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Doping in XC skiing

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Doping in XC skiing

29 Oct 2010 00:28

Setting and Participants: Samples were obtained as part of routine International Ski Federation blood testing procedures from participants at the (2001) World Ski Championships. Sixty-eight percent of all skiers and 92% of those finishing in the top 10 places were tested.

Main Outcome Measures: Using flow cytometry, we analyzed erythrocyte and reticulocyte indices. Reference values were from the 1989 Nordic Ski World Championships data set and the International Olympic Committee Erythropoietin 2000 project.

Results: Of the skiers tested and finishing within the top 50 places in the competitions, 17% had highly abnormal hematologic profiles, 19% had abnormal values, and 64% were normal. Fifty percent of medal winners and 33% of those finishing from 4th to 10th place had highly abnormal hematologic profiles. In contrast, only 3% of skiers finishing from 41st to 50th place had highly abnormal values.


http://journals.lww.com/cjsportsmed/Abstract/2003/05000/Abnormal_Hematologic_Profiles_in_Elite.2.aspx

The following is a detailed and very informative analysis of the situation in 2002-2007. It's a fantastic read.

http://www.ussa.org/magnoliaPublic/dms/documents/2008-09/Rasmus-study/Rasmus%20study.pdf

This caught my eye when having a look at the FIS Anti-Doping Rules.

FIS.B.4 Start Prohibition

FIS.B.4.1 Haemoglobin concentrations equal to or more than 17 g/dL (men) and 16 g/dL (ladies) An Athlete with a haemoglobin concentration that measures equal to or exceeds 17 g/dL (men) and 16 g/dL (ladies) after the two consecutive measurements, is not allowed to start any competitions for five consecutive days, including the day on which the test took place: e.g. if the blood test takes place on Monday the Athlete will not be permitted to start again until Saturday (and then only subject to the results of a new blood test, see FIS.B.4.7).

FIS.B.4.2 Haemoglobin z-score and OFF z-score ≥3.09
An Athlete with a haemoglobin z-score (Hbcurrent - Hbmean) /
√(σ2 (1+1/n)) or an OFF z-score of ≥3.09 is subject to a start
prohibition of 14 days. A new blood sample is obtained after 14 days
and if the haemoglobin z-score or OFF z-score is ≤3.09 the Athlete is
permitted to start after the conclusion of the 14 day start prohibition.
If the z-scores of ≥2.33 or ≤-2.33 the athlete is treated as suspicious
and follow-up testing will take place accordingly.

FIS.B.4.3 OFF-score model ≥125.6 in males and ≥113.5 in females
The OFF score depicts a previous likely EPO use. OFF score = Hb (g/l)
– 60 * √retic (%). An Athlete with an OFF-score exceeding the above
mentioned values is subject to a start prohibition of 14 days. A new
blood test is obtained after 14 days and if the OFF-score is ≤125.6 or
≤ 113.5 respectively, the Athlete is authorised start after the
conclusion of the 14 day start prohibition.

FIS.B.4.4 Positive Bayesian model
The Bayesian approach is a model that has been developed by WADA
to detect individual variations in blood profiles that are beyond the
normal variation. If the blood values generate a positive Bayesian
model, the Athlete will be issued with a start prohibition for 14 days.


http://www.fis-ski.com/data/document/fisadr2010.pdf

Any idea how the "Bayesian model" works? I understand this is a recent addition. Sounds like you can get a "health" ban for increases in Hb even if you aren't necessarily close to the upper limit.
Tyler'sTwin
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29 Oct 2010 01:10

"Of the skiers tested and finishing within the top 50 places in the competitions, 17% had highly abnormal hematologic profiles, 19% had abnormal values, and 64% were normal. Fifty percent of medal winners and 33% of those finishing from 4th to 10th place had [color="Red"]highly[/color] abnormal hematologic profiles. In contrast, only 3% of skiers finishing from 41st to 50th place had highly abnormal values."

This document states that the highest Hb concentration measured in a swede at this World Championships was 156 g/l. Swedish skier Per Elofsson (who used a hypobaric tent btw) claimed 2 gold medals.

http://ltarkiv.lakartidningen.se/2001/temp/pda23835.pdf
Tyler'sTwin
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29 Oct 2010 01:24

Good stuff. BTW, I thought I was the only xc skier on this forum! lol
BullsFan22
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29 Oct 2010 03:38

Tyler'sTwin wrote:http://journals.lww.com/cjsportsmed/Abstract/2003/05000/Abnormal_Hematologic_Profiles_in_Elite.2.aspx

The following is a detailed and very informative analysis of the situation in 2002-2007. It's a fantastic read.

http://www.ussa.org/magnoliaPublic/dms/documents/2008-09/Rasmus-study/Rasmus%20study.pdf

This caught my eye when having a look at the FIS Anti-Doping Rules.

http://www.fis-ski.com/data/document/fisadr2010.pdf

Any idea how the "Bayesian model" works? I understand this is a recent addition. Sounds like you can get a "health" ban for increases in Hb even if you aren't necessarily close to the upper limit.


This is something UCI could copy - instead of trying to force the equivalent of a doping positive out of abnormal blood values, issue a public 14-day start prohibition instead. This has been used successfully a few times by FIS - the last time I recall was during spring of 2009 when Christian Hoffman of Austria was denied entry to the last world cups in Sweden. He was later forced to retire as the Austrian federation opened an investigation into his connections to a blood centrifuge purchase with his partner-in-crime Michael Rasmussen.
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29 Oct 2010 06:41

Tyler'sTwin wrote:
This document states that the highest Hb concentration measured in a swede at this World Championships was 156 g/l. Swedish skier Per Elofsson (who used a hypobaric tent btw) claimed 2 gold medals.

http://ltarkiv.lakartidningen.se/2001/temp/pda23835.pdf


To put that in context:

- ".. The FIS stipulated maximum [Hb] of 175 g/l.."
- "From the World Nordic Championship in Thunder bay 1995 there is several recorded values of [Hb] in the interval 190-200 g/l"
- "Nothing indicates that norwegian or swedish skiers were hematologically doped during Lahtis 2001 or the previous ten seasons.

Citations form the PDF you linked.
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29 Oct 2010 10:15

I'm a (mostly aspiring) XC skier as well.

If the Giro is so hard it would promote doping, then the whole sport of XC Skiing and Biathlon is. So. Darn. Hard.

Would 1989 figures be a good reference? In the 1988 Calgary Olympics, my source says, already EPO assisted gold medals were won.

Bjoen Dahlie was tested to have the highest VO2max of all tested athletes ever, right? I now wonder in which year this was. 1986 or 1992 would be a significant diffference from a global sports health perspective.
Cloxxki
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Bayes Theorem

29 Oct 2010 14:30

See wikipedia for a good description of Bayes theorem.

http://en.wikipedia.org/wiki/Bayes%27_theorem

It has *lots* of uses in the real world. Without reading the article, it's important to have an idea what the confidence levels are. Also be aware, useful application of Bayes theorem requires a population known to be very good quality. "Good" in this context means known not to be doped.
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29 Oct 2010 14:37

Cloxxki wrote:I'm a (mostly aspiring) XC skier as well.

If the Giro is so hard it would promote doping, then the whole sport of XC Skiing and Biathlon is. So. Darn. Hard.



Agreed-- XC skiing is the most physically challenging sport I've ever participated in.
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29 Oct 2010 15:01

Cloxxki wrote:I'm a (mostly aspiring) XC skier as well.

If the Giro is so hard it would promote doping, then the whole sport of XC Skiing and Biathlon is. So. Darn. Hard.

Would 1989 figures be a god reference? In the 1988 Calgary Olympics, my source says, already EPO assisted gold medals were won.

Bjoen Dahlie was tested to have the highest VO2max of all tested athletes ever, right? I now wonder in which year this was. 1986 or 1992 would be a significant diffference from a global sports health perspective.


The one difference between xc-skiing and tour-cycling is that recovery drugs play a smaller role in skiing. Distances are much shorter in skiing and in World Champs and Olympics the races are never on consecutive days. But the shorter distances place even greater emphasis on VO2Max - and hence any blood boost plays an ever bigger role.

Analogous blood doping was in (relatively) wide-spread use during the 1980's in xc-skiing. EPO came along in the early 1990's - same timeframe as in cycling.

It's doubtful that any of the medals at the 1984 Winter Olympics were won without the help of extra blood:

http://en.wikipedia.org/wiki/Cross-country_skiing_at_the_1984_Winter_Olympics
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29 Oct 2010 15:35

If you presume 1984 to have been dirty, then why would 1989 be a better reference to compare nowadays blood profiles to?
Is analogous blood doping presumed to have diminished heading towards the EPO era? Word goes, when EPO came, champions became mere also-rans, at least in cycling.
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29 Oct 2010 15:48

Cloxxki wrote:If you presume 1984 to have been dirty, then why would 1989 be a better reference to compare nowadays blood profiles to?
Is analogous blood doping presumed to have diminished heading towards the EPO era? Word goes, when EPO came, champions became mere also-rans, at least in cycling.


I think you mean 'autologous blood doping'... It was huge in 84 (within the Olympics that year anyway - not even illegal), but then the advent of EPO allowed even greater benefits without the hassle of pulling and storing your own blood - which is actually quite clinically complicated. Just some little needles, and there you go... Instant *ss-kicker!

I believe this showed itself even more manifestly in the GTs as over a few weeks auto blood doping would be a bit untenable, but with EPO the riders could be jacked 24/7. The logistical ease of EPO use, coupled with its incredible benefits, is what really changed the scene.
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29 Oct 2010 16:11

Cloxxki wrote:If you presume 1984 to have been dirty, then why would 1989 be a better reference to compare nowadays blood profiles to?
Is analogous blood doping presumed to have diminished heading towards the EPO era? Word goes, when EPO came, champions became mere also-rans, at least in cycling.


I suspect they did not do blood tests for research in 1984 - therefore used 1989 as the reference year. The assumption they made is that 1989 is pretty safely pre-EPO era - but obviosuly discount the fact that autologous blood doping was still going on.

Once EPO came along (presumably in 1992-1994 time frame), it replaced autologous blood doping pretty completely. EPO is a lot easier to administer, safer, and you're not limited by your own body's ability to recover from drawing blood. XC-skiing did not introduce a hemoglobin limit until 1997, but this was still relatively high (18.5 g/l for men) and was widely circumvented via plasma expanders which did not get banned until 2001. Since there was no EPO test until 2000, the 1990's can be considered a "dirty" decade in xc-skiing, as it was in cycling as well.

Note that back in 1984 blood doping wasn't even illegal - the US cycling used homologous blood doping to get loads of medals at the 1984 summer Olympics. Technically, blood doping became a banned method in 1985, but there's no reliable test to detect it still today. It is widely suspected that two Estonian skiers (Andrus Veerpalu and Kristina Vaehi-Smigun) used autologous blood doping at the 2010 Vancouver Olympics - both arrived late to the games, and performed well in their first race (Veerpalu even skipped the relay to arrive just 3 days before the 50km event, presumably so that the blood boost taken at home prior to departure would not fade away).
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29 Oct 2010 20:04

Tubeless wrote:I suspect they did not do blood tests for research in 1984 - therefore used 1989 as the reference year. The assumption they made is that 1989 is pretty safely pre-EPO era - but obviosuly discount the fact that autologous blood doping was still going on.


Cloxxki wrote:1989 figures be a good reference? In the 1988 Calgary Olympics, my source says, already EPO assisted gold medals were won.


But the mean Hb value in the medalists at the 1989 worlds does not suggest doping.

Tubeless wrote:The one difference between xc-skiing and tour-cycling is that recovery drugs play a smaller role in skiing. Distances are much shorter in skiing and in World Champs and Olympics the races are never on consecutive days. But the shorter distances place even greater emphasis on VO2Max - and hence any blood boost plays an ever bigger role.


This fails to take into consideration that blood boosting helps recovery too. Also, a study on amateurs showed that EPO had a greater impact on time to exhaustion than VO2 max, but one should perhaps not jump to conclusions based on a single study on amateurs... Anyhow, I really doubt blood doping works better in a ~30 min race than in a ~4 hour race finishing with a ~30 min climb. I'm pretty sure it makes a bigger difference in climbing in cycling since technique and power are important factors in a XC ski race. Also, since a guy with Hb 15 g/dl (or lower) could evidently win 2 golds when 50% of medalists had "highly abnormal" Hb values and an entire team were on HES to stay just below the start prohibition limit.
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29 Oct 2010 20:18

Tubeless wrote:I suspect they did not do blood tests for research in 1984 - therefore used 1989 as the reference year. The assumption they made is that 1989 is pretty safely pre-EPO era - but obviosuly discount the fact that autologous blood doping was still going on.

Once EPO came along (presumably in 1992-1994 time frame), it replaced autologous blood doping pretty completely. EPO is a lot easier to administer, safer, and you're not limited by your own body's ability to recover from drawing blood. XC-skiing did not introduce a hemoglobin limit until 1997, but this was still relatively high (18.5 g/l for men) and was widely circumvented via plasma expanders which did not get banned until 2001. Since there was no EPO test until 2000, the 1990's can be considered a "dirty" decade in xc-skiing, as it was in cycling as well.

Note that back in 1984 blood doping wasn't even illegal - the US cycling used homologous blood doping to get loads of medals at the 1984 summer Olympics. Technically, blood doping became a banned method in 1985, but there's no reliable test to detect it still today. It is widely suspected that two Estonian skiers (Andrus Veerpalu and Kristina Vaehi-Smigun) used autologous blood doping at the 2010 Vancouver Olympics - both arrived late to the games, and performed well in their first race (Veerpalu even skipped the relay to arrive just 3 days before the 50km event, presumably so that the blood boost taken at home prior to departure would not fade away).


It is speculated that Finnish skier Marjo Matikainen used EPO as early as 1988. Her teammate has said that she saw a bottle of EPO on her desk at a training camp and later found out what is was by investigating what Erythropoietin meant. The athlete of course denies it and no other proof has arisen so I don't know if she could've used EPO that early.

When was EPO first developed? What could be the earliest year someone could've used it?

BTW thats interesting news about Veerpalu and Smigun, hadn't heard of that before. Where did you get that info? (=is there a site where doping in XC-skiing is discussed like doping in cycling here at CN?)
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29 Oct 2010 20:31

meandmygitane wrote:To put that in context:

- ".. The FIS stipulated maximum [Hb] of 175 g/l.."
- "From the World Nordic Championship in Thunder bay 1995 there is several recorded values of [Hb] in the interval 190-200 g/l"
- "Nothing indicates that norwegian or swedish skiers were hematologically doped during Lahtis 2001 or the previous ten seasons.

Citations form the PDF you linked.


Finnish XC-skiing head coach between 1998-2001 (Kari-Pekka Kyrö) has accused Norwegians, Italians and Russians of having been well learned in the use of EPO and blood doping in the 90's - at least a few years ahead of other nations. He states that no medalist in the 90's was clean. According to him the Winter Olympics 1994 in Lillehammer were the dirtiest in the history of sport.

I take the "few years ahead" with a grain of salt since he is afrer all Finnish, but otherwise he should know what he's talking about - after all he was overseeing the use of EPO in the Finnish national team (98-2001)
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29 Oct 2010 21:15

As I'm opening my eyes these months, I fail to see why XC should have been any cleaner than cycling, and that is apart from this interesting investigation.

Perhaps the Norwegians are just better at not getting caught, rather than being oh so hardcore and just plain training harder, and sleeping longer. Oh, and Johann Olaf Koss (speed skater) studied medicine, he's be stupid not to know all about EPO. Was it 1994 he won all? :-)
Heralded charity guy now, a save the world and our kids guy. Sounds eerily familiar.

It's good that specific athletes' behaviour is being called out in relation to possible blood doping, but let's not think suspicious behaviour is required to blood dope. There are good Canadians docs, so I've read on CN, who would gladly take the big money a European Olympic team has to offer. Hey, these athletes are pro's, they know what to ask for. Ha, why would those Norwegians hang out in the US so often in the off-season? Darn, I am slowly but surely getting the hang of this...to give some blood for the upcoming local world cups and olympics, of course! :-)

So, do I get this right, the 1989 valued LOOK more natural, making them pre-EPO era, but may in fact be 100% blood doped anyway?
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29 Oct 2010 21:21

RdBiker wrote:It is speculated that Finnish skier Marjo Matikainen used EPO as early as 1988. Her teammate has said that she saw a bottle of EPO on her desk at a training camp and later found out what is was by investigating what Erythropoietin meant. The athlete of course denies it and no other proof has arisen so I don't know if she could've used EPO that early.

When was EPO first developed? What could be the earliest year someone could've used it?

BTW thats interesting news about Veerpalu and Smigun, hadn't heard of that before. Where did you get that info? (=is there a site where doping in XC-skiing is discussed like doping in cycling here at CN?)


My information is that EPO came out in 1987. But it took a few years before it found its way to widespread doping use. Perhaps to no one's surprise, it is believed that Italians were the front runners here - whether cyclists used it first or xc-skiers, I don't know.

I've also heard the rumor about Matikainen and the EPO container in 1988 - but there never was any corraboration. There's a court case going on in Finland right now regarding the Finnish ski team's doping and subsequent reporting by the Finnish news agency STT in the late 1990's; just this week the prosecutors decided to indict 4 people (3 former team manages / coaches and 1 former athlete), Matikainen was also investigated but it was decided that there was not enough evidence to charge her.

Veerpalu's "impeccable" timing for peak condition is widely discussed in the cross-country national team circles. Smigun once tested positive for EPO - but got off as her B-sample came back negative.
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29 Oct 2010 21:30

RdBiker wrote:Finnish XC-skiing head coach between 1998-2001 (Kari-Pekka Kyrö) has accused Norwegians, Italians and Russians of having been well learned in the use of EPO and blood doping in the 90's - at least a few years ahead of other nations. He states that no medalist in the 90's was clean. According to him the Winter Olympics 1994 in Lillehammer were the dirtiest in the history of sport.

I take the "few years ahead" with a grain of salt since he is afrer all Finnish, but otherwise he should know what he's talking about - after all he was overseeing the use of EPO in the Finnish national team (98-2001)


Kyrö has not seen the actual Hb values for specific skiers from other nations (if he had, he surely would've said so when accusing Daehlie, Ulvang and the others), but he knows the mean value at the -95 Worlds and that 15% of the skiers tested would not have been allowed to start today.

The document I linked to doesn't show the average or peak numbers for the norwegians either. It only states that they are generally comparable to the swedish ones, which are as follows.

Year, In-season avg, Off-season avg, Peak

93–94 (n=7) 156,7±7,7 153,6±4,6 172 (No limit)
94–95 (n=7) 150,5±9,3 149,5±7,2 166
95–96 (n=8) 152,9±9,2 149,5±9,2 168
96–97 (n=10) 152,2±7,4 149,5±1,2 164 (limit: 185)
97–98 (n=8) 146,4±3,5 149,2±3,1 161
98–99 (n=12) 150,2±4,0 147,7±2,5 159
99–00 (n=11) 149,3±7,0 154,5±8,1 168
00–01 (n=13) 150,8±6,4 150,7±4,7 161

I believe most of the peaks are from the same guy.
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29 Oct 2010 21:35

Cloxxki wrote:So, do I get this right, the 1989 valued LOOK more natural, making them pre-EPO era, but may in fact be 100% blood doped anyway?


Yes, because everyone was hemodiluting in 1989 to avoid bio-passport issues. :rolleyes:

The mean values at the 1989 World Nordic Ski Championships were lower than population reference values.

Tubeless wrote:Veerpalu's "impeccable" timing for peak condition is widely discussed in the cross-country national team circles. Smigun once tested positive for EPO - but got off as her B-sample came back negative.


It was an anabolic actually. You're absolutely right about Veerpalu and Smigun being considered dopers by other skiers though.
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29 Oct 2010 22:41

It's interesting that they use a lower off-score than cycling. Leipheimer-like off scores get you suspended in that sport.
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