4 February 2018

New blood database alleges extensive doping in cross-country skiing

A new database of over 10,000 blood values taken from over 2,000 cross-country skiers between 2001 and 2010 has been mailed to journalists, who allege it proves widespread blood doping. The database was sent to journalist Hajo Seppelt, who enlisted help from The Sunday Times and other journalists, as well as a medical professional utilised by the International Ski Federation (FIS), to analyse the data (video below).

It is alleged that about one third of all medals, including 91 golds, have been won in the Olympics and World Championships by skiers who have recorded suspicious blood values. It is alleged that over 50 skiers on the qualification list for the PyeongChang 2018 Winter Olympics have recorded blood values so abnormal as to indicate cheating. The FIS and International Olympic Committee (IOC) have yet to comment.

Anonymised data was sent by journalists to James Stray-Gundersen, a medical consultant who has advised the FIS. He said that many of the cross country skiers exhibited extreme blood values followed by change at around the same time as major tournaments, including one high profile athlete whose blood value had a one in 10,000 chance of being due to natural causes. The Sunday Times reported that another skier’s blood values had a one in a million chance of being due to natural causes.

Stray-Gundersen told The Sunday Times that a prevalence study he had conducted on cross country skiers competing at the 2001 World Championships had found that about half of the top ten finishers had abnormal blood values. He told the newspaper that there was “considerable resistance” to his findings and his life was subsequently “made difficult”, through cancellation of accreditations.

Athlete Biological Passport (ABP)

The ABP monitors biological variables, such as blood values, over time in the hope of identifying any changes in such values that might indicate doping. A suspicious blood value detected under the ABP is still a very long way from being an anti-doping rule violation (ADRV).

Under the ABP, an expected range within which a series of Marker values will fall is predicted for an athlete, assuming a normal physiological condition. An Atypical Passport Finding (ATPF) is automatically generated by the Anti-Doping Administration and Management System (ADAMS) software used by the World Anti-Doping Agency (WADA) when an athlete’s blood values fall outside of these Markers. For a longitudinal profile of blood values over time, there has to be a less than one in 1,000 chance that they occurred naturally.

When such an ATPF is flagged under the ADAMS system, an ABP Management Unit (ABPMU) expert must conduct an initial review and ascertain if the ATPF indicates ‘likely doping’. Under the ABP Operating Guidelines (PDF below) such an expert must consider the information within an athlete’s passport, and must conclude that ‘it is likely that the Passport is the result of the Use of a Prohibited Substance or Prohibited Method and it is highly unlikely that it may be the result of a normal physiological or pathological condition’.

A finding of ‘likely doping’ means that an athlete’s pathology will then be reviewed by three ABPMU experts, including the expert that conducted the initial review. If the three experts also agree that the pathology indicates ‘likely doping’, then an ABP Documentation Package is created.

If the experts still agree that the pathology indicates ‘likely doping’ after reviewing the Documentation Package, then an Adverse Passport Funding (APF) is reported to the anti-doping organisation concerned. If an APF is agreed, the athlete concerned is notified, and can suggest explanations. If, after reviewing those explanations, the experts agree maintain that the pathology indicates ‘likely doping’, then an anti-doping rule violation (ADRV) is issued.

We’ve been here before…

The ABP was not introduced until 2009, and the blood database relating to cross country skiers relates to 2001-2010. When a similar database of blood values in athletics from 2006 to 2008 was held to indicate widespread doping in athletics, the International Association of Athletics Federations (IAAF) pointed out that a single blood value cannot indicate doping, and that blood tests collected prior to 2009 were used for different purposes.

‘The Athlete Biological Passport (ABP) was launched by the IAAF only in 2009, when WADA set out a harmonised regulatory framework allowing the use of reliable and comparable values’, read an IAAF statement. ‘That was not the case before 2009 (different sample collections conditions, transportations and analytical equipment…). The blood data collected before 2009 were used for target purposes to “trigger” follow-up urine tests for EPO detection. This was the practice by the few International Federations which were conducting blood tests back then (UCI, FIS). Abnormal results were duly followed-up by the IAAF, whenever possible logistically. One cannot draw any conclusion on whether or not an athlete has doped on the basis of one single blood value. The whole concept of the ABP is to monitor the variations of an athlete’s profile consisting of multiple values.’

The IAAF also refuted claims that a larger database, collected from 2001 until 2012, indicated widespread doping. Its key argument is that a single suspicious blood value doesn’t indicate doping. Comments to Article 2.2 of the World Anti-Doping Code allow ‘use or attempted use of a prohibited substance or method’ to be established ‘by other reliable means, such as…longitudinal profiling, or other analytical information which does not otherwise satisfy all the requirements to establish “Presence” of a Prohibited Substance under Article 2.1’. In other words, more than just a suspicious blood value is needed.

The APMU may submit a passport to an APMU Expert when there is no ATPF. Annex L.2.2.3 of the ABP Operating Guidelines (PDF above) allows an APMU Expert to consider:

• Data not considered in the Adaptive Model
• Any abnormal levels and/or variations of Markers
• Signs of hemodilution in the haematological Passport
• Steroid levels in urine below the corresponding limit of quantification (LOQ) of the assay
• Intelligence in relation to the Athlete concerned.

In other words, more than just a suspicious blood value is needed.

Problems for the FIS

It would appear that according to the wording of sport’s regulations, a single blood value cannot indicate doping. The issue for the FIS is the amount of suspicious blood values, and how far off an athlete’s ‘normal’ scale some of the values are alleged to be. A table published by The Sunday Times (right) indicates that between 15% and 34% of cross country skiers from 16 countries have reported blood values that journalists and analysts consider to be suspicious.

Some athletes reported values that had less than a one in 10,000, or one in one million chance of being recorded naturally, alleged journalists. Although the IAAF is right to point out that a single suspicious value cannot indicate blood doping and longitudinal profiling is required, such extreme values may have required notification to ABPMU Experts for review, as outlined above. Questions will need to be answered as to whether FIS officials flagged such extreme values and if not, why not.

Journalists have also been careful to not reveal the names of any of the athletes concerned. But the allegation that 50 skiers recorded blood values considered so abnormal as to indicate cheating is bound to cast a shadow on the PyeongChang 2018 Winter Olympics, which begin on 9 February.

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