50% Limit is 100% Stupid – Rant

Drug testing is a relatively simple proposition. You identify a doping agent, develop a test that detects it, then apply that test to blood or urine taken from a given athlete. Now, I know, I’m skipping several steps, here, and years of research, but what I’m trying to say is that fairly determining whether or not an athlete is on drugs is a relatively basic thing; a dope control either finds drugs or it doesn’t.

Now, in some cases, it’s not that easy. Norpseudoephedrine, for example, is a banned stimulant that can occur naturally in the body as it metabolizes pseudoephedrine, a substance that used to be found in all sorts of things before people started using it to make meth. When dealing with doping agents like these, WADA sets an acceptable limit based on studies of human metabolism. It’s not perfect, but sometimes you’ve just gotta draw a line, and, in most cases, it works.

The problem arises when this “line in the sand” approach is carried over onto things that aren’t drugs. Things like hematocrit and hemoglobin levels. Hematocrit and hemoglobin are not drugs; hematocrit is a measure of what percent of blood volume is taken up by red blood cells; hemoglobin is the protein in red blood cells that carries oxygen. Tests for each of these roughly reflect blood thickness and the ability of blood to carry oxygen. The caps the UCI and the FIS set for male athletes in each of these tests is 50% for hematocrit and 17 g/dl for hemoglobin.

Unfortunately, unlike the case of norpseudoephedrine, where any value above zero is unusual, these ‘crit and ‘globin limits lie well within the normal range of values, generally considered to be between 40 to 52%, and 14 to 17.4 g/dl (some sources go as high as 54% and 18 g/dl), respectively. Now, does it really make sense for athletes who are in no other ways average (Lance Armstrong’s VO2 max is 83ml/kg/min, Greg Lemond’s was an astounding 92; average is around 47) to have these comparatively pedestrian limitations placed on their blood levels?

WADA, the UCI, and FIS all argue yes, citing the safety of the athlete. They say pumping thicker-than-average blood around the body nearly 200 times a minute for hours on end puts too much stress on the heart, while high blood levels, and the low resting heartrates resulting from them, put athletes at risk for potentially fatal cardiac disorders. As evidence, the governing bodies point to dozens of athletes dying inexplicably in their sleep, during the years that EPO, a drug that increases hematocrit and hemoglobin levels, was coming to prominence. Thus, athletes above the acceptable limits aren’t prosecuted for doping, but merely declared “unfit to start”. It’s a nice story, but it just doesn’t hold up.

Because the “unfit” levels are set so surprisingly low, many athletes are “naturally” above the 50% mark. Damiano Cunego, Jonathan Vaughters and scores of other elite athletes register marks of 52% and higher, yet are allowed to continue competing, without taking the blood thinners you might expect the UCI or FIS to foist upon them to “protect” their health. Add to this the fact that not one of these athletes has turned up dead yet, nor even shown so much as the slightest ill effect from their athletic efforts, and the prevailing “safety of the athletes” mantra starts to ring mighty hollow.

A brief examination of endurance sports history over the past two decades reveals the true motivation behind the limits. During the 1990s, hemoglobin levels in nordic skiers were growing to unheard of levels (including reports of 19 g/dl in females), while cycling hillclimb records were beginning to fall like dominos. In 1996, Bjarne Riis annihilated the field at the Tour de France, burying riders like Luc Leblanc and Richard Virenque, who had already had their ‘crits illegally raised to 54%, while hardly breaking a sweat. These results were quickly attributed to the burgeoning availability and use of EPO, but, as a reliable test was still years away, there was no way to prosecute an EPO cheat short of catching them in the act. Athletes were doping, everyone knew it, and no one could could do a damn thing about it.

Arbitrary limits to the rescue. FIS first imposed its hemoglobin limits during the 1996-7 World Cup, and the UCI follow suit that spring. Of course, as anyone familiar with the ’98 Tour will tell you, it didn’t do a whole heck of a lot to stop EPO. Methods were devised to get around the limits almost as soon as they came out, and EPO remained as much a part of endurance athletics as it ever had been. But the new rules (and the invasive ferocity with which they were enforced) at least gave the general impression that the governing bodies were regaining control of their respective sports.

Today, it’s pretty clear to me that these arbitrary levels simply don’t work. As it stands, they’re as much an “invitation to dope” as they are a preventative measure. Let’s say you’re a talented second-tier rider with a hematocrit of 38%. All that it’s going to take to make you a star is a few stealthily-carried out injections of EPO. So long as you don’t test positive for EPO (most admitted EPO users never have) or break that 50% mark, your levels can bounce around wildly without you being sanctioned (Tyler’s levels were amiss for months, but he was never charged until his blood doping positive).

Much more alarming to me, however, is the fact these poorly-conceived blood level caps have as much potential to catch clean athletes as they do to stop dirty ones. At the Torino Winter Games, just getting underway at the time of publication, twelve cross-country skiers have already come up with “unhealthy” levels of hemoglobin, and despite the fact that these results are largely consistent with their previous tests, they’re all now under five-day bans. They haven’t tested positive for any drug, their health hasn’t been endangered to the point that they need medical attention, and yet they cannot compete in the events they’ve spent their lives training for.

This issue is further exacerbated by the fact that hematocrit and hemoglobin levels vary wildly based on a plethora of factors. Dehydration, altitude, intensity of recent training, rest, diet, physical trauma, and menstrual cycle can all skew blood level results. Heck, the test itself has a 2% margin of error (search 2%). And unlike other limits imposed on natural levels, such as those that govern testosterone in urine, hematocrit can be raised legally by several factors; testosterone generally only increases as a result of two things: cancer and steroid abuse. So an athlete perfectly healthy one day may be barred from competition the next, without having taken anything more illegal than an afternoon nap.

In the end, I guess this gets back to my extreme distaste for the militance of most anti-doping agencies and activists. I want clean sports as much as anyone, but an athlete’s right to the presumption of innocence has to come first. These limits were quick-fix attempts enacted by governing bodies panicked to be caught with their pants down when the cheaters went high-tech. In 2000, an allegedly reliable EPO test was developed, and what it’s revealed to us since then is that EPO use, even with the 50% limit, has continued unchecked. Athletes test positive, confess, and are caught with trunkfuls of blood boosters, all without having ever been “unfit to start”, while clean athletes like Dario Cioni and Jens Filbrich have endured missed competitions and suffered soiled reputations for no reason. I don’t care how vehemently you hate dopers; if you’re pro-arbitrary blood level limits, you’re not anti-doping – you’re anti-athlete.