Makwala's Involuntary Medical Disqualification

UPDATE: As I completed this post I see that Makwala has been given an extraordinary opportunity by IAAF to compete in the 200m via a time trial (solo) sprint. This story continues to develop. Official IAAF statement here.

The video above shows sprinter Issac Makwala, a sprinter from Botswana and one of the world's fastest runners, being turned away involuntarily from the athlete's yesterday at the 2017 IAAF World Championships in London.

This post seeks to document what appears to be a gross violation of a athlete's due process rights with profound and irreversible consequences for his career as a professional athlete. I'll update as new information is available and am happy to take comments or critique.

This episode involves an outbreak of norovirus, a high contagious gastrointestinal bug that broke out among athletes and their entourages who were reportedly staying at The Tower Hotel in London (the hotel denies any responsibility). Some 30 people were reportedly affected. Norovirus causes vomiting and diarrhea but is not generally viewed to be serious, with symptoms going away after a few days with no treatment.

On 6 August the IAAF shared advice with athletes and their entourages staying at the hotel (emphases added):

To contain the situation and protect your athletes, we strongly request you
comply with the following directions:

1. Report to the Guoman Tower Hotel Medical Room (430) as soon as possible any episode of diarrhoea and vomiting. This report should include the name, category of the person and the room number 2. The person must be isolated and hotel staff will assist in allocating another room. 3. Recommendations from Public Health England say the affected person must remain isolated for 48 hours after the last episode of vomiting or diarrhoea and therefore, the person will need to take their meals in their room.

The Hotel have applied Public Health England’s recommendations on enhanced cleaning procedures and will support all measures in relation to these matters.

Individuals must be vigilant on personal hygiene and apply the following:

1. Wash your hands thoroughly after going to the toilet, using soap, hot water and clean towels. 2. Wash your hands before having a meal or a drink. 

There was nothing in the advice about disqualification. In fact, over the weekend athletes diagnosed with Norovirus continued to participate in the events, such as Germany's Neele Eckhardt, shown below.

The advice from Public Health England being referred to by the IAAF can be found here (and highlighted below).

According to reports, over the weekend, Makwala was observed to have thrown up, barfed, puked (though details here are contested as well). On 7 August Makwala was disqualified ("withdrawn" in the IAAF parlance) from the 200m by the IAAF, which stated, "Isaac Makwala (BOT) was withdrawn from the men’s 200m (1st Round) due to a medical condition on the instruction of the IAAF Medical Delegate (Rule 113)."

Rule 133 refers to the IAAF Competition Rules, and it states:

The Medical Delegate shall have ultimate authority on all medical matters.

As Michael Johnson noted, soon thereafter things started getting weird.

Just got more weird. Makwala says he's been ruled out by IAAF medical officer. Makwala says he's ready to run. Need answers from @iaaforg https://t.co/mSfJs0AacC

— Michael Johnson (@MJGold) August 8, 2017

Makwala claimed he was perfectly healthy and ready to run. But the IAAF was prohibiting him from participating. That led to the situation shown in the video above where Makwala was forcibly prevented from entering the venue.

According to the official Twitter account of the government of Botswana (yes, this is serious), Makwala represented to officials that his forced withdrawal was a legal matter under UK law.

He said according to England Public Health laws, those affected by the virus are to be isolated for 48rs & Makwala was among those isolated.

— Botswana Government (@BWGovernment) August 8, 2017

In its 8 August statement on the situation, the IAAF used language indicating that they were following "UK health regulations":

As per UK health regulations, it was requested that he be quarantined in his room for 48 hours, a period which ends at 14:00hrs tomorrow (9 Aug). 

This statement is -- in measured language -- disingenuous. There are no such UK "heath regulations" related to a "quarantine." In fact, the Public Health England statement released by the IAAF makes absolutely no mention of regulations or quarantine:

In fact, the statement notes that the virus is "rarely serious."

So here is how the situation looks:

• The IAAF made a decision with profound, career-altering impact on an elite athlete;
• This decision was made with no apparent due process, very little reliance on evidence and ambiguous criteria for the forced disqualification;
• The athlete and his medical team reject the diagnosis made by the IAAF;
•  Even if he was infected, was the DQ necessary? Some experts think not (e.g., here and here);
• At least one other athlete with the same alleged symptoms was allowed to participate;
• The IAAF falsely suggested that UK law or regulation triggered the decision. 

At a minimum the IAAF (or some other body) should empanel an independent investigation into this situation, including the decision and the communication associated with it. Clearly things can be much improved.

Finally, below is a lengthy BBC interview with Dr. Pam Venning, head of the IAAF medical services for the World Championships and the authority with the power to disqualify an athlete involuntarily under IAAF Rule 113. (Note: Some people can't see the video, which may be due to your point of access or a geoblock, try this link also.)

The Errani Doping Case: An Embarassment

Today it was announced that Sara Errani, a top women's tennis player (currently 98th, but has been as high as 5th), has been suspended for 2 months for doping. The case illustrates much about what is wrong with anti-doping and the profound consequences that the failures of anti-doping have on elite athletes.

The ITF announced today:

An Independent Tribunal appointed under Article 8.1 of the 2017 Tennis Anti-Doping Programme (the "Programme") has found that Sara Errani committed an Anti-Doping Rule Violation under Article 2.1 of the Programme and, as a consequence, has disqualified the affected results and imposed a period of ineligibility of two months, commencing on 3 August 2017.

Ms. Errani, a 29-year-old player from Italy, provided a urine sample on 16 February 2017 as part of an Out-of-Competition test under the Programme. That sample was sent to the WADA-accredited laboratory in Montreal, Canada for analysis, and was found to contain letrozole, which is an aromatase inhibitor that is included under section S4 (Hormone and Metabolic Modulators) of the 2017 WADA Prohibited List, and therefore is also prohibited under the Programme.

Wow, that sure sounds serious! Another cheating athlete, it seems.

But lets take a closer look. All is not that it seems.

The drug that Errani is suspended for is call letrozole, which is an aromatase inhibitor meaning that it suppresses aspects of the human hormonal system.  In this case the thinking is that the drug increases the presence of testosterone in the human body, which may aid performance. Here is what the ITF says about the drug in its judgment on Errani (here in PDF):

There has been concern on the part of WADA that some bodybuilders were abusing letrozole and there was some anecdotal evidence online that female bodybuilders used it for that purpose. The substance has been banned for men since 2001 and for everyone since 2005, both in competition and out of competition without a valid TUE. 

Contrary to the thin "anecdotal evidence" cited here, the scientific literature on letrozole and aromatase inhibitors more generally published since 2005 indicates that these drugs do not offer a performance enhancing benefit to women.

For instance, Handlesman (2008) concludes, emphases added:

In summary, there is no convincing evidence that oestrogen blockers cause any consistent, biologically significant increase in blood testosterone concentrations in women. In the absence of direct testing of ergogenic or myotrophic properties, using blood testosterone as a surrogate marker suggests that drug-induced performance enhancement is most unlikely from oestrogen blockade. Nor is there any reason to believe that oestrogens have any other ergogenic effect whether directly on muscle, haemoglobin or indirectly via motivational effects in healthy pre-menopausal women. Finally, as oestrogen blockade for various indications is in wide, regular clinical use and poses no unusual medical risks to female athletes, there is no basis to ban oestrogen blockade in female athletes.

Handlesman (2006) concluded similarly:

In conclusion, there is no convincing evidence that either hCG or estrogen blockers (antiestrogens, SERMs, aromatase inhibitors) cause any consistent or biologically significant increase blood testosterone concentrations in women. In the absence of direct testing of ergogenic or myotrophic properties, blood testosterone is a reasonable surrogate maker, suggesting that drug-induced performance enhancement is most unlikely.

Both classes of agent are in regular clinical use and neither poses sufficient safety risks sufficient to warrant banning in sports on the basis of protecting female athletes safety.

Finally, the adverse privacy implications of hCG testing and the unjustified workload of extra TUEs for estrogen blockers in women suggest that the prohibition of these classes of agents should be restricted to men in whom they are well justified.

The peer-reviewed science is clear enough, but here is where things are a bit strange. The ITF agrees with these conclusions, writing in its Errani judgment (here in PDF), emphasis added:

However there is no evidence that letrozole would enhance the performance of an elite level tennis player. There is no evidence of any significant usage of letrozole amongst athletes in general and none was identified in respect of tennis players.

So we have a drug that no one is taking, that everyone agrees does not have performance-enhancing effects -- a conclusion which is well-supported by scientific research -- and yet 12-year old regulations based on out-dated assumptions are the basis for sanctioning an elite athlete.

Seriously, what are we doing here?

A Review of Bermon and Garnier 2017 (the new IAAF T Study)

Here are some comments on Bermon and Garnier (2017), which is the new study of the effects of testosterone levels of female elite athletes, commissioned by the IAAF in the aftermath of the 2015 CAS decision on Dutee Chand.

The paper is:

Bermon, S., & Garnier, P. Y. (2017). Serum androgen levels and their relation to performance in track and field: mass spectrometry results from 2127 observations in male and female elite athletes. British Journal of Sports Medicine. (available here non-paywalled)

These comments are in the form of bullet points, more or less following the flow of the paper:

• The paper opens by discussing testosterone as something abused by athletes, especially female athletes. This comment seems completely out of place in a paper supposedly about natural testosterone levels (but read on).
• The paper notes the "virilised phenotype" of "some female athletes." In plain English that means that they have physical characteristics found in stereotypes of men, and not in stereotypes of women. This sort of policing of women's bodies is ever-present in these discussions.
• It acknowledges the Chand vs IAAF 2015 CAS decision as the motivation for the research, but does not acknowledge the quantitative conclusion of that ruling which indicated that the CAS decision was based on a supposition that T levels in women might account for a ~3% difference in performance but not a ~12% difference common to males vs. females.
• The analysis looked at female and male athletes participating in the 2011 (female) and 2013 (female and male) IAAF World Championships. 
• The study, oddly, includes independent results for athletes who participated in both 2011 and 2013 World Championships. It appears that these athletes were thus double-counted. The paper says that it is not an issue, so why do it at all?  It is inelegant at the least and problematic at worst.
• The study focus on the athlete's single best performance in the competition, not overall performance. It would have been nice to see the sensitivity of the results to this methodological choice.The paper also aggregates all athletes' times into averages, another important methodological choice.
• So, rather than present the data as a scatter plot (time/distance vs. T), which would allow a sense of variation in any possible relationship, the analysis used "tertiles" (thirds) and compared time/distance of the bottom third (in T) with that of the top third. It is an interesting methodological choice, as it all but eliminates the possibility to see and understand individual variation, e.g., in technical terms, least squares regression vs. Chi-Square test. 
• The paper appears to include athletes who doped in the analysis of athletes with naturally high T. It thus mixes known doped athletes into the results, without quantifying the impact of this methodological choice. This is remarkable. The paper states:
• "Among the 1332 female observations, 44 showed an fT concentration >29.4 pmol/L.17 Twenty-four female athletes showed a T concentration >3.08 nmol/L which has been calculated to represent the 99th percentile in a previous normative study in elite female athletes.13 Among these 24 individuals, nine were diagnosed with a condition of hyperandrogenic disorder of sex development (DSD), nine were later found to have been doping, and six athletes were impossible to classify."
• The paper says that "In male elite athletes, no significant difference in performance was noted when comparing the lowest and the highest fT tertiles." This overall aggregation is not quite accurate. For instance, for the men's 5000m the lowest T third ran 822.96 seconds and the highest third ran 812.89, a difference of more than 10 seconds. Maybe high T men should be excluded from the 5000m? (I jest, but that is the logic at work here.)
• The paper concludes, accurately, "Our study design cannot provide evidence for causality between androgen levels and athletic performance"-- this is both the nature of statistics, but also a consequence of the methodological issues this paper has.
• Interestingly (and a side note to the focus of the paper), the paper notes that some of the observed low T numbers among male athletes could represent the results of previous doping, implying that these results are in some way contaminated by doping in a different way than the female results.
• This is a remarkable admission: "we deliberately decided not to exclude performances achieved by females with biological hyperandrogenism and males with biological hypoandrogenism whatever the cause of their condition (oral contraceptives, polycystic ovaries syndrome, disorder of sex development, doping, overtraining)."  The Chand 2015 CAS ruling applies to women with high natural T, not doping or medical consequences (e.g., possible TUE). The study consequently mixes in some apples and oranges. This alone undercuts this study in the context of the Chand ruling.
• The paper appears to address Caster Semenya directly when it states: "In female athletes, a high fT concentration appears to confer a 1.8–2.8% competitive advantage in long sprint and 800 m races." Interestingly, despite the paper's methodological issues, this is just about exactly the range postulated in the 2015 Chand CAS decision.

My bottom line: The paper has some significant methodological issues, most notably the inclusion of female athletes who doped with those with naturally high levels of T. There is some double counting of athletes in 2011 and 2013. There is also speculation that the male findings are contaminated by doping. Methodological issues notwithstanding, the paper nonetheless strongly reinforces the 2015 CAS Chand decision. There is nothing here that would provide any empirical basis for revisiting that decision. We might quibble about the methods, but the significance for the CAS decision seems unimpeachable.

The Curious and Complex Case of Alex Schwazer

"Do they realise they are part of the plot against AS and the potential consequences for them?"

This statement, by an IAAF official to a to an attorney representing the IAAF refers to an athlete  - Alex Schwazer, AS -- who WADA and IAAF are collaborating together to convict of a doping offense. The "them" that is being referred to here is the WADA laboratory in Cologne. The "plot against AS"?  Well, that is a curious phrasing.

This statement can be found in a tranche of emails involving the Schwazer case released by Fancy Bears earlier this week.

Even before the leaked emails, the Schwazer case has been much discussed as problematic in many respects.  Here I'll list some resources for this case as a starting point for discussion.  The case is complex, involves many personalities, agendas and accusations. It also has a history going back many years, centering on Schwazer's coach, Sandro Donati.

I don't understand all the ins and outs, but I'd sure like to.

• Leaked documents (emails) from Fancy Bears
• German news article on Fancy Bears leak (Google Translate)
• Italian news article on Fancy Bears leak (Google Translate)
• Sports Integrity Initiative on Fancy Bears leak
• Sport Integrity Initiative discussion of La Reppublica documentary (shown here with English subtitles), created in 2016.
• 2017 CAS judgement against Schwazer (here in PDF)
• Sandro Donati whistle blowing allegations from 2000 (via PTG)

What else should I list here?

Guest Post: The "Arnie Effect" vs. The "Tiger Effect" on PGA Purses

This is a guest post by Bill Mallon, former PGA Tour professional and current surgeon and Olympic historian. Find him on Twitter @bambam1729.
------------------------------------

Roger Pielke has written of the “Tiger Effect,” in this case defining it as the increase in purses on the PGA Tour after Tiger’s ascension to the top. Roger and I had emails back and forth on this as I said I thought the “Arnie Effect” may have been just as large in the 1960s, if not bigger.

Frank Beard, leading money winner in 1969, once said that all pro golfers should give Arnold Palmer 25 cents out of every dollar they earned, because he had gotten at least that much for them. A disclaimer here – in the 1970s, I was one of those pro golfers who owed Arnie a part of my winnings, playing from 1975-79, and if you want to know how much purses are different now than then, in 1977 I was 96th on the money list, with just under $24,000 official earnings. In 2016, the 96th player on the PGA Tour money list (Brett Stegmaier) earned $1,086,714. (Note: I am not bitter.)

So, I decided to look at the stats on this to see how much effect Tiger and Arnie had on PGA Tour purses. I chose to look specifically at the 10-year period starting when they first became the leading players on the tour. For Arnie that was 1958, while for Tiger it was 1997.

In the accompanying table [displayed below this post], you can see the PGA Tour total purses and how much they won going back to 1938, the first year that was recorded, as well as the number of events held. Because total purses are dependent on the number of events (take a look at the war year 1943 when there were only 3 events), the next column lists the average purse per event, which is a better statistic to use. Finally, to effectively use the same dollar values, this number is corrected for inflation, listed in the 5th column from the left.

The next column, P/E Adjusted, lists the Purse/Event Adjusted for inflation. This is the number we want to compare, but I went a bit further. Because there are some slight yearly deviations, I then created a 5-year rolling average of the Purse/Event Adjusted for inflation. Finally, the right-most column is what we are comparing – this is the 10-year increase in Rolling Average of the Purse/Event Adjusted for inflation.

The pertinent 10-year periods, the Tiger Era, and the Arnie Era, are marked in bold and highlighted in orange. You will note that during the Tiger Era, from 1997-2007, actual purses/event increased to 284.2%, which is quite good. In fact, the increase was even more than that in 2004-06, reaching 289.6% in 2005. In the Arnie Era, 1958-68, the actual purses/event increased even more, to 325.7%. Further, this increase continued into 1969-71, and topped out in 1970 at 355.3%.

Also of note, there is no other 10-year era that approaches the effect that Arnie and Tiger had on PGA Tour purses. The closest thing to it comes in 1992-95 when the 10-year actual purse increase was up to 218.2%. What could explain this? If anything, this should probably be called the Deane Effect, in honor of Deane Beman, then the PGA Tour Commissioner. In the late 80’s and early 90’s Deane started building Tournament Player courses, popularizing stadium courses, most notably at TPC Sawgrass, home of The Players Championship. He deserves a lot of credit for starting the increase in PGA Tour purses that has continued, led by Tiger’s popularity, into the 21st Century.

So my original suspicion, that Arnold Palmer affected purses even more than Tiger Woods did, was somewhat correct, although the differences between the two eras were not that large – maxes of 325.7% vs. 284.2%. They both had profound, and close to equal effects on PGA Tour purses, but Arnie remains “The King.”

Submission to European Athletics on Rewriting the Record Books

Submission to European Athletics on Word Record Proposals
Roger Pielke, Jr., Professor and Director
Sports Governance Center
University of Colorado Boulder
26 May 2017

European Athletics has proposed a new set of criteria for the validation of world records in the various disciplines of athletics (track and field). A world record will be recognized by European and world officials if and only if it meets the following three criteria:

1. The performance is achieved at competitions on a list of approved international events where the highest standards of officiating and technical equipment can be guaranteed
2. The athlete has been subject to an agreed number of doping control tests in the months leading up to the performance
3. The doping control sample taken after the record is stored and available for re-testing for 10 years.

Because the IAAF began storing blood and urine samples in 2005, many have interpreted the new policy to mean that all records established before 2005 would be erased.

I wish to applaud European Athletics for initiating an important discussion about the credibility of world records in athletics. Here I offer a critique of the proposed new criteria. I argue that an evidence-based understanding of the problem being solved is needed before seeking to implement solutions. In this case, there exists a lack of evidence in support of the efficacy of proposed solutions, most notably evidence to suggest that athletics completions take place on a solid foundation of anti-doping regulation.

So what is the problem to be addressed, anyway?

European Athletics offers three “main reasons” why action is now needed (PDF):

• To ensure that today’s generation of athletes are not chasing records set in completely different circumstances
• To restore credibility to the European (and World) records list 
• To regain public trust 

Let’s take a closer look at these reasons for action one at a time:

1. Difference circumstances

If there is one constant in the circumstances under which elite athletics take place, it is change. There is no stasis – in the rules that govern competition, in the technology used in sport or in the efforts to contravene and enforce the rules.

For instance, the IAAF recently approved new rules governing shoe technology, presumably in response to the new Nike shoes that allegedly provide Nike athletes of today an advantage that other athletes and all past athletes did not have.  The IAAF rulebook is a living document and athletes compete under the rulebook in place when they compete.

The intent of the European Athletics rules changes is no doubt to focus on doping in particular. The science of doping and anti-doping regulation is constantly changing. For instance, athletes who competed in 2005 did so under a Prohibited List with about half the substances on it as compared to athletes who compete in 2017.  WADA’s methodological guidelines for the detection of substances changes over time periods longer than a 10-year statute of limitations – Athletes who competed in 2005 are accountable under scientific detection methods available to 2015, whereas athletes who compete in 2017 are accountable under scientific detection methods available to 2027. The science of anti-doping regulation will advance between 2015 and 2027 (and so too will the science of doping and evading detection).

Elite athletes of different generations will compete under different circumstances. This is unavoidable. Drawing a line in 2005 – or 1990 or 2017 – is arbitrary. Sure, it can be done, but it would not address the concern of athletes competing in different circumstances.

The elephant in the room is a presupposition that records set prior to some arbitrary date are more “credible” than those set afterwards. This is a testable proposition, and the subject of the next section.

2. Restoring credibility

There is no doubt that some records of the past were achieved by athletes who broke rules that prohibited doping or, if rules were not broken, used the assistance of substances that were subsequently banned. Strong circumstantial evidence for this conclusion can be seen in the following graph created by the Financial Times.

If past records were achieved through the use of prohibited substances then the historical record of record-setting suggests that 1989 offers a clear point of demarcation for women’s events, but that no such clear date exists for men.

Another approach to establishing credibility would be to demonstrate with evidence that the prevalence of doping among elite athletes was significantly higher before some date, after which records could be considered less tainted than those which came before. 

Unfortunately, data that would provide evidence for trends in the prevalence of doping among elite athletes has not been collected.  Data that is available from rigorous studies suggest that doping prevalence among elite athletes in recent years in athletics could exceed more than 40% of all athletes (see de Hon et al. 2014 and Ulrich et al, in press).

In the absence of data on doping prevalence, efforts to establish “credibility” risk being seen more as window dressing and public relations, rather than evidence-based, rigorous and trustworthy. Credibility will best come from evidence, not exhortation.

3. Regain public trust

Similarly, it is not clear that public trust has been lost or even if was ever there in the first place. As one study concludes: “Despite the vast amount of literature available on doping in sports, little is known about how the general public actually thinks about doping.”

Further, it is not clear if public trust in the integrity of sport is affected more by evidence that athletes break rules or revelations of scandals among athletic administrators.  As suggested above with respect to doping prevalence, efforts to influence public opinion related to athletics records and, more generally, athletics integrity, will benefit from actual evidence of public opinion, what shapes it and why it matters for sponsors, fans and athletes.

Bottom Line

A decision to reset the record book related to athletics can be justified for any number of reasons. However, if the goal of such a clearing of the slate is to create more of a level playing field for verifying records over time, then the proposed approach by European Athletics remains premature, for reasons argued above.

An alternative approach would be to first address issues of integrity in sport by improving WADA and anti-doping regulation. Central to such improvement is to place anti-doping efforts on a more solid foundation of evidence and science.  In the absence of such improvements to anti-doping regulation, efforts to rewrite the record book will be undercut by the very first, inevitable scandal to occur in the coming years. Doping remains prevalent in sport, and creating a new record book won’t change that fact.

If and when anti-doping regulation is placed on a more solid foundation, then the time might be right to discuss a new era of performance and achievement.  Until then we should let past records stand as an indication that the work of anti-doping reform remains to fully be done.  

IAAF Changes its Shoe Rules (Again) and CAS Awaits a Case

As you might expect, the IAAF has rules in place governing shoes used in athletic competition. In The Edge I explain that one of the first rules for shoes was put in place in the 1950s after a clever Russian high jumper was launching himself off of platform shoes.

The rules governing shoes, and prosthetics used by Paralympians, are under sections 143 and 144 in the IAAF Rulebook.  These rules have changed a lot over the past decade, specifically in 2009, 2010-2011, 2012-2013, 2014-2015, 2016-2017 and now, 2017-2018.

The most recent changes to the rules can be seen in the figure below, screenshotted from the recently released amendments to the 2016-2017 IAAF competition rules.

The new rules are likely introduced in the context of controversy and discussion of a new Nike shoe, designed to provide runners additional assistance. I discussed some of the issues associated with the new shoe technology in The Guardian earlier this month. 

The newly adopted rules changes take a badly-written rule and make things worse.

For instance, the previous version of the rules explained that shoes "must not be constructed so as to give an athlete any unfair additional assistance, including by the incorporation of any technology which will give the wearer and unfair advantage." The phrase "additional assistance" refers to additionality over running barefoot. 

The new phrasing "must not be constructed so as to give an athletes any unfair additional assistance, including by the incorporation of any technology which will give the wearer any unfair or advantage."

It seems clear that the new language is crafted to eliminate controversy over the new Nike shoe because it removes the notion of "additional assistance"and the specific reference to shoe technology. 

What then is "unfair assistance or advantage"?  It is undefined.

As I argued in The Guardian we can look to Rule 144 governing prosthetics for insight to what "unfair" actually means in an IAAF context. There I explained:

In 2015 the IAAF quietly changed the requirement that it had to show an “advantage” provided by technology in order to ban an athlete. The rule change meant that the burden of proof was now on the athlete to show that the use of technology would “not provide him with an overall competitive advantage over an athlete not using such an aid” . . .

Thus, if we apply the same standards to Nike’s fancy new shoes that the IAAF applies to prosthetic limbs, then the shoes clearly are illegal under IAAF rules. They provide an overall competitive advantage over athletes not using the shoes. That is both what they were designed to do and also what is indicated by testing by my colleagues here at the University of Colorado. Not all athletes can use the shoes, because not all are sponsored by Nike. For the shoes to be allowed, proof would have to be provided that they do not provide an advantage.

As I concluded in that piece, thus IAAF has one set of standards for Olympians and Paralympians. They are inclusive for Olympians and exclusive for Paralympians. This would seem to be the dictionary definition of discrimination.

The new IAAF are a CAS case waiting to be heard. I expect that it will not be long before an excluded Paralympian takes this up. Watch this space.

Twitter Talk: Scientific Integrity and Anti-Doping Regulation

I have just embarked on an experiment in communication. I have created a "TwitterTalk" of my presentation yesterday at the Norwegian Academy of Sciences and Letters. The talk is titled "Scientific Integrity and Anti-Doping Regulation."

You can see the whole thread starting here.

Comments welcomed as it is a paper in progress.

Oslo Forum on Doping with Independent Experts: 26 April

Doping: science, ethics and law

Location: Norwegian Academy of Science and Letters, Drammensveien 78, Oslo, Norway
26. April 2017 15:00

Sport has great social importance and popularity, requires large resources and receives much public attention. But the sport's values ​​are challenged by doping. In Norway, processes against Martin Jonsrud Sundby and Therese Johaug have triggered vigorous debates on the relevant issues. Why are these matters so important? Is there a good match between people's sense of justice and what is actually happening in anti-doping matters? What rules are applicable? How should anti-doping work be regulated? Good answers require informed debate based on ethical, scientific and legal expertise.

If you'd like to attend register here.

Program

• 15.00: Opening by the president of the Academy, Ole M. Sejersted
• 15.05: Roger Pielke, jr., Univ of Colorado: Scientific Integrity and Anti-Doping Regulation
• 15.35: Michele Verroken, Sporting Integrity, Ltd.: Does anti doping serve sports and athletes or its own interests?
• 16:05 Sigmund Loland, Norwegian School of Sports: The Ethical Dilemmas of doping
• 16.30: Coffee break
• 17.00: Jens Evald, Universitu of Aarhus: Anti-Doping - The balance between efficiency and the rule of law
• 17.25: Erik Boye, Oslo University Hospital: Scientific variability and fallibility
• 17.45: Odd O. Aalen: Statistical aspects: How to evaluate the uncertainty of diagnostic tests
• 18.00 Discussion & invited comments
• 19.00 End

Roger Pielke, Jr. has been on the faculty of the University of Colorado since 2001. He is the director of the Sports Governance Center within at the Department of Athletics, having Previously directed the university's Center for Science and Technology Policy Research. Pielke is the author of The Honest Broker: Making Sense of Science in Policy and Politics and The Edge: The War Against Cheating and Corruption in the Cutthroat World of Elite Sports.

Michele Verroken is a qualified arbitrator, mediator and adjudicator, a former teacher and lecturer in sports science and physical education. She is the founding director of Sporting Integrity and the Director of Ethics and Anti-Doping at UK Sport, Michele created the UK's Drug Information Database, education programs The, Independent Doping Control Officer training and national anti-doping policy based on ISO-certified standards. Michele has significant experience in anti-doping programs The at national and international level.

Sigmund Loland is professor of sport philosophy and the Rector of the Norwegian School of Sport Sciences (2005-2013). He has published extensively within at sports ethics, the ethics of performance-enhancing technologies, epistemology of movement, and the history of ideas in sports. Dr. Loland ice forms President of the International Association of the Philosophy of Sport (2002-03) and the European College of Sport Science (2011-13), and he is member of the Ethics Board of the World Anti-doping Agency (WADA ) (2004-).

Jens Evald is professor of sports law; Head of Sports Law Research Unit, Institute of Law, Aarhus University; Member of the Board of the Institute of Sport (1998-2007); Chairman of the Dispute Resolution Committee, Danish Kayak & Canoe Federation (2000-presented); Vice Chairman Danish Sports Law Association (2001-2005); Chairman of the Board of Anti-Doping Denmark (2006-2012); Member the Political Commission, Danish Football Association (DBU) (2016-2017). He is author and co-author of more than a dozen books and numerous at articles. His work includes books and articles on private law issues, legal history, legal philosophy, biographies and sports law.

Erik Boye is retired professor and department head, Institute for Cancer Research in Oslo. With a background in experimental cell biology and biochemistry he has a long experience with Biochemical analytic techniques. Through the last five years he HAS BEEN Involved in Evaluating the quality of anti-doping analyzes.

Odd O. Aalen is professor of biostatistics in the Medical School at the University of Oslo. He has beenworking on statistical methodology Applied two medical research. He Also has an interest in the statistical aspects of diagnostic testing.

Talk at UF on "Sex Testing" in Sport

I gave a talk at the University of Florida earlier today on "sex testing" in international sport. I have attached the slides as a PDF here. The talk comes from The Edge, and is also the subject of a more technical discussion currently in late stages of peer review.

Comments always welcomed!

Foxes in the Henhouse

Yesterday, the House Energy and Commerce Committee held a hearing on anti-doping that featured testimony of Olympians Adam Nelson and Michael Phelps. The hearing also included testimony of Travis Tygart, head of the US Anti-Doping Agency as well as representatives of the IOC and WADA,

Tygart argued for "a clear separation between those who promote sport and those who police it. To do so otherwise, we believe, is to encourage the fox to guard the henhouse" (PDF). Tygart, and others, are arguing for the IOC, and other organizations of the Olympic Movement, to recuse themselves from the administration of anti-doping regulations in sport. Such a fix, Tygart suggests is "easy."

Tygart is right about the fox in the hen house, but he is wrong about the fix being easy. This post goes into a bit of the institutional history behind IOC's tight grip on WADA to set the stage for discussions of how the fox might be excused from the hen house.

Earlier this week comments by officials at IOC and USOC illustrated the different incentives faced by anti-doping regulators and organizations of the Olympic Movement. For instance, a Russian IOC official commented on Tygart's passionate anti-doping agenda:

"Fighting with an organization responsible for giving future Olympic Games — it’s a big mistake. This gentleman [Tygart] is doing a very counterproductive job with respect to the Los Angeles [2024] bid."

The head of the USOC said of Tygart:

"Travis’s style, I would be lying if I told you it wasn’t having an impact [on the LA 2024 bid]. At the end of the day, he’s doing his job, and he’s doing it really well. Would we like him to be a little bit more of a silver-tongued devil? Yes, we would."

If you are new to the world of sport let me translate all that: These administrators of leading Olympic sports organizations would prefer that USADA tone down its efforts to improve anti-doping regulations and governance around the world. The reason for this is that anti-doping efforts can lead to scandal and a stain on sport and the organizations that govern it. 

These dynamics are not new and can be traced to the origins of WADA in the late 1990s. At that time the IOC was reeling from a bribery scandal of its own making related and the world of sport had just suffered a big black eye due to doping revealing by the so-called Festina affair at the 1998 Tour de France.

Something had to be done.

So in response the IOC moved to create an "Olympic Movement Anti-Doping Agency," Right away many of those interested in anti-doping reforms saw this proposal to be highly problematic. General Barry McCaffery, who was President Bill Clinton's head of the Office of National Drug Control Policy with jurisdiction over matters related to sports doping, testified before the US Senate in 1999 on anti-doping reforms underway under the auspices of the IOC. He stated:

"IOC is rushing forward to build an institution that we cannot support-- one which is more public relations ploy than public policy solution. . . The proposal should have stronger guarantees that the agency  will be independent and operate based on basic principles of good  governance and democracy, such as transparency and no conflicts of interest."

Also testifying that day was Frank Shorter, US Olympian who had won a Gold Medal in the Marathon. He agreed:

"everything  possible should be done to avoid even the hint of a conflict of  interest. This obviously means no IOC control"

So too did Prof. Doriane Lambelet Coleman, of Duke University Law School:

"the reason it is so critical that the IOC and USOC  both externalize and make independent their drug testing operations is that they are neither willing nor capable, as a structural matter, of conceiving and administering a fair and effective drug testing program."

The pressure being put on IOC by the US and Europe meant that they had to give up their desire to own the new anti-doping agency. Instead, they had to settle for partial ownership. 

The New York Times reported in 1999:

Richard Pound, a Canadian lawyer and I.O.C. vice president, who is drafting a proposal on the agency to be considered by the conference on Thursday, acknowledged that the I.O.C. has had to scale back its plans to be at the center of the agency. Pound said national governments would have a much larger role than anticipated, a reflection of the widespread skepticism about the I.O.C.'s leadership ability in the wake of the burgeoning bribery scandals involving host cities. . . Pound said it was possible the new agency, if approved, would have as much as 50 percent representation from public authorities, whereas before the conference the I.O.C. had anticipated no more than 20 percent. It was an indication of the increasing inclination of governments to take anti­doping enforcement out of the hands of sports bodies . . .

Ultimately, it was a 50% split in governance responsibility between governments and sports organizations that came to characterize how WADA was run, and that split still exists today. In practice, however, it is fair to question how much of a role governments actually play in the oversight of WADA, Consider that the US government representative to WADA listed on its website today, Michael K. Gottlieb, left the US government in 2015. I do not recall any instance of a government official on the WADA Board speaking for the organization - it s always sports people.

There is nothing in the international treaty on anti-doping that dictates how WADA is to be governed. In practice, to change the composition of the WADA governing committee (its "Foundation Board") requires a super-majority of 2/3 votes of its 38 members. Currently on this committee  there are 19 members from the Olympic Movement including 5 IOC Members, one of whom is the WADA president. To remove the fox from the hen house would thus require many people from sports organizations to vote themselves out of a job at WADA. It is hard to envision how this might happen.

One consequence of the tight grip that the IOC (and its related organizations) have on WADA can sure be seen in how WADA implements sanctions for violations of its Code.  Consider the case of Russian athletes who were part of the institutionalized doping scandal revealed over the past several years. Below is a list of organizations and individuals culpable in the scandal as argued in the four recent WADA reports (by Pound & McLaren).

• Russian athletes
• Rusada
• ROC
• IAAF
• WADA
• IOC

I have highlighted in RED where WADA has jurisdiction to sanction. 

That is right -- WADA has no ability to sanction sports organizations of the Olympic Movement, as the WADA Code focuses almost exclusively on athletes caught doping, not corrupt organizations or people in them. This is why in the lead up to the Rio Olympics last year WADA sought to ban all Russian athletes from the games, but instead IOC delegated the task to each international federation to sort out, leading to ad hoc and arbitrary decisions. 

Similarly, the fact that the IAAF leadership was extorting athletes for money to cover up positive doping tests is not a violation of the WADA Code -- if it were then the IAAF could be found non-compliant, and potentially suspended or otherwise sanctioned as a governing body for Athletics. Imagine that. Does anyone really think that sports organizations would willingly expose themselves to such oversight?

Getting the fox (IOC) out of the hen house (WADA) is thus no easy task. For its part the IOC responded to yesterday's hearing by stating that: "As for WADA’s governance, we hope to make it more independent from both sports organisations and governments."

Yet, it is not clear that IOC really understands what "independent" actually means in the context of governance (a failing not unique to IOC in the world of sports). Consider that IOC also says that it has "appointed independent experts for the WADA governance working group to give independent advice on how best to reform the governance of WADA." These "independent" experts are a lawyer for the IAAF and a CEO of a national sports federation, perhaps great guys but hardly independent of the Olympic Movement or the IOC. 

The notion of getting the foxes out of the hen house this raises some important questions:

• If the foxes are to leave the hen house who is to replace them?
• Who are these "independent" people who will oversee WADA?
• Should all sanctioning be delegated to CAS?  And if so, then shouldn't CAS itself become more independent of the Olympic Movement?
• Is it time to consider more radical solutions to anti-doping governance, perhaps such as WHO, UNESCO, private sector, etc.?
• Who watches the watchers? to who are anti-doping regulators to be accountable too?

None of this is easy.  And this is just the governance structure -- I have not mentioned issues associated with the substance of the prohibited list, scientific integrity standards, athlete due process and participation and other important aspects of WADA reform.

Doping is endemic in elite sport. The organizations tasked with regulating doping aren't working. In fact, some sports organizations are working at cross-purposes to anti-doping. There is a lot of work to be done here.

Bibliography

COE, 1999. Proposals for the independent international anti-doping agency.

Copenhagen Declaration on Anti-Doping in Sport, 2003. (PDF)

Hanstad, D. V., Smith, A., & Waddington, I. (2008). The Establishment of the World Anti-Doping Agency A Study of the Management of Organizational Change and Unplanned Outcomes. International review for the sociology of sport, 43:227-249.

International Convention Against Doping in Sport - UNESCO, (PDF) Background document: (PDF)

Lausanne Declaration, 1999. (PDF)

Teetzel, S. (2004, October). The road to WADA. In Seventh International Symposium for Olympic Research, October (pp. 213-24). (PDF)

Bloodgate Short

I'm posting this here for future classroom use. It is a Sky Sports Short on "Bloodgate" - some great footage here. (HT Alex)

A List of Elite Athletes Falsely Accused of Doping

There are enough cases of elite athletes falsely accused of doping that I thought I'd start a list. The list below includes cases where the evidence is strongly suggestive, at least, that the athlete was falsely accused by WADA (or other organizations) of having violated the provisions of the WADA Code.

Below I list the athlete, the sport and the drug that the evidence suggests that the athlete was falsely accused of taking. Click on the athletes name for supporting information. I welcome any comments or suggestions to the list.

• Mamadou Sakho (France, football, Higenamine)
• Kusal Perera (India, cricket, 19-Norandrostenedione)
• Paola Pliego (Mexico, fencing, modafinil)
• Andrus Veerpalu (Estonia, Nordic skiing, recombinant human growth hormone)
• Erik Tysse (Norway, race walking, rEPO)
• Steven Colvert (Ireland, athletics, rEPO)
• Hossam Ghaly (Egypt, football, nandrolone)
• Samir Ibrahim Ali Hassan (UAE, football, nandrolone)
• Hassan Tir (UAE, football, nandrolone)
• Al Kowaibki (Saudi Arabia, football, nandrolone)
• Pedro Solberg (Brazil, beach volleyball, testosterone)
• Diana Taurasi (US, basketball, modafinil)
• Monique Coker (US, basketball, modafinil)
• Deco (Portugal, football, hydrochlorothiazide and tamoxifen)

The consequences to an elite athlete of being falsely accused of doping can be career ending. I will update this list as warranted.

Review of the Professional Cyclists’ Union, A Guest Post

This is a guest post from Steve and Joel at The Outer Line.

Review of the Professional Cyclists’ Union

The Cycliste Professionnels Associés (CPA), formed in 1999, had two important early accomplishments - the “Joint Agreement” with the teams to help govern the relationship between teams and their riders, and a riders’ “Solidarity Fund” -to provide limited financial support to certain retiring riders.  However, the CPA has struggled to grow or expand its influence very much in pro cycling over the intervening fifteen years.  A recent review and assessment by The Outer Line takes a detailed look at the performance and operations of the CPA, evaluating how well the organization has complied with its own by-laws, and benchmarking its performance against a widely-accepted set of external sports governance guidelines.  Although clearly hamstrung by its historical financial and human resources constraints, the CPA nevertheless rates fairly weakly in terms of complying with accepted governance standards - particularly in terms of its financial management and the general transparency of its operations.  The Outer Line report describes the current  risks and the future opportunities by which the CPA might play a greater role in pro cycling, and provides a set of eight specific recommendations for how the CPA can become more powerful in the future.   The report argues that a stronger cycling union would actually strengthen the overall sport, and would actually be good for the other key stakeholders in the sport, pointing out that other pro sports made their greatest leaps in popularity and revenue following the development of a more powerful voice for the athletes. 

An executive summary of the report can be found here, and the full 15-page report is available to be downloaded here.

Lab Times Exchange on Problematic Doping Conviction of Steven Colvert

Today, Lab Times has published an exchange between WADA (Christine Ayotte) and the team of Norwegian scientists who first raised questions about the problematic doping conviction of Irish sprinter Steven Colvert. For background see: here and here and here.

WADA's response comes in the form of a version of the letter first posted on the WAADS website last month, which I discussed here. Ayotte's main response is to appeal to authority:

While it may sound seemingly insignificant to refer to 'WADA’s credibility', this oneside vitriolic opus is a charge against skilled, experienced scientists. The SAR-PAGE and IEF data presented are of excellent quality, the results clear and convincing. The methods, the interpretation of test results were published in the peer-reviewed scientific literature (more than 40 research articles from anti-doping scientists) and so were the criteria for issuing positive findings that are available on WADA’s website.

Let me point out what should be obvious: everyone in this issue is an expert. All have impressive degrees, publications and long CVs. Appealing to authority doesn't get you very far. In fact, with various WADA labs suspended around the world, including for improper false positive results, now is probably not the time to appeal to WADA's authority. Ultimately, what really matters here is evidence and procedure.

The team of Norwegian scientists (Jon Nissen-Meyer, Erik Boye, Bjarne Østerud,Tore Skotland) respond in the same issue of Lab Times.  They note the appeal to authority presented by Ayotte, and push back against the idea that it is improper to discuss this issue in the academic literature:

It is fair to say that Ayotte presents no scientific arguments against the assessments we make in our article. She claims that the scientists involved in analysing Colvert’s urine sample were highly competent and that the methods applied (PAGE, IEF) are widely used and have been the subject of many publications. We are not convinced that these matters determine whether the data were correctly obtained, interpreted and presented. More importantly, they certainly cannot determine whether or not problematic and inconsistent results should be subject to public discussion.

The exchange does get into some very important substance.

First, Ayotte criticizes the Norwegian scientists for not presenting their own data. This is of course ironic because WADA destroyed the original samples and has thus far refused to make available the original images from the case to either Colvert or the Norwegian researchers.

But the original data is probably not even necessary to resolve this case. The most important aspect of the exchange is that Ayotte repeats her claim that WADA scientists made mistakes in their evaluation of the data in Colvert's case:

If the laboratory expert was correctly quoted, he made a mistake when he stated that the amount of recombinant was small when compared to the endogenous EPO.

The Norwegian scientists, in their response to Ayotte, document that indeed the expert was correctly quoted making this claim, as was a second WADA expert. They write:

Ayotte clearly states in her letter that the laboratory experts are incorrect in their judgments of the PAGE results, and thus there is a disagreement among WAADS experts in the interpretation of the results used to convict an athlete for doping. We maintain that if the experts in the hearing are correct about the low level of rEPO in the PAGE analyses, the hearing should have concluded that the analyses are not consistent with one another and the case should have been dismissed. Alternatively, Ayotte’s interpretation is correct, in which case she has to explain how she can see such a large amount of rEPO in a gel where other people experienced in interpreting PAGE tests, including experts from two WADA labs, see little or nothing.

Either way, something is not right here.

The Norwegian researchers are correct. With WADA scientists in open disagreement on the data in this case and a team of independent researchers having published a critique of the application of WADA guidelines, that should provide sufficient evidence to overturn the Colvert judgment.

I don't know if Colvert doped and neither do you. Nor does WADA. At this point proof of guilt or proof of innocence is probably not forthcoming. But that is the point. Colvert should be presumed innocent until proven guilty, and WADA's evidence does not prove him guilty.

Here is a big problem that Colvert and other athletes falsely convicted face: An expert familiar with the case tells me that for Colvert to take on WADA with a legal challenge would cost him more than $200,000, just to start. That would appear to be prohibitive for Colvert, based on media reports.

So even as the scientific literature and the court of public opinion appear to indicate that Colvert was wronged by anti-doping authorities and procedures, he essentially has no recourse to right the wrong. His athletic career has been derailed and that won't change. But it is not too late for Irish Sport, in particular, to do the right thing in support of one of its athletes.

Mistakes can be made, even in the best run processes. How organizations respond in the face of evidence of mistakes says far more about the integrity of those organizations than the mistake itself.

Irish Sport, do the right thing.

My November Daily Camera Column: Going Pro in Sports

In my column this month for The Daily Camera I look at data on prospects for top-level men's basketball and football players to make it to the pros. The NCAA, in its ubiquitous commercial (shown above), tells us that the vast majority of college athletes go pro in something other than sport.

While this is true, it does not accurately represent what happens at the highest levels of college sport. It turns out that in top-level football and basketball programs scholarship athletes have a considerable chance to "go pro" in their sport. In the article I show numbers indicating that perhaps 20% of Power 5 football players go pro and 59% of D1 basketball players go pro.

These numbers raise some important questions about how we at universities structure athletic programs. We are in fact preparing such students for professions in athletics. They are not simply college students who do sports on the side.

Here are some links for those interested in digging deeper.

• The analysis depends on the excellent work done by Nick Harris (@sportingintel)  in the Global Sports Salaries Report. Here is the latest version. The data that I use comes from the 2015 edition.
• I developed the analysis over the past few years via several blog posts and commentaries: NFL analysis (here) and NBA analysis (here and here), 
• Here is the NCAA data on basketball players that go pro, and here is the data for several other sports,
• Finally, here is a recent op-ed I had in the NYT on the idea of degrees in sport in big-time athletic programs.

Comments/questions welcomed!

A Summary of Olympic Drug Re-Testing So Far

This is a guest post by Bill Mallon (@bambam1729), Past President and Co-Founder of the International Society of Olympic Historians, and Hilary Evans (@OlympicStatman), a founding member of the OlyMADMen - an Olympic statistics group. Both are incredible resources on Twitter and worth a follow. This post appears on their blog here as well.

A Summary of Olympic Drug Re-Testing So Far

Over the last few months, the media has been awash with stories about positive doping findings from the 2008 and 2012 Olympics, after the International Olympic Committee (IOC) mandated re-testing of the samples from the London and Beijing Games, using more modern methods of detecting performance-enhancing drugs (PEDs). It has been difficult to follow, as the press releases from the IOC have come in flurries, and there is confusion as to how many athletes have been affected and how many medals will be re-distributed.

To date, however, there has not been a summary of the number of positive tests, the types of substances used, and which sports and nations were most affected. Although there were some suspicions based on the press releases, it seems appropriate to produce such a summary, although admittedly, it may well be a work in progress, as the re-testing is ongoing.

First of all, our sources are mainly the IOC press releases and releases from the Court of Arbitration for Sport (CAS). All of the IOC press releases can be found here. The IOC press releases contain summaries of the decisions, but at the end of each summary they note “The full decision is available here” with a link to a PDF of the full decision. CAS decisions are available on their website here, under Jurisprudence --> Recent Decisions, or Database. Only cases that have been appealed to the CAS will have a ruling by that body. In a few cases, in attempting to find the specific substances named, we have relied on press reports, although that has been rare.

Now to the summary. The decisions have been coming from the IOC since April of this year, with the most recent one released on 25 November 2016. During that time 99 athletes from the 2008 and 2012 Olympics have been sanctioned on re-testing for PED use. There are actually 104 cases, as 5 athletes have tested positive for both the 2008 and 2012 Olympics, as follows:

• Hripsime Khurshudyan (F¬¬–ARM / WLT)
• İntiqam Zairov (M–AZE / WLT)
• Oksana Menkova (F–BLR / ATH)
• Ilya Ilyin (M–KAZ / WLT)
• Maiya Maneza (F–KAZ / WLT)

Here is the breakdown by nations of the 104 offenses:

Of note, fully 86 of the 104, or 82.7%, come from nations from the former Soviet Union.

Which sports have been the most affected? If you’ve been following this, you surely realize that athletics (track & field) and weightlifting seem to have been mentioned the most, and that is accurate. In fact, 92.3% of the sanctions have come from those two sports, with athletics having 49 offenses, and weightlifting 47. The others sanctions have come from wrestling (5), cycling (2), and swimming (1).

What have they been taking? The various sanctions have been for 14 different substances, in many cases with the athlete(s) taking 2 or more PEDs, but by far the most frequently used PEDs were Turinabol (64 cases) and Stanozolol (36 cases). The full breakdown is as follows:

The total is much more than 104 because of the athletes taking multiple substances. Also note that 14 cases are for abnormalities in the biological passport, in which cases we do not always know the precise substances involved.

Of the above, Turinabol, Stanozolol, Oxandrolone, Drostanolone, Methandienone, and 3a-hydroxy-5a-androst-1-en-17-one (there will not be a pop quiz on this) are anabolic steroids. GHRP-2 is a type of growth hormone releasing peptide, a stronger analogue of the older GHRP-6, with fewer side effects. 

EPO is erythropoietin, which increases red blood cell volume, and thus may increase oxygen carrying capacity by the blood, and is usually used by endurance athletes. One of these cases was used by a mountain biking cyclist, Blaža Klemenčič (SLO), but the other case was in a Russian weightlifter.

Ipamorelin is not often detected but stimulates growth hormone secretagogue receptors, which then stimulate growth hormone release. Methylhexanamine is a sympathomimetic drug, meaning it stimulates the sympathetic nervous system – the section of the nervous system responsible for the “fight or flight” phenomenon. It is used as a stimulant or dietary supplement and may be helpful in keeping weight down.

Acetazolamide is a diuretic which increases urine formation. It has no performance enhancing effects, but is used by athletes to dilute the urine, and thus decrease the concentration of other drugs in the urine, ostensibly to allow them to defeat the tests.

Finally, tamoxifen affects estrogen receptors and is best known as a treatment for women with breast cancer. It is used by athletes to mask the effects of anabolic steroids, especially gynecomastia, or production of breast tissue in men.

By far the two biggies above are Turinabol and Stanozolol. Turinabol was invented in the former East Germany (GDR) – no big shock there. It’s chemical name is variably known as dehydrochloromethyltestosterone, or chlorodehydromethyltestosterone. It is a derivative of testosterone, the male anabolic-androgenic steroid, which has been modified by attachment of a hydroxyl group (-OH), a choride ion (-Cl), and a methyl group (-CH3) to the basic sterol molecule. Turinabol was the main drug used the East German state-sponsored doping program, as later revealed by the release of documents from the Stasi, or East German secret police.

Stanozolol is another anabolic-androgenic steroid created by modifying the testosterone molecule by the addition of a hydroxyl group and three methyl groups. Stanozolol was best known by bodybuilders and other strength athletes as Winstrol, and was the drug that caused Ben Johnson to have a positive doping test after the 1988 Seoul Olympics 100 metre final.

It should be noted that despite many rumors about poor drug testing programs in Kenya and Ethiopia, which could benefit their outstanding distance runners, there were no positive re-tests from either of those nations. Now, it should be noted that those athletes would be most likely to use EPO, and tests for that are difficult, and involve checking for reticulocytes (a type of immature red blood cell) in the blood. After 4 or 8 years, it’s not certain how valid that test would be.

One question many people have is how many medals will be lost and who will they go to? The second part of that is difficult to answer and we’ll address it in a bit. In all, 52 medals have been lost because of the re-testing – 14 golds, 18 silvers, 20 bronzes. The most affected athlete is Kazakh weightlifter Ilya Ilyin, who loses gold medals from both 2008 and 2012. In this case, weightlifting is much more affected than athletics, losing 35 medals (8 golds, 7 silvers, 18 bronzes) to athletics’ 17.

Here are the nations most affected in terms of medals lost:

So who will these medals go to. Sorry, can’t help you there yet, at least not officially. The way that medals are redistributed is Byzantine and complex. First, the International Federations (IFs) are responsible for changing results, not the IOCs. But it is the IOC that re-distributes medals, so we often have to wait for word from both the IF and the IOC. It is not always as easy as moving up the next placed athlete to a medal position, although that is the most common scenario. But the IOC has left medal positions empty in the past, going as far back as 1972. Further, not every athlete who competes is drug tested, so for the famous example from weightlifting where the 9th-place finisher (Tomasz Zielinski [POL]) in the 2012 94 kg class could move up to bronze medal position, was Zielinski even subjected to drug testing? We don’t know as that is not always released.

These athletes did break the rules and this certainly looks terrible, but it’s important to remember one thing about this. The IOC tries to catch the drug cheats, more so than in most professional sports, notably in the four major pro sports in the United States (although baseball has gotten much better in recent years). Further, the WADA penalties are far more punitive than those in US professional sports, notably the NFL where a positive drug test costs you 4 games, or ¼th of a season, versus 2 years or more in Olympic sports. It is easy to criticize the IOC for this plethora of positive tests, but one should also note that they took the trouble to do the re-testing, something we will almost never see from the NFL or most professional sports.

The game goes on. The athletes will often look for an advantage, or “The Edge,” and the drug testers will continue to try to catch them. This is certainly far from the last we will hear on this problem.

Guest post: Are Funding Opportunities in Anti-doping Restricting Knowledge and Debate?

This is a guest post by Paul Dimeo, University of Stirling.

Those of us who work in Universities are faced with the on-going challenges of attracting research funding, publishing, and demonstrating that our research has impact outside of academia. Which in some ways makes a lot of sense; public funds should be utilised in purposeful ways. There is little point in entrenching ourselves in esoteric debates only of interest to a handful of like-minded colleagues. There are many challenging social issues that research might help to address.

However, there is long-recognised risk that we lose sight of the many attributes of independent research and thinking. Chomsky articulated these as: ‘fostering creative and independent thought and inquiry, challenging perceived beliefs, exploring new horizons and forgetting external constraints.’ He even argued that the extent to which these are ‘realized is a good measure of the level of civilization achieved.’

Pursuing external funding is an expectation now, but it might come with certain costs; the result of meeting the aims of the funder, which may well contradict the orthodox aims of open-minded, objective inquiry.

The scope and scale of research into anti-doping has dramatically increased over the past 20 years, coinciding with the creation of the World Anti-Doping Agency in 1999. Ostensibly, we are in a fruitful period where policy and research have a potentially beneficial relationship. WADA, the IOC, and other organisations like The Partnership for Clean Competition (PCC), have dedicated research funding schemes offering scholars the opportunity for attracting much-needed resource, publishing findings and impacting upon policies that have lofty ambitions: clean sport, health and the ethical virtues inherent in fair play.

Anti-doping research: using funding to shape knowledge

Any scientist hoping to work in this field needs to relate their research to the purpose of anti-doping.

The PCC defines their objectives as:

‘Every day, the PCC acts to protect the integrity of sport and public health by engaging and supporting the world’s top scientists and innovators in high-quality anti-doping research and development. The PCC also facilitates adoption of these methods into the WADA-accredited laboratories. We aspire to help generate the world’s most influential, effective and coveted methods and resources for detecting and deterring the use of performance enhancing substances by all athletes in all sports at all levels. Through this work, we demonstrate the value of science, collaboration and innovation related to doping control in sport and ensure the benefits of sport participation.’ 

They provide annual funding of over $2m.

WADA are another significant funder of scientific research; since it was formed, it has committed $65m to finding the best scientific solutions to anti-doping problems. Much like the PCC, the aim is to develop ‘new and improved detection methods for prohibited substances and methods.’

As an indication of the growing relationship between WADA and the scientific community, its President has been fund-raising from international organisations and developed a stronger relationship with the IOC. Last year, it was announced that the IOC would contribute $10m, and WADA had secured pledges of $6.45m.

The IOC describe their aims as: ‘The priority is then innovative and novel research in all areas of anti-doping, which have the potential to lead to a significant change in the way anti-doping programmes are carried out and will have a direct impact on the daily life of the clean athlete.’
By prescribing the type of research they will fund, these organisations have structured the global environment for research.

Important research outside this remit

It may be understandable that a large, wealthy organisation seeks supporting evidence to enhance its own goals. In this instance, those goals are supported by Governments, sports organisations, athletes (in the main), and the watching public. However, behind the image of clean sport lies a lot of potentially interesting and valuable issues for which scientists would struggle to get funding.

For example, research on the nature of the drugs that are banned: do they enhance performance?; are they a risk to health, and at what specific dosage levels? That sort of information might lead to a reconsideration of the Prohibited List, which is not in the interests of the PCC, WADA or IOC.

Critical work that looks at potential flaws in the current system would not get funded. There have been concerns expressed by independent researchers about false positives, false negatives, sanctions based on competing interpretation of laboratory data, and the efficacy of the Athlete Biological Passport (the longitudinal blood profiling method that does not detect drug use, but instead highlights changes to blood values).

In the social sciences, it is hard to get funding for projects that critically assess the policy as defined by the World Anti-Doping Code. That is not within the interests of any anti-doping agency. Arguably, important and strong projects could be funded by other agencies, such as those interested in public health. This would be a high risk strategy given the competitive nature of health funding, and without the support of sports organisations would look light on potential impact. Yet there is a need to understand the negative consequences of anti-doping.

By offering lucrative but narrowly defined opportunities, anti-doping funders draw talented and committed researchers towards a specific policy goal, distracting them from more critical or broader approaches. This risks the loss of objectivity, creativity, cross-disciplinary learning, and innovation. If research is driven by policy aims then it can only work in the interests of reinforcing the nature of that policy. Critics are outside of the system, marginalised and under-funded. This sucks the life out of the debate on the ethics of anti-doping, as there are very few opportunities for meaningful engagement between policy leaders and ‘detached’ academics.

Talk on Wednesday at CU Athletics on Prostheses & Olympics

Do leg prostheses provide an advantage or disadvantage to Paralympic athletes?

Professor Alena Grabowski
Integrative Physiology Department
CU Boulder

Wednesday, November 16, 2:30
CU Athletics
Champions Center Auditorium, 3rd floor

Abstract: Running-specific leg prostheses (RSPs) are comprised of carbon-fiber, designed to emulate the spring-like function of tendons during level-ground steady-speed running, and allow considerable elastic energy return; however, unlike biological legs, passive-elastic RSPs cannot generate mechanical power anew, vary stiffness, nor allow foot-ground clearance during the swing phase. The international association of athletics federations has banned the use of RSPs in non-amputee track and field competitions. Thus, understanding how use of RSPs affects performance is paramount to decisions of inclusion or exclusion in sport. I will present a series of studies that assess the biomechanical and metabolic effects of using RSPs during running, sprinting and jumping to determine if use of such prostheses augment or impair performance for athletes with leg amputations.