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Interview with Doping Hunter Professor Frank Delbeke
By Staff
Date: 4/20/2005
Interview with Doping Hunter Professor Frank Delbeke

Professional doping hunter Professor Frank Delbeke receives us in his brand new office in the Zwijnaarde Technology Park. Rows of colourful cycling hats attached to the wall betray a love for the sport, and in the hallway certificates of the World Doping Agency (WADA) and the Flemish Government decorate the walls. Delbekeís DoCoLab [Doping Control Laboratory associated with Ghent University, Belgium] is one of the 31 internationally recognized doping labs. Last year it analyzed 5470 samples, of which 240, or 4.4%, turned out to be positive.

Doping usage, Delbeke knows, isnít diminishing. In the next hour and a half professor Delbeke talks fast and passionately about his trade. Since his lab started testing for EPO in urine samples eight months ago, five professional sportsmen tested positive: 4 cyclists and 1 triathlete. But he also says that cycling doesnít deserve itís stigma of a ďdoper-sportĒ. ďNot over here anyway. Weíve got around 4-5% of positives in cycling here, but other sports score much worse: 20% in boxing, 7% in basketball, 20 to 30% in bodybuilding and weightlifting.Ē

Sport Magazine: Is it just general perception then that there are so many doping cases in cycling?

Frank Delbeke: Well, there are two reasons for the growing number of positives: the fact that weíve started testing outside of competition, and the Flemish Governmentís policy to test during the week. Before it was only done during weekends. Most athletes Ė Iím not just talking about cyclists here - know damn well how long a doping product remains traceable. For an average dose of EPO that period is 3-4 days after injection, while its maximum effect is some 8 to10 days later. So we canít find anything if theyíre checked between the third and the tenth day.

Athletes used to know when to stop: you were safe for a race on Sunday if you didnít inject EPO any later than Wednesday. But thanks to the new regulations we can test them on a Wednesday and catch them, which was the case with Filip Meirhaghe. Same thing with Dave Bruylandts: after the GP Pino Cerami he had to deliver a urine sample, and he probably figured ĎIím safe, why would they want to test me two days in a row?í Next morning we were at his door. He probably injected it himself that morning, or the night before.

SM: Bruylandts always claimed that EPO came into his body through a food supplement.

Delbeke: That was a bit silly. For one, EPO has to be kept in a fridge. And there are only two ways to take it: subcutaneous - beneath the skin - or intravenous, in your veins. The latter is supposed to make any traces disappear quicker. I know that Bruylandts had been warned before by the UCI. Theyíve been keeping files with the blood values of riders for some 5 years now. So if they see a rider shoot from 41 to 48 all at once they know somethingís up. Itís people like that who can expect unexpected visits.

SM: What are considered normal fluctuations in hematocrit level and what arenít?

Delbeke: Your hematrocit level will invariably drop if you perform heavy physical feats. You canít start the Tour with a hematocrit level of 45 and finish it at 45. Thatís how they caught Rumsas: his hematocrit actually rose during the Tour. And apart from that, a rise from 41 to 48 in a few weeksí time is abnormal too.

SM: But canít you achieve a similar effect with an oxygen tent or elevation training?

Delbeke: Yeah, an oxygen tent can do that. I consider it to be doping too, because itís raising your hematocrit level artificially too. But you canít do it with high elevation training, no way. Simply because you canít train 5 hours a day at great heights. But you can sleep in your low pressure chamber every night.

SM: How often do you have to use EPO to enhance your performance?

Delbeke: There are rumours about athletes who Ďvanishí for a while - which is impossible for cyclists these days, by the way. All professional cyclists have to list their staying addresses during the season. But anyway: they go abroad and when theyíre there they take their big Ďshotí, so that they reach 47-48. After that they only have to take smaller doses to sustain their hematocrit level. EPO is hard to trace as it is, and thereís been little testing with such small doses. Most of the tests are done on kidney and cancer-patients, people who are administered large quantities of EPO. So I donít have a clear view on those micro-doses. Itís possible that we canít find them, at all.

SM: In his book Willy Voet wrote that they quickly used infusions with liquids before doping controls to lower hematocrit levels. Is it possible to hide the use of EPO that way?

Delbeke: Such an infusion can influence the blood values that are being tested before the race starts, in the morning. Riders used to have half an hour to present themselves for a control, these days itís a mere ten minutes. So youíd have to be really quick with such an infusion. But up until a few years ago I saw riders at doping controls that were still dripping blood. Theyíd been recently injected with a needle, probably to administer a plasma-thinner to lower their blood values.

But those methods donít have anything to do with tracing EPO in urine samples. Itís impossible to mask an average dose of EPO in the first three days after injection. Unless you can thin your urine. Thatís what I saw at the Tour two years ago, as an observer for the UCI. In one particular team none of the riders managed to provide a urine sample for an hour and a half after the race. They couldnít, so they had to drink a lot. All of them from the same team, very strange. But coincidence? Probably not. Because there are two ways to thin your urine: either you take diuretics, but those are on the list, or you drink litres of water. A watery urine makes it harder for us. A few riders of that team tested positive later on, but youíll understand that I canít name the team.

SM: That must be Euskaltel or Phonak.

Delbeke: Maybe.

SM: To what extent do you think that the teams are aware of their ridersí doping use?

Delbeke: Iím almost certain that there used to be Ďmedical guidanceí within the teams in the past. But I donít think that the top teams can afford to do that anymore these days, and that itís happening behind the backs of the team doctors.

SM: On the other hand: a lot of teams constantly keep their ridersí hematocrit levels in check.

Delbeke: Thatís right. When we bought the machine that we use to check hematorcrit levels here, the representative of the manufacturer told us: Ďthis is a great system, because that team recently bought it tooí. That machine cost 10,000 dollars when we bought it. Now, you donít even need a big machine like that, a smaller centrifuge will do. I know of a few riders that own one. Thatís controlled doping, eh. The teams hide behind the fact that the doctors need such a machine to check if their riders are healthy or not, but they know very well that the chance of getting tested at a big race is very high, so they test everyone the evening before the race: everyone clean?

SM: But even if the riders prepare on their own; their medical supervisors canít not be in the loop.

Delbeke: I think theyíre just trying to make the best of it, and try to keep everything within the realm of the acceptable.

SM: But they know it happens.

Delbeke: (sighs deeply) Yeah, if someoneís hematocrit suddenly reaches 47 when it was 41 three weeks ago...undertrained, maybe? Of course, team doctors must administer some substances, like minerals, during the Tour to compensate after a major physical performance, but not EPO. In the days of doctor Rijckaert [Note: Festina team doctor in 98í] people said that they had to give EPO because the ridersí hematocrit levels dropped dramatically after such performances. But our body can handle that, you know. When weíre lacking oxygen our kidneys send a signal to our bone marrow that extra red blood cells need to be produced, through the messenger that is EPO. In the Tour people used to claim for years too that they needed to give extra testosterone to the riders, because they were suffering so much. Of course your testosterone level will drop after three weeks of riding like crazy, but your body will handle that. And if it canít, youíre sick and need to stay in bed, itís as simple as that.

SM: So itís stupid to say that youíre better off using EPO in a big mountain stage?

Delbeke: It will probably be easier, but saying that itís healthier is bullshit.

SM: Is EPO by definition unhealthy? Why not just give EPO until you reach the limit of 50?

Delbeke: Iím a chemist and not a doctor, but you canít forget that that 50 is an arbitrary value. It doesnít mean that everything below 50 is automatically healthy. A person thatís naturally at 38 and uses EPO until heís at 45 is being unhealthy too. Because thereís that limit some people say: just dose me up until Iím at 49.

SM: Are you surprised that thereís still a lot of EPO being used? A while ago it seemed like it wasnít used that much anymore.

Delbeke: There was a period in which they mostly used Aranesp. Aranesp is a different kind of EPO that, so to speak, is three times as effective because it stays in your body 3 times as long. So you donít have to inject it every two days. But we can detect it so easily now that itís not used anymore. Besides, Aranesp costs a lot of money. The five positives we had at this lab were all EPO, not Aranesp.

The net around EPO is tightening ever more, which is why theyíre going back to blood doping, like what they did at Phonak for example. A method from the 1970ís which I never believed theyíd use again: injecting someone elseís blood. On the other hand, itís just as effective as EPO. An average person has around 5 litres of blood, so you add 10% of red blood cells with one transfusion of an extra half litre. There are two ways of doing this: either you take some of your own blood and inject it again six weeks later, or you use someone elseís compatible blood. And why donít athletes use their own blood most of the time? Because itís not recommended to drain half a litre of blood during a training period, and because itís very hard to conserve it properly. Itís a lot more practical to use someone elseís blood.

SM: But where do they get that blood then?

Delbeke: At a regular blood bank, I suppose. It has to be relatively fresh.

SM: Your lab has just been given a grant by the department of sports to teach a blood doping test. How does it work?

Delbeke: Blood cells have certain antigens, like the blood group and the Rhesus factor. With these tests we look at 12 other antigens. The thing about those antigens is: you either have them or you donít. You score a 100 or 0. But if you donít have a particular antigen and you receive blood from a donor who does have it, your score will be around 10. Which means that you got 10% of your blood from someone else. The chance that youíre given blood that scores exactly alike on all of the antigens is 1 out of 500.†

With this method you can detect blood doping for 3-4 weeks if someone has been given one bag of half a litre of blood. Coincidentally thatís also the time between the Olympics and the Vuelta. At the Olympics they couldnít make a b-analysis for Tyler Hamilton, we donít know what exactly went wrong there. So he was free to go, but three weeks later they did an extra test during the Vuelta. The strange blood was still in his body, and he hung.

SM: Hamilton is fighting the validity of the test now. How frustrating is that for you?

Delbeke: As an athlete youíve got three choices when youíve been caught for using doping: denial, denial and denial. In the past - and Iím talking about the classic doping analysis now, not the EPO tests - people tried to blame the labs, until they realized that the evidence was foolproof during court cases. After that they tried to find procedural mistakes during tests, during transport of the samples, etc. And now theyíre blaming the labs again. They already tried to take down the EPO test before at the TAS, with Bo Hamburgerís and Urs Meierís case in 2000. They failed. A couple of Russian athletes tried to do the same with the Aranesp test during the Olympic winter games of Salt Lake City, and they failed as well. There are judicial precedents now, I donít think that they have any ground anymore to claim that the tests arenít working.

SM: Youíve been involved in doping research for 30 years now. How did you see the use of doping evolve during all those years?

Delbeke: In terms of products: it went from amphetamines to anabolic steroids, and then they switched to products natural to the body: first testosterone instead of anabolic steroids, then oxygen-enhancing products such as EPO. And then thereís Human Growth Hormone (HGH). But of course, our methods have advanced dramatically as well over the years. In the days of amphetamines we could detect micrograms per millilitre, by now weíre about a 1000 times more precise. For anabolic steroids weíre at a nanogram per millilitre, weíre even below that for corticosteroids. To give you an idea what a nanogram per millilitre is: thatís one particle that can be spotted in one billion particles of urine. A colleague of mine once compared it to tracking down one person in the entire population of India. That evolution is necessary, especially for anabolic steroids. Athletes are using more and more cocktails: very small amounts of anabolic steroids that are very hard to detect, but when you take them as a cocktail they have the same effect.

SM: What effects do all these doping products have on an athleteís body?

Delbeke: Amphetamines make your mental alarm bell ring much later when youíre tired, which is why theyíre so dangerous. And itís addictive. Anabolic steroids and testosterone grow muscles, but the side effects are liver tumors, cardiac issues, dependence and aggressiveness. EPO enhances the transport of oxygen to the muscles. If you use too much EPO your blood Ďthickensí and at a given moment your heart wonít be able to handle it anymore. And growth hormones grow everything that can grow, including muscles.

SM: Do you have the feeling that athletes are taking more and more risks; that itís getting more dangerous?

Delbeke: Genetic doping is only a few steps away, eh. For clarityís sake: all those doping products are medicines that are being abused. Amphetamines were used to slim, anabolic steroids were given to grow back some muscle tissue after heavy surgery, EPO is for kidney patients and HGH is for little people. There hasnít been one product yet that was made for the sole purpose of doping, with the exception of a sort of horse growth hormones that was put on the market in Australia.

SM: How fast can genetic doping become reality?

Delbeke: Within less than 10 years. Genetic doping will be an exponent of the gene therapy thatís used to fight cancer. Recently there were some tests with genetically altered material that burns fat and turns it into muscle tissue. Researches developed a mouse that could run twice as long as a normal one that way. Theyíre also working on a gene therapy that makes you produce more natural EPO, itís bound to be abused once the research is finished. Fortunately, the EPO produced that way is different from the one thatís made in our kidneys, so weíll be able to trace it easily. But as far as, for example, growth hormones are concerned: youíd need to take a biopsy for that. But which athlete would allow you to take a piece of their flesh?

For a long time I thought that genetic doping was a distant reality. There were indications that itíd be a dangerous procedure, one of which we donít know the side effects yet. We never thought athletes would meddle with it, but at a symposium in Utrecht last year I heard that a lot of these products are ready to be used as doping.

SM: About the dangers of doping: a few years ago at the Giro they caught Dario Frigo with NSR 13, an experimental medicine.

Delbeke: Yeah, that was a bitter joke: it turned out that guy paid a whole lot of money for ordinary water. The mafia was behind that and it wasnít NSR 13, there wasnít anything it. But NSR 13 indeed was a medicine for cancer therapy in an experimental phase. That was the silly idea that some cyclists had: Lance Armstrong beat cancer, the stuff they use to treat cancer must be good. Itís absurd.

SM: NSR 13 was said to be potentially lethal.

Delbeke: Iím not sure about NSR 13, but I do know that at they used a product to enhance oxygen transport in the peloton during a certain period. Perfluorochemicals or PFCís, a sort of liquid Teflon that binds oxygen very easily. That product did have one drawback: you had to administer oxygen while you took it. A few years ago some riders experimented with it in the Tour, but when one of them almost stayed in it, terror struck the peloton and they stopped using it.

SM: Are you ever still surprised?

Delbeke: (thinks for a while) No. People keep going further and further. Where it will end? It wonít, thereís too much money involved. Plus; there are enough athletes who think that Olympic gold is worth their life.

Source: Sport Magazine Cycling Season Special, translation by Jan Janssens.

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