Blood doping in athletics: methods, detection, and sporting implications

Blood doping, as a performance enhancing method, has been around for more than three decades now. The Finnish athlete and the four time Olympic gold medallist, Lasse Viren is widely regarded as the first successful user of Blood doping to achieve sporting success. However, only much later after the 1972 and 1976 Olympic success, it was determined that Lasse Viren had used blood doping to boost his performance. [The Gale Group, 2010] Compared to the use of stimulants and steroids, the practice of blood doping was relatively unnoticed and only in 1986 "Blood Doping' was officially banned. [The Gale Group, 2010] Over the last decade, doping strategies have evolved to foil anti-doping testing programs and there has been a constant battle between the doping and the detection methodologies. A brief overview view of doping, the different types of doping with a discussion of the doping detection tests and the potential dangers of doping would provide more insight into the topic.

Blood Doping (Sporting Implications)

The World Anti-doping Agency (WADA) defines blood doping as the "Misuse of certain techniques and/or substances to increase one's red blood cell mass, which allows the body to transport more oxygen to muscles and therefore increase stamina and performance'. [WADA, 2009] Blood doping gives an unfair advantage to the sportsperson by improving his/her stamina, which is particularly critical in events such as marathons, cycling, trekking, etc. that test the endurance of the participants. This is achieved by inducing erythrocythemia, a condition wherein there is more concentration of erythrocytes (red blood cells) in the blood. Since erythrocytes contain hemoglobin, the main oxygen transporter in blood, increasing the erythrocyte concentration helps to increase the oxygen transport. Improved oxygen supply to the muscle tissues is the key to improved athletic performance and thus blood doping does have considerable implications for a sporting event.

Types of Blood Doping

Three different approaches to 'blood doping' are known. They are the use of 1) Erythropoietin, 2) Synthetic blood carriers and 3) transfusions. In the human body, the hormone erythropoietin (EPO), is secreted by the kidneys and it acts as a trigger for the bone marrow to increase the production of erythrocytes. Since the late eighties, when synthetic EPO was readily available, the use of the EPO has become widespread in athletic circles. In 1990, the international Olympic committee banned EPO and since then routine EPO tests are part of the anti-dope tests in major athletic events. Both direct and indirect methods of detecting recombinant human EPO (rHuEPO) are used for this purpose. [Robinson et.al (2006)] In the 2002 Olympic games at the salt lake city, three athletes tested positive for the use of synthetic EPO and were banned. Synthetic oxygen carriers include both hemoglobin-based oxygen carriers as well as perfluorochemicals (PFC), a group of synthetic fluids that can duplicate the role of the naturally occurring hemoglobin. The PFC molecules are in fact more effective in oxygen carrying capacity compared to hemoglobin. [Michelle Venables, 2008] The IOC has also banned these artificial oxygen carriers.

The other important mode of blood doping is by means of blood transfusion. There are two main types of blood transfusions namely autologous and homologous blood doping. Autotransfusion is a multistage process in which the athlete stores his own blood (between 500 to 1800 ml) months in advance of the athletic event. The collected blood is centrifuged to separate the fluid plasma from the erythrocytes. The plasma is immediately administered back into the body while the separated erythrocytes are frozen using glycerol freezing technique. The frozen erythrocytes are then intravenously administered few days prior to the commencement of the sporting event. The homologous transfusion involves the use of blood from a matching person. Studies have demonstrated both improved aerobic capacity and thermoregulatory capacity in athletes who use transfusion. Blood transfusion, as a doping practice has been around for a long time. For instance, in the 1984 Olympics, seven members of the U.S. cycling team including four medallists openly admitted using blood transfusion as an ergonomic aid. [Morris et.al, 2003. pg 167-168]

Conclusion

The stakes are high in the world of competitive sports and athletes are resorting to every means available to boost their performance. Blood doping using transfusion or synthetic EPO or artificial oxygen carriers have been tried by many in spite of the prevailing ban on these practices. As anti-doping research advances, the doping methods also evolve in an attempt to evade the screening tests. There are serious side effects involved in blood doping. Improper handling of the Autotransfusion techniques can result in serious health risks while homologous transfusions also carry the risk of infections from the donor. Increasing the erythrocyte levels by using synthetic EPO involves the risk of abnormal thickening of the blood creating a potential risk for developing stroke, cerebral embolism and cardiac complications. Blood doping, as an ergonomic aid should be avoided at all costs not only to make sports events fair and competitive but also to protect the athletes from the dangerous side effects.