Doping in XC skiing

[Bavarianrider]

Thanks you

 

[Trond Vidar]

I don't have time to write much, but WOW this is a cool live presentation. Extremely interesting to hear Erlend Hem present his stuff. He has collected values since 1989, and been on almost every altitude camp and has controlled 10.000 O2 test. Incredible insight.

They experimented on sleeping in the cable-cabin in Val Senales @3200 meters above sea level etc, and testing with Hemocue. Shows many values, some extreme ones. He found that after a while, Hemocue could not be used to exactly measure the HB but it was an extremely efficient way of telling if the skier needed to drink more at altitude.

 

[Alesle]

I don't have time to write much, but WOW this is a cool live presentation. Extremely interesting to hear Erlend Hem present his stuff. He has collected values since 1989, and been on almost every altitude camp and has controlled 10.000 O2 test. Incredible insight.

They experimented on sleeping in the cable-cabin in Val Senales @3200 meters above sea level etc, and testing with Hemocue. Shows many values, some extreme ones. He found that after a while, Hemocue could not be used to exactly measure the HB but it was an extremely efficient way of telling if the skier needed to drink more at altitude.

I found it truly facinating, though I haven't had time to watch it all yet. Some small exerpts I found intersting:

Average Hb values of the male team from laboratory tests from '89 to '01 +' 12 (tests mostly taken between June and November, less available data from during the season), taken at both sea-level and altitude. The '01 values of 15.6 are based on the numbers presented in Dagbladet that year, using a combination of the low, normal and high. Thinks maybe part of the '01 values were with hemocue tests.

Comparison with the WC average from the same years, no available WC average for the early 90s.

Hb values for 12 skiers from before and a couple of days after (with normal fluid balance) a 17 day altitude camp, living at 2000 m above sea level and training at up to 3200 m.

Hb values for an individual skier with laboratory tests before and after (respectively 15,8 and 16,7), with hemocue tests during the altitude camp. Hemocue tests varied from 15,5 to 18,6, and was mainly used to make sure the athletes stayed hydrated.

Some of the "accused" skiers wanted to present their individual values. These are based on laboratory tests from '96 to '98.
Daæhlie: 15.7, 15.6, 15.3, 16.0, 15.3, 14.9, 15.1
Jævne: 14.8, 15.2, 14.7, 15.2, 15.1, 15.2, 15.5
Skjeldal: 15.5, 16.9, 15.3, 14.9, 15.5, 15.5 (I might have missed one of the values)
Mikkelsplass: 13.7, 14.2, 13.3, 13.4, 13.5, 14.1 (Some of the later tests done at a different place/machine or something, due to her not staying with the national team at that time)

 

[dukoff]

Here is a quick run-through of the key points I was able to note during the presentation, and referencing the slides. Sorry images are just links, but it's max 4 per post, so don't wish to split it.


Speaker: Ola Rønsen

Numbers are a collection of measurements 408 (men), 277 (women).
Taken from training camps and competition.
Most are from training.
Most are vein-samples analyzed by laboratory or hospital.
Most are taken by approved lab instruments.
Measurements taken both at low altitude and at altitude.

This presentation is not an investigation, but a way to be able to present data on short notice.
We are open for any external investigation, but such will take a much longer time.

Slide shows average Hb of Norwegian male skiers from 1989 to 2001 and 2012, along with a bit poor overlay of the numbers of average FIS values during the same years.

Samples between 92-94 were analyzed at and is the property of Aker hospital. Their policy is different and requires approval of every individual athlete even to give out anonymous data. Hence these numbers were not possible to include for this presentation.

2001 column shows numbers given by athletes in Dagbladet 2001. This average for 2001 becomes unnaturally high, due to the mathematical method of calculating an average based on 3 numbers including a maximum. A single maximum value will then have an unrealistic impact on the average.

http://img823.imageshack.us/img823/2365/screenshot2013031309081.png

Here we also show minimum, mean and maximum values for the same data:
(Note max/min are likely average of maximums/minimums of individuals)

http://img855.imageshack.us/img855/1254/screenshot2013031309094.png

Here are same slides for women:

http://img23.imageshack.us/img23/6169/screenshot2013031309113.png

http://img716.imageshack.us/img716/6915/screenshot2013031309114.png


From a project in 1998(?) measurements were taken at men's 50k and women's 30k.
16.4 avg before start, 16.0 after race.
Measurements taken just before start, after warm-up. Makes them higher than in morning.

Values for Bjørn Dæhlie (and some others) are from a research project by external party 96-98. Only lab tests, done on the same lab machine.
And some other racers that have been commented on: Jevne, Skjeldal, Mikkelsplass.

Dæhlie shows values: 15.7, 16.6, 15.4, 16.0, 15.3, 14.9, 15.2.

http://img853.imageshack.us/img853/9297/screenshot2013031309171.png


Speaker: Doctor at Blodbanken (blood bank) Richard Olaussen.

Natural individual variation can be 3 points.
Notes the importance of distinguishing mean value time series from an individual's time series, as the former will have minimal variation.
Explains an individual's natural values are determined over a long time and sees a person's response pattern to different type of stimuli.

Shows data of time series for different blood givers:

http://img823.imageshack.us/img823/7218/screenshot2013031309244.png

http://img59.imageshack.us/img59/1563/screenshot2013031309262.png

http://img208.imageshack.us/img208/1024/screenshot2013031309271.png

Shows difference of a mean data series vs individual time series:

http://img687.imageshack.us/img687/7756/screenshot2013031309291.png

The blood bank used finger-tests (capillary) for approval before drawing blood up to 2008. From 2009 they changed to vein-test where the Hb is immediately tested with the first volume of blood drawn, and procedure is stopped if values are not within the persons desired range.

Our data shows that the measurements up to 2008 (capillary) shows a significantly higher variation, and a higher average, than from 2009 forward. Shown by slide:

http://img507.imageshack.us/img507/1698/screenshot2013031309324.png


Speaker: Erlend Hem. Sport physiologist at Olympiatoppen, since 1988.

Worked in test-lab field for 30 years. He is a "measurement-expert" and studying how training affects physiological parameters.

Got involved with xc in 1989, when the Skiing federation in cooperation with NIF started the altitude-project, with the target of Albertville as the main challenge.

Shows data before and after 17 days living at 2000m altitude, training up to 3200m.
Shows average increase of 0.7 points. Some 0.3, some 1.2.

http://img801.imageshack.us/img801/4923/screenshot2013031309434.png

Shows variation of Hb after 24 hours at 3000m:

http://img24.imageshack.us/img24/3695/screenshot2013031309452.png


Part of altitude training was held at Stelvio, Italy, with living altitude of 2700m, training above 3000m.

One racer for example shows values 15.8, 17.9, 18.6, down to 16.7 after return to low-land.
Before and after values are taken by vein samples analyzed at Norwegian lab.
Measurement at altitude are taken by Hemocue, and include variations due to dehydration.
Hemocue was well fit for analyzing and planning drinking procedures to avoid dehydration.

http://img600.imageshack.us/img600/6143/screenshot2013031309465.png

At Val Senales, some athletes lived in the ski-lift-house at 3200m.

Individual series of the racer with high peak values:

http://img716.imageshack.us/img716/6788/screenshot2013031309501.png

Has tested 10000 VO2max values during his career.
Shows Norwegian mens xc team average 90-92, 93-95, 96-98. No marked difference.

http://img27.imageshack.us/img27/2342/screenshot2013031309504.png

Dæhlie tested 96 out of season. Has a 3-4% error margin.
He got many tests above 90.
In step-tests he was always on top.
80/85 (didn't catch what number he said) is average of male skiers.
We want them ideally at 85-90, some are able to pass 90.
Higher for xc than other sports, because the training is optimal for increase of aerob performance.

Presentation finished.

Question about confidence of numbers presented vs other values that may exist:
- If to give a value I would say we have a 95% certainty on these numbers. We are open to include other measurements, but this means we do not believe it will be different than the numbers presented.

 

[maltiv]

Well done, publishing blood values primarily from the off-season...

That will stop the speculations

 

[Alesle]

Well done, publishing blood values primarily from the off-season...

That will stop the speculations

Yeah that's a bit unfortunate. Rønsens comment on that:

- Hvorfor er dette prøver fra utenfor sesongen?

- Fordi vi har ikke hatt laboratorietester og instrumenter med oss på mesterskap og verdenscuprenn av helt forklarlige og naturlige årsaker. Vi har tatt noen stikkprøver med dette apparatet på 90-tallet, så der har vi ikke de samme testseriene fra desember til februar, sånn er det bare, sier Rønsen til VG.

- Er det en svakhet at man ikke har resultater fra løperne i sesong?

- Det er FIS som samler inn i sesong, og vi hadde håpet at de skulle ha et datamateriale som vi kunne se til, men de har ikke det. Og vi har ingen plikt på oss til å drive laboratoriemålinger gjennom sesongen. Jeg kaller det ikke svakheter, men bare konstater at vi ikke har de kvalitetesmålingene fra desember til februar.

- Why are the samples from the off-season?

- Because we have not had laboratory tests and instruments with us at the Championships and World Cups of completely explainable and natural causes. We have taken some samples with this instrument in the 90s, but we don’t have the same test series from December to February, that’s the way it is, Rønsen says to VG.

- Is it a weakness that you do not have the results of the skiers in the season?

- It's FIS that collects during the season and we had hoped that they would have a data set that we could see, but they have not. And we have no obligation on us to conduct laboratory measurements throughout the season. I call it not weakness, but only the ascertainment that we do not have the quality measurements from December to February.

 

[python]

we do not have the quality measurements from December to February.

this phrase jumped at me. it seems to suggest that there is another in-season set of data that was considered of inadequate quality.

i would consider it a fair answer, if rønsen elaborated...was the data considered poor because:

it was a capillary measurement ?
it was at dehydrated state ?
incomplete/too few samples ?
athletes could not be set in 'standard' posture ?
.....

personally, i would find it the explanation given plausible pre-'97 as there was no fis limit (lets forget for a moment that scientific/medical/training staff would still want to know the hematological status BEFORE world cup races)...but why no quality data after 97 when everyone was scared of the new fis limit ? in fact, the same factors were in play - one dehydrated, unmonitored athlete could cost an absolutely unneeded scandal. so not having quality data under theses conditions would seem unwise.

 

[Tyler'sTwin]

Nice cherry-picking of data.

But at least it lets us know these guys and gals had in fact normal natural blood values, not naturally high.

Jævne: 14.8, 15.2, 14.7, 15.2, 15.1, 15.2, 15.5

17.0 in Salt Lake.

Mikkelsplass: 13.7, 14.2, 13.3, 13.4, 13.5, 14.1

16.1 in Lahti -97.

Daæhlie: 15.7, 15.6, 15.3, 16.0, 15.3, 14.9, 15.1

I wonder what it was in Thunder Bay, Trondheim and Ramsau?

They deny >17.5 in TB, so why not show us the real numbers?

 

[Trond Vidar]

They deny >17.5 in TB, so why not show us the real numbers?

I think the point was that they don't have those numbers. FIS do.

 

[Alesle]

this phrase jumped at me. it seems to suggest that there is another in-season set of data that was considered of inadequate quality.

i would consider it a fair answer, if rønsen elaborated...was the data considered poor because:

it was a capillary measurement ?
it was at dehydrated state ?
incomplete/too few samples ?
athletes could not be set in 'standard' posture ?
.....

personally, i would find it the explanation given plausible pre-'97 as there was no fis limit (lets forget for a moment that scientific/medical/training staff would still want to know the hematological status BEFORE world cup races)...but why no quality data after 97 when everyone was scared of the new fis limit ? in fact, the same factors were in play - one dehydrated, unmonitored athlete could cost an absolutely unneeded scandal. so not having quality data under theses conditions would seem unwise.

I found a different quote and interview where he clarifies somewhat (though I think he might be talking about their own measurements here):

– Vi har ikke tall som er pålitelige fra sesongen. De er ikke tatt under standardiserte former og med ordentlige instrumenter. Vi reiser ikke rundt med et laboratorium på den tiden. På samlinger og i høyden gjør vi det, men det gjør vi ikke på verdenscup, sier Rønsen.

- We do not have numbers that are reliable from the season. They are not taken under standardized forms and with proper instruments. We do not travel around with a lab at that time. At team gatherings and at altitude we do, but not at the World Cup, says Rønsen.

He also added that they had hoped FIS had some reliable ["laboratory"] data from the 90s, and said that unfortunately they didn't. He also put an emphasis on that they had presented the data they collected during the 90s, and welcomed anyone [that have the competence] to take a look at their data if they want to.

I got the impression this presentation was mostly about proving their openness to "the Swedes" in combination with showing how unreliable the hemocue tests can be, and backing up their claims regarding the possible benefits from altitude training.

 

[Tyler'sTwin]

I think the point was that they don't have those numbers. FIS do.

Well, maybe if they asked nicely...

 

[python]

i got the impression that what we just saw is the first round...

some in-season quality data must exists. but the data easily available on a short notice (that is, not requiring extensive digging into the athletes personal files) is mostly a capillary screening data of elevated nature and it was judged that it would be either out of sync or premature to share at this time without seeing what 'others' (fis and the swedes) got.

will fis move ? well, they can if they want (i am sure the data is available) but if they they don't want, there is a multitude of good and semi-good reasons they can hid under - from legal non-disclosure to the grandness of scope...

 

[Cobblestones]

I think the point was that they don't have those numbers. FIS do.

If they don't have those numbers, how do they know they weren't >17.5?

 

[Libertine Seguros]

If they don't have those numbers, how do they know they weren't >17.5?

Same reason we knew Valverde was involved with Fuentes but he was still riding? They may have plenty of evidence or even knowledge of what the numbers are but not have the access to the numbers to actually be able to publish them. They may have seen the numbers but it be a breach of some regulation on confidentiality or ownership of those test results for them to publish it without jumping through a number of legal hoops first.

Or, they might have just picked figures out of thin air or got their denial in first.

 

[abcdaniel]

First post, long time lurker in this thread.

Went to the midwife today (having a baby soon) and amongst other things checked my partner's blood values. The midwife used a HemoCue machine, blood sample from fingertip, and I asked her about the reliability of the machine. According to her, they consider the error margin to be 1.0 both ways (ie 14.5 could be between 13.5 and 15.5). I didn't probe any more into the model/age of the HemoCue, or the differences in precision compared to other methods. It was just a way to get an opinion outside of the sports world from someone professionally measuring multiple blood values every day. If they see a strange value, they immediately do a second test.

The medical professionals handling the screening tests before the races in the 90's, surely understood the HemoCue machines and the results as well as our midwife. Otherwise it was simply unprofessional. They must have done a second test, if the values were strange, but someone might want to correct me on that. If the HemoCue machines were so flaky, and the operation of the screening procedure unprofessional, what was the value of a start ban? It amounts to a joke, except for the one getting the ban.

I think it is important to (again) point out that the HemoCue screenings took place before the races, with the athletes supposedly in as good shape as possible, not in dehydration and fatigue, as opposed to after the races.

There has been a lot of attempts to discredit the screening values. They probably weren't perfect, but to disregard them completely is to say that FIS ran a joke regime of blood value screening in the 90's.

 

[Cobblestones]

Same reason we knew Valverde was involved with Fuentes but he was still riding? They may have plenty of evidence or even knowledge of what the numbers are but not have the access to the numbers to actually be able to publish them. They may have seen the numbers but it be a breach of some regulation on confidentiality or ownership of those test results for them to publish it without jumping through a number of legal hoops first.

Or, they might have just picked figures out of thin air or got their denial in first.

I'd bet on the latter. What I got out of this is (I) high altitude may increase Hgb by one unit, not 3-4 as has been implied some places, and (II) who really believes they don't have 'in competition' numbers? After all if you go through all the effort with altitude tents etc. and you know or assume that the competition is using EPO and whatnot, you wouldn't even bother to monitor Hgb of your top athletes? Riiight

 

[Libertine Seguros]

Sounds silly, but then testing isn't cheap. If the FIS was testing then giving them access to the numbers they may have settled for that, at least with regularly tested athletes. This would then give them the perfect excuse today - not having FIS' permission to publish those numbers, even though they saw them and have had them for years. Quite likely they did conduct tests to monitor where FIS weren't doing so, but as a result they would be 'filling in the gaps' from the FIS testing, as it were, so when the FIS tests are removed from the figures, they become less representative of anything.

Just a theory. I feel it's more likely to be the latter too, but they may have sound reasons for not publicising certain numbers (although if they don't tally up I'd bet they're 'trying to get those numbers' in a 'not really trying to get those numbers' kind of way).

 

[neineinei]

First post, long time lurker in this thread.

Went to the midwife today (having a baby soon) and amongst other things checked my partner's blood values. The midwife used a HemoCue machine, blood sample from fingertip, and I asked her about the reliability of the machine. According to her, they consider the error margin to be 1.0 both ways (ie 14.5 could be between 13.5 and 15.5). I didn't probe any more into the model/age of the HemoCue, or the differences in precision compared to other methods. It was just a way to get an opinion outside of the sports world from someone professionally measuring multiple blood values every day. If they see a strange value, they immediately do a second test.

The medical professionals handling the screening tests before the races in the 90's, surely understood the HemoCue machines and the results as well as our midwife. Otherwise it was simply unprofessional. They must have done a second test, if the values were strange, but someone might want to correct me on that. If the HemoCue machines were so flaky, and the operation of the screening procedure unprofessional, what was the value of a start ban? It amounts to a joke, except for the one getting the ban.

I think it is important to (again) point out that the HemoCue screenings took place before the races, with the athletes supposedly in as good shape as possible, not in dehydration and fatigue, as opposed to after the races.

There has been a lot of attempts to discredit the screening values. They probably weren't perfect, but to disregard them completely is to say that FIS ran a joke regime of blood value screening in the 90's.

FIS haven't said it was a joke, but according to Aftenposten Gian-Franco Kasper og Bengt Erik Bengtsson have said that the FIS blood tests done prior to January 1997 were 'worthless' (Norw: forkastelige). This not just on account of the HemoCue, but the fact that there were no guidelines at all for the testing. Bengtsson also said that skiers who were found to have too high values were told to go drink a lot of water and come back for a new test in 3 hours.

http://sport.aftenposten.no/sport/skivm_2013/article270116.ece (Norwegian)

 

[dukoff]

If they don't have those numbers, how do they know they weren't >17.5?

FIS are the ones who confirmed no Swede or Norwegian was measured > 175 in Thunder Bay, which was the claim. So they obviuosly trust FIS.

But that is >175, not at 175. Some news articles I think wrote that Uppdrag Granskning claimed an anonymous source had stated Dæhlie had measured 175. I don't remember how or if that was presented in the documentary. Still Rønsen said about that 175 and Mikkelsplass 161;

They may be correct, we can not dismiss it. But if true it must have been extreme measurement values, as the majority of the data we have show different levels.

So they didn't refute him being tested at 175. In principle they may not know what screening measurements FIS has registered if the athlete only got an "ok/not ok" result.

 

[Tubeless]

Hb values for 12 skiers from before and a couple of days after (with normal fluid balance) a 17 day altitude camp, living at 2000 m above sea level and training at up to 3200 m.
.
.
.
These are based on laboratory tests from '96 to '98.
Daæhlie: 15.7, 15.6, 15.3, 16.0, 15.3, 14.9, 15.1

This chart shows that a 17-day period at a relatively high altitude camp is unable to move the Hb much - an average of less than 1 g/dl.

Which is to say that it's not realistically possible to increase your Hb level beyond 1 g/dl with altitude training alone. Daehli's reported values (which average out to 15.4) could be already altitude-living/training elevated - which means any values above 17 would be a clear sign of blood doping.

 

[dukoff]

Unless my Norwegian language skills are deficient, I think you have it backwards. They lived at an altitude of 3200m and trained at 2000m.

This chart shows that a 17-day period at a relatively high altitude camp is unable to move the Hb much - an average of less than 1 g/dl.

Which is to say that it's not realistically possible to increase your Hb level beyond 1 g/dl with altitude training alone. Daehli's reported values (which average out to 15.4) could be already altitude-living/training elevated - which means any values above 17 would be a clear sign of blood doping.

No, "bohøyde" is living altitude.

The data on Dæhlie that was measured by the external research group 96-98 (they were Finnish for what it's worth), shows one value of 16.6 on Dæhlie. And that has also been confirmed before that he often was above 16. (Note the 2nd value of Dæhlie was 16.6, not 15.6 which was reported in some news articles ).

If you have a 16.6 lab value, you can easily be measured at 175 on an HemoCue due to the 1g positive bias we have discussed before, or even higher due to the tolerances. Specially in 1995 when they did the screen test after the races.

 

[Cobblestones]

No, "bohøyde" is living altitude.

True, but shouldn't you 'live high' and 'train low'?

 

[dukoff]

True, but shouldn't you 'live high' and 'train low'?

In general yes, well more like live high, train high, but this depends on the individual. So what one with years of personal optimization of input/response will do may differ. Dæhlie has been known in particular to test more extreme altitudes.

 

[Tyler'sTwin]

They may be correct, we can not dismiss it. But if true it must have been extreme measurement values, as the majority of the data we have show different levels.

THEN SHOW US ALL THE DATA! Right now, we know Mikkelsplass was tested at 16.1 before a WC-race that she won, which is ~2.5 g/dl above her off-season median and 1.9 g/dl above her peak. We know Jevne was tested at ~2 g/dl above his median in Salt Lake and it has been alleged, by a very credible source, that Dæhlie tested more than ~2 g/dl above his median in Thunder Bay. If these values are in fact one-offs (or in the case of Dæhlie - non-existant) it can only benefit the norwegians to present the full picture.

 

[Cloxxki]

This story even hit http://www.nu.nl which never reports on XC. Mentioned no abnormalities found. Well, DOH. Why else would Daelie allow the data set to be published?