Current IssuesNo.52
January 2008
 
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Breaking the Culture:
The UCI’s Recent Strategies
for the Detection and Deterrence of Doping in Cycling
Anne Gripper

 

Introduction
During 2007, the Union Cycliste Internationale (UCI) publicly launched several new aspects to our anti-doping efforts:
  • In March, we launched “100% Against Doping”, a programme designed specifically to address the doping isses within the ProTour.
  • In June, three weeks before the Tour de France, we announced an important element of 100% Against Doping, the ‘Riders Commitment to a New Cycling’.
  • In October, along with the World Anti-Doping Agency (WADA) and the French Ministry for Sport, we announced the concept of the biological passport to be implemented in 2008.
As important as these measures are in their own right, they also provided excellent opportunities to “go public” on our strong stance against doping and our desire to break the entrenched culture of doping that seemed to be prevalent in the professional elite ranks of our sport. The announcements also offered an opportunity to engage riders and teams in a public demonstration that all members of the cycling family were equally committed to changing the culture of doping.
The design and implementation of these new initiatives during 2007 must however, be viewed in the broader context of UCI’s increasingly stronger and more effective anti-doping efforts over the last 10 years. Our efforts have traditionally focussed on the twin strategies of:
  • Detection - detecting the cheats and removing them from the sport
  • Deterrence - deterring riders from starting or continuing to dope.
More recently, we have added the third aim of engaging key stakeholders in our efforts – particularly riders, professional teams and race organisers.
This article outlines the responses by the UCI to the increasingly complex and effective types of doping chosen by riders over the last 10 years.
A Solid Foundation: 1997 – 2006
Between 1997 and 2006, the two cornerstones of the UCI’s anti-doping programme were:
  1. a high volume, post-competition urine testing program. Approximately 5,000 in-competition tests were conducted at over 350 international cycling events per year
  2. a high volume, pre-competition blood screening program. Approximately 2,500 blood screens were conducted at approximately 40 cycling events each year.
Human recombinant erythropoietin, commonly known as EPO, appeared at the beginning of the 1990s. A highly effective doping product, which improved performance and sped up recovery, it propelled doping into a new era. Although banned, it was undetectable. It was soon recognised as the drug of choice for endurance athletes, including road cyclists.
EPO can be lethal. Several unexplained deaths due to cardiac arrest of otherwise healthy riders during the 1980s and 1990s were linked to the use of EPO. In order to contain the risks, some cycling teams instigated a system of medically-supervised doping.
It was at this point that the UCI decided to invest a significant proportion of its resources into combating an increasingly sophisticated doping culture and strengthening its programme to protect riders’ health. The introduction of pre-race, unannounced blood testing was a landmark in the fight against doping and in the protection of riders’ health. It was the culmination of the cooperative efforts of the UCI, the scientific community, riders, doctors and team managers.
These blood screens were not doping controls, but they did enable the detection of abnormal blood parameters, which may be the consequence of doping. It was an innovative approach, which even today remains an advanced tool in the fight against doping. From this point on, all riders whose haematocrit levels exceeded the permitted limit were declared unfit to compete and were obliged to abstain from cycling for 15 days.
The “Festina Affair” during the 1998 Tour de France (which involved doping materials being seized from an official car of the Festina team by French police), certainly put the spotlight on what, until then had been a little-known phenomenon - organised, systematic doping within a team, as opposed to doping by individual cheats. The fallout from the 1998 Tour de France certainly reinforced the UCI’s determination to focus on the elimination of blood doping.
During this period, the effectiveness of the blood screening program to detect doping practices was increased by the addition of further parameters with corresponding “no start” limits.
Table 1 – Introduction of new parameters and “no start” limits for men and women.

In particular, the measurement of the percentage of reticulocytes, free plasma haemoglobin and the Stimulation Index (a derived parameter based on haemoglobin and percentage of reticulocytes), led to an increased capacity to target riders for follow up anti-doping tests based on the outcomes of their blood analysis.
Table 2: The type of anti-doping follow up tests indicated by abnormal parameters in blood screens.


“Operation Puerto” provided one of the best examples of the effective use of information from blood screens. In 2003, the UCI began to notice a large number of suspicious blood parameters among Spanish riders, and riders who rode for Spanish teams. At the same time, we received information that was passed on to the World Anti-Doping Agency and national law enforcement authorities. This led to a police enquiry, which culminated in 2006 with the dismantling of a supply ring of illegal doping products.

Strengthening our efforts: 2006-2007
The dramatic events before and after the 2006 Tour de France were a catalyst for even stronger anti-doping efforts by the UCI.
Just days before the start of the 2006 Tour, a public announcement about the status of “Operation Puerto” was made. The release by Spanish authorities of the names of over 50 riders who may have been implicated in using the autologous blood doping services provided by Dr Fuentes, led to the expulsion of several named riders from their teams. And then, to create the other dramatic bookend of the 2006 Tour, the day following the final stage saw the public announcement that the winner, Floyd Landis had returned an adverse analytical finding for testosterone.
These events clearly indicated that the doping problem was still embedded in the professional ranks of the sport. In response, we designed a new program, “100% Against Doping” during the latter part of 2006. The program was designed specifically to be conducted on riders in the 20 licensed UCI ProTeams. A significant new element within the program was the introduction of properly planned, out-of- competition testing. Both blood and urine samples would be collected from riders during training, specific preparation or resting phases. The out-of-competition testing was both broad (covering a large spread of ProTeam riders) and targeted (testing conducted more frequently on riders considered to be more at risk of doping).
The true strength of “100% Against Doping” was the combination of several elements:
  • Introduction of out-of-competition urine testing
  • Introduction of out-of-competition blood screening
  • Increased in-competition blood screens and urine tests
  • The creation of haematological and steroid profiles for selected riders
  • The participation of riders in active anti-doping research projects
  • The agreement of riders to provide DNA samples for the purposes of identification of biological material
  • Increased security of samples and confidentiality of riders results
  • An advisory board to govern the program.
Most importantly, this program was a means of gaining the financial, practical and public support of the most significant stakeholders in the fight against doping – the professional teams and their riders.
One of the most important individual elements of “100% Against Doping” was the opportunity provided to riders through the ‘Rider’s Commitment to a New Cycling’ to indicate their support for clean cycling and to provide their agreement to the use of DNA to assist in the resolution of Operation Puerto. By signing the commitment, rider’s agreed to pay an amount equivalent to their 2007 salary if they were found to have breached an anti-doping rule violation for which a two year sanction was imposed.
At the request of professional teams, a second version of this document was created which provided a similar opportunity for team managers to express their commitment to clean cycling. A third version of the document was created prior to the World Championships in Stuttgart, which provided non-professional riders the same opportunity to express their commitment to a new cycling, free from doping.
By October 2007, a total of 688 professional riders had signed the document. In addition, 67 members of team management had signed, as had 474 non-professional riders.


The Way Ahead: 2008 and Beyond
The planned implementation of a biological passport for approximately 660 professional riders during 2008 represents a significant paradigm shift in the international anti-doping effort. The eyes of the sporting world will be on cycling as we journey down this new path. We believe that it offers a significantly enhanced likelihood of detecting drug cheats.
The biological passport is an individual, electronic record for each rider, in which the results of all doping tests over a period of time are collated. The passport for each rider will contain:
  • Results of individual urine tests
  • Results of individual blood tests
  • A haematological profile consisting of the combined results of haematological parameters analysed in a series of blood samples
  • A steroid profile consisting of the combined results of steroid levels in a series of urine samples.
During 2008, each of the 660 professional riders included in the UCI passport program will have:
  • Approximately 12 blood tests, a majority of which will be collected out-of-competition for the purposes of establishing a haematological profile
  • Approximately 4 urine tests, a majority of which will be collected out-of-competition for the purposes of establishing a steroid profile
  • Stand-alone blood tests collected in-competition in relation to specific races, which are not included in the haematological profile
  • Additional out-of competition tests, if required, for follow-up or targeted testing.
The total number of tests, and in particular, the number of out-of-competition tests will increase significantly in order to ensure the success of the biological passport.
Table 3: Testing numbers for 2006, 2007 and 2008

The haematological profile is a newest element to the UCI’s anti-doping program.
The main difference between profiling and traditional testing is that a series of tests from each rider are organised into a profile, which enables individual limits for each rider to be established. The current anti-doping approach compares each blood sample to a population limit. The population limit currently determines the “no start” rule. With the new approach, each sample will be compared with the rider’s own individual “normal” haematological levels. Any significant variations can then be assessed for possible blood doping manipulation.
The approach relies on the concept of “indirect” detection. Scientific experts will not actually “see” a banned substance in a sample. Instead, they will compare the parameters of the new sample to parameters measured in previous samples. In this way, fluctuations in the riders’ levels, which may indicate manipulation, can be identified. It is impossible for a rider to maintain a steady profile if he is manipulating his blood for performance enhancement and/or manipulating his blood to escape detection through a doping control.
The haematological profile was the key outcome of the Paris Summit on Doping in Cycling organised by the French Ministry of Sport, UCI and WADA on 22 and 23 October 2007, at which the concept of the biological passport was announced and discussed. The UCI’s concept of the biological passport includes the haematological profile, a steroid profile and individual anti-doping tests.
Blood samples to be included in the haematological profile will be analysed and the results examined in three steps as follows:
  1. Each blood sample will be analysed by an accredited laboratory using specialised blood analysis equipment. These laboratories will provide raw data to the World Anti-Doping Agency (WADA) accredited Swiss Doping Analysis Laboratory at Lausanne University (the Lausanne laboratory).
  2. The Lausanne laboratory will determine the Abnormal Blood Profile Score using multiple parameter measures from each sample. They will then apply a Bayesian statistical model to the full sequence of samples provided by that rider.
  3. The report from the Lausanne laboratory will be interpreted by a group of independent scientific experts who will recommend further actions to the UCI. The group of scientific experts will be appointed by WADA and the UCI . The group will comprise of leading researchers in this new field of anti-doping.
The scientific assessment of a rider’s profile applies similar principles to those used in forensic medical science to determine the likelihood of guilt.
Once sufficient evidence is gathered that indicates guilt at an agreed level of certainty, scientific experts will recommend that the UCI open disciplinary proceedings for an anti-doping rule violation. It is expected that a profile of six tests will enable the detection of blood manipulation. In some cases, a fewer number of tests may be needed to detect doping.
Such a violation will be based on Article 15.2 of the UCI Anti-Doping Rules – “the use or attempted use of a prohibited method”.
To support this rule, The List of Prohibited Substances and Prohibited Methods maintained by WADA is incorporated into the UCI Anti-Doping Rules. Section M1 of the Prohibited List prescribes the “enhancement of oxygen transfer through blood doping” as a prohibited method.
The expected sanction for a first offence under this rule is a suspension from competition for 2 years.
The development of a steroid profile follows the same principles as the haematological profile, except that the matrix of analysis is urine.
Urine samples will be collected from riders as normal. In addition to analysing the sample for the full range of prohibited substances, WADA-accredited laboratories will be required to provide a detailed steroid analysis for each sample.
Once sufficient steroid analyses have been conducted, the Lausanne laboratory will apply the same Bayesian statistical model to determine possible enhancement of performance through the use of endogenous (naturally occurring) steroids such as testosterone.
The provision of accurate and timely whereabouts information is critical to the success of this program. High quality, no-advance notice testing can only occur when we know where to find the rider.
Each rider in the passport program will be held individually responsible to provide his location details every three months. He must also ensure updates to his location are provided to the UCI before the change occurs. Riders will be encouraged to provide specific information about their location in the mornings before training. This will ensure blood samples are collected consistently, most importantly before physical effort
Riders and teams are strongly advised to use ADAMS (Anti-Doping Administration and Management System) for the provision of whereabouts information. ADAMS is a worldwide database maintained by WADA, which ensures rider confidentiality and minimum duplication of effort. Once using ADAMS, riders are no longer required to provide separate information to their National Federation or National Anti-Doping Organisation (NADO).
The biological passport is a great step forward. It is part of the continuous effort already undertaken by the UCI to eliminate doping from cycling. The UCI has been a pioneer in the use of haematological parameters for the detection and prevention of doping activities since 1998.
What is new about this approach to anti-doping is that:
  • It draws upon important new scientific methods of indirect detection;
  • It uses sophisticated statistical tools to interpret results;
  • It uses a sequence of tests to provide greater sensitivity in testing.
One thing is certain - this new approach will enable the detection of riders who use blood doping methods or endogenous steroids such as testosterone. Once a rider is included in the biological passport program, it will become impossible for him to escape detection if he uses blood or steroid manipulations to enhance performance.
We are closing the gap on cheaters. Those who dope will be caught. The culture of doping in cycling is being eliminated.


Contact
Anne Gripper
Manager, Anti-Doping
Union Cycliste Internationale
Aigle, Switzerland
Email: anne.gripper@uci.ch





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