Saturday, August 27, 2005

Accused of EPO doping by the French cycling daily L’Équipe in a four page story on Aug. 23, cyclist Lance Armstrong appeared on CNN’s Larry King Live TV show Aug. 25, saying he did not trust the French testers or the French testing system, and that his urine was manipulated to falsely accuse him of doping.

Dr. Christiane Ayotte, director of a Montreal doping detection laboratory said that ethically critical and important scientific questions were raised by the EPO doping allegation against seven-time Tour de France winner Armstrong.

USA Cycling official Gerard Bisceglia said these L’Équipe charges were unfair and lacked credibility. Bisceglia is chief executive of USA Cycling, principal authority over Armstrong for cycling sports in the United States.

L’Équipe released Paris lab data allegedly finding banned EPO in five year old samples of Armstrong’s urine, originally taken after he won the 1999 Tour de France. No official source would confirm medical identification of Armstrong as provider of the anonymously tested urine, and to do so would be a violation of World Anti-doping Agency (WADA) regulations.

Armstrong suggested motivation for such manipulation is a French national hatred of all non-French sport winners, and specifically because a French rider has not won the Tour de France for a quarter century. As evidence of malice toward him, Armstrong cited a French newspaper poll in which he was named the third most hated sportsman in France.

Dr. Ayotte is Doping Control director at Canada’s Institut National de la Recherché Scientifique in Montreal, which is a WADA certified lab nearest to WADA’s Montreal headquarters. Ayotte is also a world class scientific authority and instructor on sports doping detection. Dr. Ayotte’s expert opinion has significant influence on the outcome of WADA regulatory decisions.

L’Équipe reported that the EPO detection method used was experimental, which raises a scientific question. All experimentally based forensic evidence is subject to the close scrutiny of scientific opinions before it can be used in a disciplinary or legal proceeding.

Ayotte expressed surprise that chemical testing of 1999 urine could have been done in 2004 at the French national anti-doping laboratory at Châtenay-Malabry. She said that she routinely instructs all doping laboratory organizations, that previously detectable EPO protein deteriorates and disappears after two or three months, even if the urine is frozen.

Ayotte thinks that a new statistical mathematics model was used to reanalyze numerical data resulting from earlier chemical testing. “My interpretation is that retesting itself must have been conducted in 2000 or in 2001, but the results were reviewed using the new mathematical model that is now being developed in Paris.”

Ayotte does not question whether the new type of analysis is correct; rather she questions the ethics of long-delayed test results.

The first ethical problem is that this adverse finding cannot be confirmed with second samples. There are normally available two urine samples, “A” and “B”. The Châtenay-Malabry EPO findings were based on Armstrong’s “B” samples. Armstrong’s “A” samples were depleted in 1999 for tests that did not include EPO, because no EPO test was available that year.

Without addressing the ethics problem, Dick Pound, the head of WADA, said. “You can count on the fingers of one hand the times a “B” sample has not confirmed the result of the “A” sample”.

Both France and USA officials observed that L’Équipe’s unofficial adverse finding was not consistent with WADA regulations. French Sports Minister Jean-François Lamour said that without the “A” samples, no disciplinary action could be taken against Armstrong. USA official Bisceglia confirmed that WADA regulations require a confirming “A” test to prove guilt.

The second ethical problem, according to Ayotte, is that an athlete charged with doping long after the athletic event, has no way to submit to additional testing to disprove an adverse finding. This same ethical problem was also stated by USA official Bisceglia.

The third ethical problem for Ayotte is that L’Équipe disclosed Armstrong’s medical identity. “It seems to me,” Ayotte continued, “that this whole thing is breach of the WADA code. We are supposed to work confidentially until such time that we can confirm a result. By no means does this mean that we sweep a result under the carpet, but it has to meet a certain set of requirements.”

In a further ethical complication, the medical identification of Armstrong is completely unofficial and is made only by L’Équipe. Ayotte characterized the disclosure as “leaked”.

Châtenay-Malabry’s lab refused to confirm L’Équipe’s claim that the urine samples belonged to Armstrong. Nor is it likely that Châtenay-Malabry will ever identify Armstrong, because WADA regulations require that all single “B” samples used for experimental testing must remain permanently anonymous. Ayotte said, “I’m worried, because I have a great deal of respect for my colleagues in Paris. I am concerned that they did not cover their backs before being dragged into a very public issue of this kind.”

Lance Armstrong has responded on his LanceArmstrong.com website, branding L’Équipe’s reporting as being “nothing short of tabloid journalism.” Armstrong says: “I will simply restate what I have said many times: I have never taken performance enhancing drugs.”

Further confusing public understanding of the EPO doping claim is Armstrong’s statement in his autobiography, It’s Not About the Bike: he said he received EPO during his cancer chemotherapy treatment. “It was the only thing that kept me alive,” he wrote.

Armstrong last received chemotherapy EPO in late 1996. Apparently speaking from his knowledge of conventional EPO testing, Armstrong agrees that traces of 1996 synthetic EPO should not have been present in his 1999 urine. There are now tests to distinguish natural from synthetic EPO. But it remains an unresearched scientific question whether the sensitivity of the experimental new method could detect use of synthetic EPO from three years previously. By scientific analogy, the polymerase chain reaction process can detect as little as a single molecule of DNA.

Jean-Marie Leblanc, the director of the Tour de France, said that Armstrong owes cycling fans an explanation. Armstrong subsequently provided an explanation claiming urine test manipulation.

Leblanc also said; “For the first time—and these are no longer rumors, or insinuations, these are proven scientific facts—someone has shown me that in 1999, Armstrong had a banned substance called EPO in his body.”

“When people start using comments like, ‘irrefutable scientific evidence,’ that’s a pretty strong statement to make,” said Bisceglia, “when the person you’re making it about has never been given the opportunity to refute the statement. You’re making claims about something that took place in 1999. Based on what I’ve read, it’s pretty clear that any opportunity to have a black-and-white resolution to this case has been destroyed.”

Bisceglia said that USA Cycling, the governing body in the United States, lacks the officially required evidence, and therefore will not investigate the L’Équipe report.