Human Limits

Exploring performance and health with Michael J. Joyner, M.D.

Photo of Michael J. Joyner, M.D.

Tour de France: Is Drug Testing Working?

The Tour de France ended today and the Olympics will start in little less than a week.  My first two posts have been about doping in cycling and I thought it might a good time to look at this issue more broadly and ask if doping control can work.  This is a complex issue with differing interpretations of the same data.

1) There are a very limited number of positive tests.  Some argue that this is evidence that drug testing is working.  Others argue the tests are beatable and the limited number of positive tests prove the point.  In 2008 Joris Delhanghe and I wrote an editorial in the Journal of Applied Physiology related to testing for EPO and took the position that the tests are beatable.

The doping control agencies also seem to acknowledge this because a number of individuals who have been banned passed numerous tests and people can be banned with “non-analytical” evidence.  If the tests are so great who needs non-analytical evidence?  The best example is Marion Jones, one of the stars of the Sydney Olympics who was later banned and spent time in prison.  The bottom line is that the tests are beatable and the limited number of positive tests doesn’t tell us much about how well doping control is working.

2) Another argument is that performances are continuing to get faster and when large databases from elite cycling are considered increases in the average speed since the early 1990s “question the role of extra-physiological parameters in this recent progression.”  However, there is more recent data showing that things are slowing down suggesting that doping control might be having an effect.

Analysis of power outputs during climbs in the 2012 Tour suggests this is true.  A newer analytical approach to testing is the so-called biological passport which tracks blood parameters that might be altered by doping over time and looks for suspicious changes.  While this approach can’t ensure that doping isn’t happening, it may be able to level the playing field and keep excessive values for a number of factors related to performance in check.

In summary, this is a very complex topic with enough information, controversy, and angles for several books!  However, at least for EPO and drugs designed to improve oxygen transport there is some evidence that the biological passport is keeping doping in check.  However, doping is a cat and mouse game and there are a host of innovators out there who are looking for next best undetectable compound to use for an illegal edge.

During the Olympics I will focus on specific events to highlight issues related to human performance and focus on the factors that have led to improved records over time.

Note: when possible I will link to full copies of scientific papers.  If this is not possible due to copyright and access issues the links will be to a summary of the article of interest.

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