BLOOD TESTING FOR PROFESSIONAL CYCLISTS: What's a fair hematocrit limit?
David T. Martin, [Senior Sports Physiologist, AIS, 2012]
Michael Ashenden, [ABP specialist]
Robin Parisotto, [Anti-doping expert:
http://www.cyclingnews.com/features/anti-doping-expert-parisotto-speaks-on-blood-passport]
David Pyne, [Senior Sports Physiologist, AIS, 2012]
Allan G. Hahn,
Department of Physiology and Applied Nutrition, Australian Institute of Sport, Belconnen, Australia
Attempts to Discourage Use of rhEPO
The news has made headlines on sport pages around the world. Both the Federation Internationale de Ski (FIS) and the Union Cycliste Internationale (UCI) have implemented random blood tests prior to competition
to deter the alleged use of DNA-recombinant human erythropoetin (rhEPO), a hormone known to increase the rate of red blood cell production. These decisions have come after years of finger-pointing and unsubstantiated claims that some of the world's most competitive cyclists and cross-country skiers are receiving an illegal performance advantage by injecting rhEPO. The governing bodies for these two endurance sports have decided upon slightly different methods and cut-off values for screening blood samples.
Whereas FIS have identified specific hemoglobin concentrations (16.5 g/dl women; 18.5 g/dl men),
the UCI have decided to use a 50% hematocrit for male cyclists.
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At their annual meeting in Geneva (24 January 1997), UCI delegates, in consultation with medical professionals, decided to implement blood testing to deter the alleged use of rhEPO by selecting a 50% hematocrit as an upper limit.
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No More Hematocrits Higher Than 50%
UCI president, Hein Verbruggen, has stressed that the testing is a " health check" and that a positive test does not imply rhEPO use. The testing has been primarily established to insure that professional cyclists will not begin a major road race with a dangerously high hematocrit
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But are there data indicating that a 51% hematocrit is dangerous for a professional road cyclist?
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RhEPO Can Be Dangerous
It is now well recognized that the uncontrolled use of rhEPO can be dangerous. Within the first four years of rhEPO's introduction, this synthetic hormone was suggested to have caused over 17 athlete deaths (Ramotar, 1990).
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Why a 50% Hematocrit?
Although the UCI should be congratulated for their efforts to prevent the illegal use of rhEPO, the 50% hematocrit limit (approximately 16.5 g/dl) may be too aggressive and result in many false positive tests. The UCI cut-off is obviously much lower than the 18 g/dl hemoglobin limit selected by FIS.
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Hematocrits in Australian Road Cyclists
A retrospective analysis of 360 blood samples collected from Australia's top road cyclists between 1987-1996 resulted in 10 hematocrit values of 50% or more. Thus, 2.8% of blood samples from the Australian Road Cyclists exceed the 50% hematocrit value recently set by the UCI as an acceptable limit.
It is believed that these cyclists were training and competing in a "clean environment" at the time of testing. In other words, it is unlikely that they were taking rhEPO. The maximum hematocrit 52.0%, recorded in one cyclist.
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Hematocrits in Other Competitive Australian Athletes
A more detailed examination of the hematocrit data from all sports determined that the percentage of tests where hematocrit was greater than 50% ranged from 0.3% in netball to
25.7% in weight lifting.
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In Conclusion
However, the
50% hematocrit limit appears too aggressive on the basis of 10 years of data collected from road cyclists tested at the Australian Institute of Sport. A 52% hematocrit limit would result in fewer false positive tests and could still deter the suspected use of rhEPO
April 97. The UCI 50% Hematocrit rule has been implemented at the 1997 Paris-Nice Road Race. Three out of the 20 professional cyclists tested registered hematocrit measures greater than 50%. Their fate? An individual fine of 1,000 Swiss Francs and a team fine of 10,000 Swiss Francs. In addition, the riders with the "dangerously high" hematocrits were removed from competition for a period of 15 days. Erwan Mentheour (Fra, La Francaise des Jeux), Luca Colombo (Ita, Batik-Del Monte) and Mauro Santaromita are the riders who have lost money and a chance to win UCI points in Paris-Nice despite any evidence of rhEPO use.