Our sport was shaken to the core recently by the leak of the International Cycling Union’s (UCI) now infamous “suspicious list”. The list, which was leaked to French sports newspaper L’Equipe, ranked all 198 riders from last year’s Tour de France on a scale of doping suspicion, from zero to 10. The ratings, with 10 the highest level and zero the lowest, were based on readings from each rider’s biological blood passport profile before the Tour started. They included the latest blood tests two days before the start of the 2010 race.

The tests are carried out on all riders before every major tour, with the results and biological profiles used to determine the testing plans during the race.
UCI President Pat McQuaid has spoken of his regret at the leak and subsequent publication of the “index of suspicion”. But he has defended how the list was compiled and insisted that the blood passport program is an essential tool in the fight to kick out cheats from the sport. So is he right?

Background: The Blood Passport Program

Blood passport profiling was introduced for professional cyclists in January 2008 to great fanfare. It was hailed as the answer to cycling’s doping problems because it was centred on long-term blood and steroid profiling. The thinking was that having such information to hand would allow the authorities to take action against riders whose natural values highlighted suspicious fluctuations, even if they did not test positive for a specific banned substance. The sporting community as a whole applauded this innovative new approach and the extraordinary possibilities it offered.

The results have been evolutionary rather than revolutionary, but the UCI is finally beginning to reap the benefits of its programme. Only last month Slovenian cyclist Tadej Valjavec was given a two-year ban for doping. The Court of Arbitration for Sport found that Valjavec’s “anti-doping tests performed in April and August 2009 revealed abnormalities in the context of the athlete’s biological passport to a degree which was entirely consistent with blood manipulation”.

It was a third successive legal victory for the UCI at sport’s highest court in cases involving its flagship anti-doping blood program.

The Way Forward

While I think it is sad that this confidential information was leaked to a newspaper, I firmly support the cycling blood passport program.
Prioritizing which riders should be given more attention definitely makes a lot of common sense to me. The probability of a positive test is a lot higher when you test the riders who are the most suspicious. That is the fundamental concept of the blood passport scheme.

Last year I was at the Scandinavian Congress of Sports Medicine, where I visited a session about anti-doping. It included a talk by Anne Gripper, who was manager of the UCI’s 
anti-doping team when the blood passport was introduced back in 2008. She highlighted several cases involving both clean and suspicious riders and these examples illustrated to me why the blood passport makes perfect sense. 

As a medical doctor I am well used to prioritizing which blood samples should be used on which patients. From a cost and benefits point of view this system of prioritization does not differ too much from what the UCI is trying to achieve.

I think that the blood passport scheme is a great tool to get more value for the limited resources available for anti-doping. The information about this program should never have ended up at the offices of the media and I have no words for that. I also feel extremely sorry for all the riders and teams named on this list.

But while the UCI should clearly be sorry for the way this information was leaked to the press, it should not apologise for the way the data is compiled or interpreted. The list is a vital working document that establishes an order of priority for carrying out doping tests. This prioritization is crucial: it is established based upon a number of solid indications and not upon mere coincidence or conjecture.

So there is no doubt in my mind that the blood passport scheme could be the tool needed to eventually wipe away the scourge of doping from our wonderful sport.

“I used doping. I used EPO. It was my own choice. “ said Bjarne Riis today at a press conference in Copenhagen, Denmark. The winner of Tour de France 1996 has previously claimed that he won the Tour de France without using illegal substances. Today he changed that explanation.

Doping confessions from Team Telekom
It is not a big surprise for me that Bjarne Riis decides to explain about his past now. Since the former soigneur at the Telekom Team, Jef d’Hont, published his book about doping abuse, there has been an increasing pressure on the successful riders from the German team. This week Udo Bölts, Christian Henn, Rolf Aldag, Erik Zabel and Brian Holm have confessed abuse of EPO in the Tour de France 1996, confessions that made it even more difficult for Bjarne Riis to neglect what really happened when he won the race.

Bjarne Riis introduced cycling as a sport in Denmark
It’s a sad day for cycling enthusiasts from all over the World, and especially for Danish cycling fans. Bjarne Riis was the rider that introduced cycling to most of the riders I train, and Bjarne Riis has actually been riding in my local cycling club when he was 8 years old. It was a dream to watch him win the Tour de France back in 1996 and I guess most people in Denmark remember that summer as something special. But it was an illusion that he won without illegal substances and I guess that most people are convinced that professional cyclists used EPO in the 90’s. There were probably clean people in the peloton, but I guess they were a minority at that time.

You can ride, but you can’t hide
After Bjarne Riis’ victory journalists started to have a closer look on what happened behind the scene. A journalist from Danish television worked undercover as soigneur on an Italian team, Gewiss Ballan. He found out that Bjarne Riis was medicated with EPO when he was on the Gewiss Ballan team in 1995. Riis’ relationship to Dr. Cecchini has been the topic in a lot of media the last 11 years. Why was he using a doctor as coach and why was he having the same coach as several of his competitors had? It is not strange that people got curios.

Bjarne Riis started as director on the CSC team back in 2000 and since then there have been several episodes that didn’t improve his reputation as a clean rider. Remember the Tyler Hamilton case and the Ivan Basso case. These things all point in one direction: Bjarne Riis was doped back in the 90’s and he has used his successful experiences from that time to improve his team captains on Team CSC.

Now with the confessions from almost all his team mates, the Telekom doctors and the riders he worked so close with at the Team CSC, Riis finally found out that it was time to confess. I guess it was one of his hardest decisions ever, but probably a decision that will make life easier for him in the future.

I really hope that all riders that have been cheating themselves, their families, friends and all their cycling fans will confess. Remember: You can ride, but you can’t hide. Someday people will find out if you cheated them.

It is uncertain who will be the next rider to confess. 

1. Tyler Hamilton: “I have a twin that was never born. That’s why my blood contains a different blood type than my own”

2. Floyd Landis: “I had some beers and whiskeys last night. I have a very high natural level of testosterone. I am innocent.”

3. Raimondas Rumsas: “My wife was bringing a car full of medical substances for her sick mother. I am innocent.”

4. Frank Vandenbroucke: “The drugs were for my little dog. I am innocent.”

5. Dario Frigo: “It’s just a bad habit I have to wear illegal drugs. I don’t use them. I am innocent.”

Read more at Floyd Landis Case

In the published material you will find:

This publication is made of Landis’ crew and should be read with a critical point of view.

In an article in International Herald Tribune there is an interesting theory about hiding of EPO abuse. Scientists in laboratoriums in Switzerland work to develop a test that can prove a special powder used to destroy traces of the drug EPO (erythropoietin). In the past year there has been a significant increase in the number of tests showing no EPO at all. The scientists have the theory that the riders use a protease that can break down proteins in the urine.

“We have no proof so far but there are indications that a powder exists. It can happen that people who excrete less EPO than others have a result where there is no EPO but it is unusual. And over this last year we’ve seen some suspicious cases of EPO-free urine samples, where we did not understand why suddenly it was undetectable” Said Martial Saugy, the head of the Swiss anti-doping laboratory, to International Herald Tribune.

Small amount of protease can remove EPO
It is possible to remove EPO from the urine by putting protease on their hands, then urinating on their fingers. Only a small amount of protease is needed to break down all EPO in the urine.

This theory might explain why so relative few riders have delivered a positive EPO test compared to how many riders have been caught with an enhanced hematocrit.