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. Delbeke’s 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, isn’t 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 doesn’t deserve it’s stigma of a “doper-sport”. “Not over here anyway. We’ve 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.”

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 we’ve started testing outside of competition, and the Flemish Government’s policy to test during the week. Before it was only done during weekends. Most athletes – I’m 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 can’t find anything if they’re 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 didn’t 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 ‘I’m safe, why would they want to test me two days in a row?’ 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. They’ve 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 something’s up. It’s people like that who can expect unexpected visits.

SM: What are considered normal fluctuations in hematocrit level and what aren’t?

Delbeke: Your hematrocit level will invariably drop if you perform heavy physical feats. You can’t start the Tour with a hematocrit level of 45 and finish it at 45. That’s how they caught Rumsas: his hematocrit actually rose during the Tour. And apart from that, a rise from 41 to 48 in a few weeks’ time is abnormal too.

SM: But can’t 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 it’s raising your hematocrit level artificially too. But you can’t do it with high elevation training, no way. Simply because you can’t 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 ‘vanish’ 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 they’re there they take their big ‘shot’, 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 there’s 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 don’t have a clear view on those micro-doses. It’s possible that we can’t 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 it’s a mere ten minutes. So you’d 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. They’d been recently injected with a needle, probably to administer a plasma-thinner to lower their blood values.

But those methods don’t have anything to do with tracing EPO in urine samples. It’s impossible to mask an average dose of EPO in the first three days after injection. Unless you can thin your urine. That’s 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 couldn’t, 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 you’ll understand that I can’t 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 riders’ doping use?

Delbeke: I’m almost certain that there used to be ‘medical guidance’ within the teams in the past. But I don’t think that the top teams can afford to do that anymore these days, and that it’s happening behind the backs of the team doctors.

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

Delbeke: That’s right. When we bought the machine that we use to check hematorcrit levels here, the representative of the manufacturer told us: ‘this is a great system, because that team recently bought it too’. That machine cost 10,000 dollars when we bought it. Now, you don’t even need a big machine like that, a smaller centrifuge will do. I know of a few riders that own one. That’s 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 can’t not be in the loop.

Delbeke: I think they’re 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 someone’s 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 98’] people said that they had to give EPO because the riders’ hematocrit levels dropped dramatically after such performances. But our body can handle that, you know. When we’re 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 can’t, you’re sick and need to stay in bed, it’s as simple as that.

SM: So it’s stupid to say that you’re better off using EPO in a big mountain stage?

Delbeke: It will probably be easier, but saying that it’s healthier is bullshit.

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

Delbeke: I’m a chemist and not a doctor, but you can’t forget that that 50 is an arbitrary value. It doesn’t mean that everything below 50 is automatically healthy. A person that’s naturally at 38 and uses EPO until he’s at 45 is being unhealthy too. Because there’s that limit some people say: just dose me up until I’m at 49.

SM: Are you surprised that there’s still a lot of EPO being used? A while ago it seemed like it wasn’t 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 don’t have to inject it every two days. But we can detect it so easily now that it’s 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 they’re going back to blood doping, like what they did at Phonak for example. A method from the 1970’s which I never believed they’d use again: injecting someone else’s blood. On the other hand, it’s 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 else’s compatible blood. And why don’t athletes use their own blood most of the time? Because it’s not recommended to drain half a litre of blood during a training period, and because it’s very hard to conserve it properly. It’s a lot more practical to use someone else’s 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 don’t. You score a 100 or 0. But if you don’t 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 you’re 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 that’s also the time between the Olympics and the Vuelta. At the Olympics they couldn’t make a b-analysis for Tyler Hamilton, we don’t 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 you’ve got three choices when you’ve been caught for using doping: denial, denial and denial. In the past - and I’m 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 they’re blaming the labs again. They already tried to take down the EPO test before at the TAS, with Bo Hamburger’s and Urs Meier’s 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 don’t think that they have any ground anymore to claim that the tests aren’t working.

SM: You’ve 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 there’s 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 we’re about a 1000 times more precise. For anabolic steroids we’re at a nanogram per millilitre, we’re even below that for corticosteroids. To give you an idea what a nanogram per millilitre is: that’s 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 athlete’s body?

Delbeke: Amphetamines make your mental alarm bell ring much later when you’re tired, which is why they’re so dangerous. And it’s 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 ‘thickens’ and at a given moment your heart won’t 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 it’s getting more dangerous?

Delbeke: Genetic doping is only a few steps away, eh. For clarity’s 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 hasn’t 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 that’s 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. They’re also working on a gene therapy that makes you produce more natural EPO, it’s bound to be abused once the research is finished. Fortunately, the EPO produced that way is different from the one that’s made in our kidneys, so we’ll be able to trace it easily. But as far as, for example, growth hormones are concerned: you’d 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 it’d be a dangerous procedure, one of which we don’t 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 wasn’t NSR 13, there wasn’t 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. It’s absurd.

SM: NSR 13 was said to be potentially lethal.

Delbeke: I’m 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 PFC’s, 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 won’t, there’s 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.