Tuesday 17 January 2012

German Skater Unmasked by Biological Passport

Lessons can be learnt by governing bodies seeking to combat doping in their sports from the example of Claudia Pechstein, a speed skater, who was a darling of the German sports scene. During the course of an illustrious career she accumulated no less than 9 Olympic medals including 5 golds and competed in 5 consecutive Winter Olympic Games from 1992 to 2006.
 In February 2009 the fairytale turned into her nightmare. 
Between 2000 and 2009 Pechstein had been drug tested numerous times in and out of competition. Significantly she had never failed a drug test. At the 2009 World Championships she was tested shortly before the competition was due to begin. As a result of the findings, in particular, unusually raised levels of reticulocytes (immature red blood cells) she was tested again the following day. She was then withdrawn from competition by her Federation. She was suspected of 'illegal manipulation of her own blood', specifically EPO blood doping. The tests did not reveal the presence of performance enhancing substances.
As part of the International Skating Union's anti doping programme 90 blood samples had been taken from Pechstein over the course of a number of years both in and out of competition. They afforded the anti doping team an in depth biological passport of the skater. The ISU's experts analysed these blood samples and considered the 2009 findings. On the 6th and 7th February 2009 Pechstein's reticulocyte levels were 3.49, 3.54 and 3.38. The average European would have values between 0.4 and 2.4. At the same time her haemoglobin and hematocrit values were effectively normal ie within ISU limits. Pechstein's mean value over the course of 17 tests from November 2007 until January 2009  was 2.10 with a maximum of 2.84 and a minimum of 1.27. There were also significant fluctuations in Pechstein's levels. On the 8th January 2009 her level was 1.74, by the 6th February it was 3.49 (an increase of 100.6%) and by the 18th February it was down to 1.37 (down 60.7%). Following EPO administration it is usual for reticulocyte level to decline significantly.
Expert evidence suggested that a difference from the mean value of between 24 and 36% would equate to  an 'abnormal value'. In Pechstein's case an acceptable  increase would only have taken her level to at most 2.85.
Although the ISU Disciplinary Commission did not have the benefit of an adverse analytical finding, its case that Pechstein had doped, was enhanced by further circumstantial evidence. During the early part of 2009 Pechstein had frequently changed her 'whereabouts' at short notice rendering out of competition testing 'near impossible'. It was also signifant that Pechstein's performances were still improving at an age when a decline in performance would be expected.
In order to prove a doping violation the ISU were allowed by their rules to establish 'by any reasonably reliable means' and to a standard of 'comfortable satisfaction' that the offence had been committed. Their case was that Pechstein's values were generally within acceptable norms, but, at the time of important competitions since 2007, her levels were 'clearly abnormal'. These abnormal levels would then rapidly return to normal or even to much lower than normal levels shortly after that competition (consistent with EPO blood doping). The ISU's case was that the circumstantial evidence could only be explained by an 'artificial method of manipulation that stimulates red blood cell production'.
One of the difficulties for Pechstein was that the level of reticulocytes provides a 'real time assessment of the functional state of erythropoiesis (process of red blood cell formation) in a person's organism'. The reticulocyte level cannot be reduced by an increase in the fluid content of the blood through an outside intervention. A cheat therefore has no means of hiding the reticulocyte level's increase through blood doping.
If Pechstein had used EPO, then as was argued on her behalf, why was EPO not detected in her tests? The answer, according to experts and as found by the ISU and subsequently the CAS Panel is that exogenous EPO can only usually be detected for a couple of days after its administration and in no case has it been detected after 4 days. All trace of it disappears, but its effects remain. The answer in this case would appear to have been that during the approach to competition and whilst defeating the out of competition testers by constantly changing her whereabouts Pechstein used EPO, but at sufficient distance from the competition to avoid a positive test result. Experts also testified that hematocrit and haemoglobin levels can remain stable during EPO doping and that 'hemodilution' can mask any such changes, but cannot act upon reticulocyte levels.
Claudia Pechstein put forward a number of arguments, especially at the CAS appeal hearing. The majority of these were swiftly dismissed as implausible, unsubstantiated or demonstrably untenable. By way of example she argued that the extreme cold affected her test results. Unfortunately all the other athletes tested produced results within acceptable norms in spite of competing in the same chilly conditions.
The pool of experts before CAS did agree that a plausible explanation might be that the appellant suffered from a 'potential haematological abnormality' such as 'hereditary spherocytosis'. During the original investigation and prior to the ISU Disciplinary hearing, Pechstein had refused to cooperate with investigations of this nature. Ironically, for the CAS appeal, Pechstein had undergone an examination and investigations by Germany's most regarded expert in the field, an expert of Pechstein's choosing. All the experts agreed that the appropriate tests had been carried out by him. Pechstein's expert found no evidence at all to support the proposition that the disease existed in her case.
The CAS Panel cited this factor as the 'decisive element' in the case.
This was the first doping case to be proved by circumstantial evidence rather than an adverse analytical finding. The case continued to attract controversy. The German Society of Hematology and Oncology concluded that this was a case of a light form of blood anaemia 'spherocytosis' inherited from her father'.
 Pechstein, continued to protest her innocence and even tried to appeal the CAS findings to the Swiss Federal Supreme Court. They rejected her appeal. She served a 2 year ban, only returning in February 2011, when she managed to win a bronze medal in the 5000m at the World Championships. She continues to compete at almost 40 years of age, but with her reputation tarnished beyond repair.
Of course skating had the advantage of numerous blood samples going back some years to enable the biological passport of Pechstein to be established. Sports such as tennis, for instance, will have to bite the bullet and invest in a significant blood testing programme to achieve similar results. The key question is whether, in a sport in which its stars make fortunes, there is the will to redirect sufficient sums towards a credible testing programme?

2 comments:

  1. Are You ignorant or just vile to ignore numerous reports that Pechstein was diagnosed with a blood-cell-disorder (the same as her father has)? Highly regarded experts stated that this was the reason for one blood-parameter out of sync.
    Do You really not know that the ISU changed sanctioning-rules right after the Pechstein verdict. so now there has to be different blood-parameters wrong to get a doping-verdict. Not just the one in the Pechstein case?
    Shabby reporting of the worst case!

    Andreas Lorenz#

    Berliner KURIER
    Sports Editor

    ReplyDelete