Biology Reference
In-Depth Information
letes and their medical entourage follow pharmaceutical developments close-
ly. Thus, it is not surprising that rumors of rHuEPO's potential for abuse by
athletes first surfaced before rHuEPO was approved for marketing (1987), and
that rumors of actual use circulated before the 1988 Winter Games of Calgary
(Tab. 1).
In the late 1980s, a cluster of up to 20 deaths occurred among elite cyclists
in the Netherlands and Belgium. The story was widely reported, followed by
an official investigation, but no details emerged. It is speculated that rHuEPO
may have been involved in these deaths [15, 16]. We were unsuccessful in
obtaining the details through contacts in the sport community. Because the
deaths occurred after rHuEPO received marketing approval, it was widely
speculated that they were due to excessive doses of the drug. In 1990, “ery-
thropoietin” and analogues were added to the IOC list of prohibited sub-
stances.
Although it was widely accepted that rHuEPO was being abused through-
out the 1990s, it was not until the 1998 Tour de France that its use was docu-
mented. The discovery of rHuEPO and other drugs in the trunk of an automo-
bile just before the race led to a widespread investigation that eventually result-
ed in recovery of many drug products, confessions from several athletes, and
evidence of widespread involvement of cycling teams and coaches [17-19].
This exposé differed from other sensational drugs in sport stories (such as Ben
Johnson, the track and field athlete, in 1988) in that most of the competitors
were involved, not an individual athlete. This finding convinced cycling offi-
cials that rHuEPO doping was pervasive and that users and winners were high-
ly correlated. Further, officials in other endurance sports understood that their
sports were at risk. Some of the steps taken collectively by sport included fur-
ther implementation of blood screening methods (discussed later in this chap-
ter), monitoring athletes' red blood cell parameters, increased funding for
research on detection, formation of expert committees, and more emphasis on
the role of police authorities. A most unfortunate aspect of such developments
is that success is equated with doping, thereby raising suspicions about any
athlete who performs well. This belief has led drug-free athletes to speak out
against doping and to pressure authorities for more effective action.
Prevalence of doping with erythropoietic proteins
It is nearly impossible to estimate the prevalence of blood doping of any kind.
Only one survey has attempted to do so and commingled data on transfusion
doping with rHuEPO doping. Scarpino et al. [20] interviewed 1,015 Italian
athletes and reported that 7% regularly used red blood cell infusions or
rHuEPO techniques and that 25% were “occasional” users. In the same study,
coaches, managers, and team physicians also estimated that 7% of athletes
were regular users of doping. Sport hot-lines are another source of informa-
tion. Throughout the 1990s, the United States Olympic Committee operated an
