following the big revelations by Lance Armstrong and reports of mass doping cases from Spain, Italy and Germany amongst others. But what did the report have to say about the current use of drugs in the peloton?

There is a big hole in our knowledge of the prevalence of doping. Two estimates are in the report from “respected cycling professional(s)”, one speculates that 20% of current cyclists are doping while the other estimates 90%. The majority of those who gave evidence to the Commission did not appear to know. According to academic literature, the number of athletes who dope is likely in the range of 14-39%.

Before the 2012 Olympics the World Anti-Doping Agency (WADA) director general David Howman believed that dopers were in the “double-digit percentage”. So all things considered, the most conservative estimate at 10% would mean that 20 cyclists who start a major cycling race may be doping.

That doping is still occurring is without doubt, as illustrated by a positive result for EPO use revealed the day after the report was released and the fact that at least 20 cases are currently under UCI investigation.

The Commission recommends that “prevalence studies of doping … should be undertaken by [the] UCI to establish the level of doping”. Only when the scale of the problem is known can the UCI know whether they are “beating the cheats” or being beaten.

The report provides a very good timeline showing the historical use of drugs. The goals of doping in cycling are to increase endurance, increase the power-to-weight ratio and to aid recovery for multi-day events.
Improved endurance is the aim of most doping, through the use of “oxygen vectors” (increasing transport of oxygen around the body) such as blood doping or injecting the hormone erythropoietin (EPO).

Currently “microdosing”, or the use of sub-therapeutic doses of EPO or blood products on a more frequent basis, is used by cyclists aiming to avoid detection by the Athlete Biological Passport (ABP). The ABP records changes in each athlete’s blood over time. Large doses lead to measurable changes, while consistent small doses keep blood parameters stable. Research from one of the world’s leading ABP experts has shown micro-dosing to increase oxygen carrying ability whilst avoiding detection. The ABP appears to be setting limits on doping an individual can get away with, not eliminating it.

Another issue is the use of “permitted” drugs, either not on the prohibited list or which require a Therapeutic Use Exemption (TUE). A friendly doctor may give an athlete a TUE when a drug is not necessarily being used therapeutically. Maybe independent medics should be used for all such TUEs? Legally used drugs, including tranquilisers, Viagra and narcotics appear to be “widely used” which causes some concern.

Cycling is third among sports in numbers of tests for doping (below football and athletics). The report claims the UCI policy is “one of the best among international federations.. [with] room for further improvement”. Just increasing numbers of tests is not the answer as the percentage caught is very small.

Testing statistics from WADA reveal that 1.2% of 22,000 UCI tests produced a positive result, almost identical to athletics. Testing during competition reveals a higher positive percentage than out of competition (1.8 % vs 0.3%) so potentially out of competition could be reduced. Although any testing does have a deterrent effect, out of competition surprise testing should be a better tool for catching dopers,perhaps targeted more to time periods prior to major events.

One suggestion in the report is 24-hour testing during competition, as tests are not at present allowed between 11 pm and 6 am. While this sounds a good idea for catching dopers, imagine having raced hard for six hours, with the knowledge you have the same again the following day, only to be woken at 2 am for a drug test. Perhaps unsurprisingly this is unlikely to gain much support.

The expansion of ABP to include urine (started in 2014) should allow a profile of urinary steroids to be built up for each athlete. The use of isotope ratio mass spectrometry should also be increased. This allows testers to determine whether urinary steroids such as testosterone are naturally produced or through pharmaceutical means. This was only used on 860 cycling samples in 2013, with 3% being positive, suggesting the use could be greatly increased.

The development of new tests is being held up by lack of research funds, which is another problem that needs to be addressed. The freezing of suspect samples for future testing when new methods become available is another way to both deter doping and catch those who use new drugs. How about each cyclist gives at least one sample per week to be stored for future use whilst some of these are also tested at random?

Another testing method to consider is the use of hair samples alongside blood and urine. Currently WADA does not allow these tests but hair gives a much better chance of detecting historical drug use compared to urine or blood. Most doping products can be detected in hair although more research is required to detect use of EPO or blood doping. But can it be mandated that cyclists turn up to events with hair of a certain length?

All in all, cycling may not come out of this looking very good, but if the changes recommended in the report are followed and testing is improved then cycling may become the sport leading the fight against doping it currently claims to be. However, there is a long road ahead.

 

Thanks for reading – any thoughts on my suggestions??

Dr Tom Bassindale

About Dr Tom Bassindale

Dr Tom Bassindale is a forensic scientist, and the founder of We Are Forensic. He's managed hundreds of forensic toxicology cases, and is an experienced court witness. He has specialist expertise in forensic toxicology and drug testing in sport. Dr B is currently a senior lecturer at Sheffield Hallam University. And yes... he watches CSI.