Impey cleared of doping - free to race

[fmk_RoI]

Impey's experts included Ivan Miltz, Christopher Kok, Justin Bitter, Mike Morgan and Chris Hattingh - deets

 

[Alex Simmons/RST]

This is not even going into discussing using bicarb soda for the sprint at the end of a race. pffffffftttt ever read the experiences from people who are doing that for world champion level track races?

And he's going to pop a few before the sprint?

Are the gel caps in a bottle in his back pocket?

Do they have anything else in them?

Well what's even stranger is that Impey said he took them during the race.

His positive doping control was after the TT, not the road race.

Even if popping bicarb was something Impey does do and managed to do during races without getting a dose of the ****s, who the **** sits up to take half a dozen home made bicarb tabs during a time trial?

He won by ~ 30-seconds.

 

[King Boonen]

So tablet hitting plastic and dislodging probenecid particles - that's one aspect.
Chemist not knowing he has gel caps and then all of a sudden finding some.
Gel caps hitting plastic and soaking up said probenecid particles - another.
Probenecid particles remaining on caps as Impey prepares them - another.
Probenecid particles remaining on caps as Impey races and they bang around in his pocket or in a container in his pocket - another.
Probenecid particles remaining on caps as Impey consumes them - another.

All that handling and what not leaves sufficient probenecid on the gel caps so that when consumed he tests positive.

Amazing.

Remember, most tablets are a half gram to about 2 grams in weight, and the active is distributed evenly across that (OK, it's not always even but it's usually meant to be). Many are coated which would drastically reduce the chance of active loss. It's been reported that he had people testify it was possible. It is, but until we see the numbers it's impossible to say how possible it actually is. And it's strict liability, I believe it is meant to be beyond reasonable doubt.

As for stickiness of the capsules that I can believe, if they were to come into contact with a powder I'd expect some of it to stick, but whether it was enough to return a positive I don't know. Very easy to test though...

Of course, this relies on such small quantities that both the chemist and Impey didn't see the contaminant, no-one is stupid enough to use empty capsules covered in a unknown powder are they?

Which makes it even more like a bench in respect to the way I described the situation to which Tailwind mocked me for making stuff up.

They're little trays with wells. You pour on the tablets, shake it and they fall in the wells. You then remove the ones you don't want and tip them into a bottle. There are also triangle ones of specific dimensions so each row equates to a specific number of tablets.




It is all very difficult to believe. If it comes out that the test showed a very small amount of probenecid then that'll be believable, just.


What we also need to remember is that this could all be true, but both Impey and the Pharmacist knew the contamination was happening and it was allowed so a cover story was in place. The pharmacist found them and called him didn't he? Maybe the pharmacist called him and said "I've just dispensed that probenecid prescription, come in and get your capsules."

 

[Dear Wiggo]

Well what's even stranger is that Impey said he took them during the race.

His positive doping control was after the TT, not the road race.

Even if popping bicarb was something Impey does do and managed to do during races without getting a dose of the ****s, who the **** sits up to take half a dozen home made bicarb tabs during a time trial?

He won by ~ 30-seconds.

Yeah my bad I read "road race" and thought he meant to use them for the road race.

I was under the impression the buffering lasted all of 30 seconds or something? As in it may be useful for a pursuit but not much longer. If he was popping them at regular intervals, would it make it into his system in time to be useful?

Did I read upthread somewhere someone denigrating the idea he would be doping for his national champs? Coz bicarb isn't doping but dayam that's commitment to wringing out the most you can via a rather unpleasant mechanism.

 

[Catwhoorg]

a pill counter with different inserts.


That's another factor in this story. Would the same insert be used for both

 

[fmk_RoI]

For the Sherlocks who query whether it is possible for tablets to leave powder in a pill counter that would then stick to a gel cap, this, using aspirin http://goarticles.com/article/Helping-Pharmacists-Prevent-Medication-Cross-Contamination/3347458/

 

[Dear Wiggo]

For the Sherlocks who query whether it is possible for tablets to leave powder in a pill counter that would then stick to a gel cap, this, using aspirin http://goarticles.com/article/Helping-Pharmacists-Prevent-Medication-Cross-Contamination/3347458/

Not sure if you are seeking to disparage people by calling them Sherlocks, but noone here is stupid enough to think pills being handled do not leave residue.

The question is whether sufficient residue is being carried across to produce the positive result for which Impey was pinged.

And whether some form of cleaning protocol would not be used.

 

[neineinei]

Well what's even stranger is that Impey said he took them during the race.

His positive doping control was after the TT, not the road race.

Even if popping bicarb was something Impey does do and managed to do during races without getting a dose of the ****s, who the **** sits up to take half a dozen home made bicarb tabs during a time trial?

He won by ~ 30-seconds.

He brought water to wash down the capsules over the 40 kilometers.

The route was pretty straight forward. I knew that the guys were all hungry for the win and I had to keep it consistent. I feel less prepared than I was for last years Champs, but sometimes with a more relaxed approach when you go into these races, it all just works out on the day. I felt confident after the Tour Down Under, and I rode very strong there. It all went well for me today.

http://www.bicycling.co.za/race-news/impey-moolman-pasio-claim-elite-tt-national-titles/

 

[Dear Wiggo]

Given the skinsuit has no pockets, he must have consumed them just before the race started?

 

[Alex Simmons/RST]

Yeah my bad I read "road race" and thought he meant to use them for the road race.

Well the way Impey spoke/wrote, or at least was quoted, it definitely sounded like he was referring to using bicarb for a/the road race, so it's quite understandable you thought that. I did too.

Hence why I thought it was a strange comment, since the confirmed positive sample was from the TT 3 days before the RR.

IOW his suggestion that he used them during the race, combined with the confirmed positive can only mean he is saying he took bicarbs capsules during his TT.

I was under the impression the buffering lasted all of 30 seconds or something? As in it may be useful for a pursuit but not much longer. If he was popping them at regular intervals, would it make it into his system in time to be useful?

It's more for helping intermittent sprint type activity and yes potentially pursuit events as well. Not all research shows it to be ergogenic.

Did I read upthread somewhere someone denigrating the idea he would be doping for his national champs? Coz bicarb isn't doping but dayam that's commitment to wringing out the most you can via a rather unpleasant mechanism.

Well it's not doping, so whether or not it should be used then becomes a question of laws, ethics and efficacy (which is individually variable).

It's a supplement listed in AIS Supplements Group A, which are pretty much considered OK when used appropriately with guidance for sport specific applications using evidence based protocols.

You do have to be careful as it can play havoc with digestive system.

It's not a supplement with strong evidence to support its use in a longer TTs (~1-hour / 40km). Studies are equivocal, some positive, some not.

I wouldn't consider occasional considered use of bicarb particularly radical for events where it makes sense, and for which you are doing so with clear support on proper usage and you have tested for your own ability to cope with it. Don't stray far from the dunny the first time you try it though.

 

[King Boonen]

For the Sherlocks who query whether it is possible for tablets to leave powder in a pill counter that would then stick to a gel cap, this, using aspirin http://goarticles.com/article/Helping-Pharmacists-Prevent-Medication-Cross-Contamination/3347458/

For the Watsons that can just about manage google you should probably not that the only reference cited is from 1977. Formulation has come on a fair bit since then. You should also note they use aspirin, which is formulated for instant release, is sometimes dispersible, and is therefore likely to produce the highest level of contamination, which is still only an average of 0.2mg a capsule and no doubt relies on the person not cleaning or even inspecting the counter. It is also done by densiometry, so it's likely that 0.2mg is actually the formulated product, not total aspirin or at best is calculated on percentage mass, which can be very wrong.

 

[Dear Wiggo]

Well it's not doping, so whether or not it should be used then becomes a question of laws, ethics and efficacy (which is individually variable).

I didn't say it was doping, either.

The basic belief is he was doping, and the probenecid was covering it up.

The counter is that this is a low ranked race and not worth doping for.

Using bicarb is - from what I have read - pretty uncomfortable and of dubious benefit. To use such a thing (if that is in fact what was happening, which I doubt) to me refutes the assertion it's not worth doping to win - he was clearly doing everything he could to get max performance.

 

[Merckx index]

Using thin layer chromatography phenoxymethyl penicillin, sulphadiazine, aspirin and paracetamol were identified as contaminants which were transferred by automatic counting machines. Quantitative analysis by densitometry, indicated that as much as 9.75 mg of aspirin the model contaminant used, could be transferred to 50 hard gelatin capsules following the counting of 100 aspirin 300-mg tablets. A rank correlation was observed between the amount of contaminants produced and the friability of the tablets.

This is very interesting, and certainly relevant to the discussion. It is a very old paper, and you would think that if pharmacists were aware of the problem that long ago, they would have avoided cross-contamination by now. Those trays that were pictured upthread certainly look disposable to me, and would obviously solve the problem. But I'm not a pharmacist, and don't know what they use.

Anyway, let’s look at the numbers. I couldn’t access the full paper, so I don’t know how much variability there was in the amount of contamination, and how much it depends on the friability of the pills, let alone how friable probenecid pills are. Also, of course, if the pills are sealed in some manner, this would drastically reduce the amount of contamination.

The number they quote was obviously a worst case scenario, and corresponds to about 200 ug/capsule. Some of this would come off as the capsules were handled, filling them with bicarb, putting them in some kind of container, etc., but there would still likely be a substantial amount remaining. So if he Impey took several of these capsules, he might, as a worst case, ingest up to 1 mg. Again, this is assuming that the level of contamination was just as with aspirin in this report.

As I discussed earlier on this thread, at what I think are current detection levels, an athlete would have to consume about 25 ug probenecid to test positive within about twelve hours later. So the contamination theory is certainly possible. It depends, of course, on how much contamination probenecid pills could produce, and the level of the substance that Impey actually tested for.

Wrt taking bicarb during a TT, why wouldn’t he just dissolve it in his water bottle? Would seem to be the simplest way to take it.

 

[TailWindHome]

Would seem to be the simplest way to take it.

Simplest maybe but palatable?

 

[fmk_RoI]

This is very interesting, and certainly relevant to the discussion.

Thank you. Different product, different time, I know, but nonetheless pertinent.

 

[fmk_RoI]

Given the skinsuit has no pockets, he must have consumed them just before the race started?

You've never put anything up the cuff of your shorts?

This rider does:

Source (c) Cor Vos

 

[TheGame]

For the Sherlocks who query whether it is possible for tablets to leave powder in a pill counter that would then stick to a gel cap, this, using aspirin http://goarticles.com/article/Helping-Pharmacists-Prevent-Medication-Cross-Contamination/3347458/

Most modern automated pill counters have built in vacuums to clean the various trays and chutes. Most are also designed not to use the same chute in successive transactions.

Technology has moved on.

 

[Catwhoorg]

Not least that the overwhelming majority of prescription my father was filling in his last years were pre-packed in standard amounts.

That doesn't affect the possibility of cross contamination in a counter when it is actually used, but it does mean that the number of uses is well down.

 

[Benotti69]

Most modern automated pill counters have built in vacuums to clean the various trays and chutes. Most are also designed not to use the same chute in successive transactions.

Technology has moved on.

fmk_Rol hasn't

 

[fmk_RoI]

Comment removed by fmk_roi as issue resolved by others

 

[Granville57]

An a measure of embarrassment that they didn't know cyclists were using Bicarbonate of Soda

Really? An ol' skool method of dubious effectiveness is being used by the Beet Root Juice/Rice Cake generation?

That can be played two ways.

It's something that's been done for decades, and is still widely in use.
And yet Daryl Impey, professional athlete, manages to find himself without the necessary empty capsules to deliver this victory elixir—so commonly in use for decades across multiple sports, and still on the menu for anyone with the desire to be competitive—and he just happens upon a pharmacist who doesn't (at first) have any in stock either. In 2014 (this being the internet age, and all). Uh huh.

Or

The new, post-2006 Clean Generation of riders doesn't rely on such things as Bicarbonate of Soda. They train better and more efficiently than those EPO-fuled dinosaurs of the past; they have better equipment; better nutritional methods; and they've discovered ice-paks, warming down, and cooling up (or whateverthefck terms they're throwing around these days).

So which is it?

Do you "know" that other pro cyclists are currently using this on a regular basis?

And yeah, I'd love to know which ones.

(Seriously, I would )

 

[TailWindHome]

It's something that's been done for decades, and is still widely in use.
And yet Daryl Impey, professional athlete, manages to find himself without the necessary empty capsules to deliver this victory elixir—

We've frozens pea two or three times a week in our house.
Opened the freezer tonight and guess what? We had none.
A full investigation will follow.

The new, post-2006 Clean Generation of riders doesn't rely on such things as Bicarbonate of Soda. They train better and more efficiently than those EPO-fuled dinosaurs of the past; they have better equipment; better nutritional methods; and they've discovered ice-paks, warming down, and cooling up (or whateverthefck terms they're throwing around these days).

Why would a rider who is clean not take Bicarbonate of Soda?
One does not preclude the other

And yeah, I'd love to know which ones.

(Seriously, I would

)

I'd never heard of it before - check out the thread on BR - a Paralympic World Championship explains how he does it (while querying the use of capsules)

 

[Granville57]

For the Sherlocks who query whether it is possible for tablets to leave powder in a pill counter that would then stick to a gel cap, this, using aspirin http://goarticles.com/article/Helping-Pharmacists-Prevent-Medication-Cross-Contamination/3347458/

Nice tone. How about just simply, "For anyone interested in the possibility that..."

Anyway, I'm assuming you read this part? [emphasis mine]

Theses minimal amounts of transferred contaminants could pose serious threats, such as allergic reactions from drugs like penicillin and sulfides or even death due to contamination from chemotherapy drugs. Hospitals, and pharmacists are aware of these hidden dangers and take every precaution to prevent it.

You've never put anything up the cuff of your shorts?

This rider does:

Yup. That is one, single pill. Not sure how that's relevant to this particular discussion though.

 

[fmk_RoI]

That is one, single pill. Not sure how that's relevant to this particular discussion though.

Really? Oh, well. Not much point in pressing the point with you then, is there? Carry on as you were, assuming he must have taken them before the race just because he had no pockets.

 

[Merckx index]

I hadn’t realized there was a somewhat similar case involving four Brazilian swimmers three years ago, who all tested positive for furosemide. One of them, at least, Cesar Cielo, claimed that he bought caffeine capsules at a pharmacy, and they were contaminated by previous use of a pill counter for furosemide. So the claim was very similar to Impey's. The case went to CAS, and the original "sanction", which was merely a warning, was upheld. Furosemide is a diuretic, so like probenecid, could be used as a masking agent, though in a different way. However,

Furthermore, the conclusion of the urine test was that the athletes’ urine was not dilluted at all. This is different than saying that there was a “low level of concentration of furosemide.” Saying that the urine was not dilluted means that regardless of the level of furosemide, it had absolutely no masking affect on the urine tests, so if the athletes were using it to cover up any illegal substances, those substances would have shown up on the test as well.

The “short half-life” of furosemide that has often been cited further enhances this idea. If furosemide breaks down that quickly, but still had trace elements in the urine, then that means it had to have been taken fairly shortly before the test. But if it was taken shortly before the test, but still did not dillute the urine, there was clearly no attempt at a coverup.

FINA did not dispute any of the facts in the case, but requested a 3-month ban solely on the basis of the idea that athletes are responsible for whatever they put in their bodies, though that was apparently not their opinion when they signed the WADA Anti-Doping Code (hence the inclusion of the exceptions for certain substances).

Probenecid also has a fairly short half-life, so I'm guessing Impey's team used a somewhat similar argument. Very interesting, though, that the other case of cross-contamination also involved a masking agent.

As a result of this, several pharmacies in Germany were the subject of studies. I'm not sure if any scientific analysis of contamination was conducted, but there were some interesting comments by staff members during interviews:

REGARDING the recent turmoil and emotions erupting over the positive tests of Cesar Cielo, BRA, Henrique Barbosa, Nicholas dos Santos and Vinicius Waked for furosemide, combined with the possibility of the substance coming from cross-contamination in a pharmacy, interviews were conducted early last week, 72 hours prior to the published CAS announcement, with five different pharmacists at three different pharmacies in Germany.

In speaking with Pharmacist 1 named "Mark" and his senior female colleague, he confirmed: "The pharmacies are not 100 percent sterile. There are hundreds of types… thousands of types of substances and medicines that come through our store every year."

"They are in powder form, packets, capsules, liquids, crèmes, etc. We have one space for filling the orders (a room about 3.5m long on one counter).

SW: Are all the orders and substances done there in the lab preparation area/counter? (on the same counter, with the same instruments)?
Pharmacist 1: "Yes."

SW: Knowing that the anti-doping authorities can take blood and urine tests and read them, at so many parts per million, could there be some substances in your blood from cross-contamination working here?

Pharmacist 1: "Oh! SURE! (laughter, more laughter…)

Pharmacist 2: "Yes! Of course."

In the third pharmacy, I spoke with two pharmacists, who were knowledgeable in their respective fields of study. They knew about the recent nutritional food supply chain issues in China, and the cycling athletes (and others) testing positive for clenbuterol. They also stated knowledge of inadvertent cross-contamination issues with pork, beef, fish, and with other drugs in Europe and Asia.

SW: If you had to submit to a doping test like the athletes are required to submit to, throughout the year, would you be 100 percent clean from cross-contamination?

Dennis Effertz: Laughing, "NO!"

"We would not mix up an order, nor would there be enough cross-contamination ever to affect or harm a patient/customer. But, there are small (micro) amounts of substances, sure… that could be transmitted. Sure."

What I don't know is if scientific analyses were submitted by Cielo to support the possibility of contamination.

Ok, here is the decision. Very interesting, Cielo's father was the local health inspector, and responsible for overseeing pharmacies...

Also, as I alluded to before, there have been studies of cocaine contamination of dollar bills. One reported, that about 80% of all dollar bills tested were contaminated, with a very wide range, from less than 0.1 ug to more than 1 mg. Though somewhat different from contamination in a pill counter, the study has some relevance in that much of the contamination is thought to result not directly—the handling of bills by cocaine traffickers or users—but indirectly, from contact of uncontaminated bills with contaminated ones, by individuals and in ATMs and other bill counting machines.

A more recent study found that 90% of bills were contaminated.