Blood Tests and Fair Competition: The Biathlon Experience

Abstract

In recent years, some international sports federations have introduced blood testing procedures that can lead to suspension from competition for athletes whose haematologic values exceed certain established limits. In 1994 the International Biathlon Union initiated a three-phase blood testing program to safeguard athletes' health and ensure fair competition. The first phase, lasting three years, was aimed at measuring the haematocrit values of biathletes in order to determine statistically acceptable limits for participation in competition. The second phase, lasting four years, consisted of pre-race testing for an increasing number of athletes and suspension from competition for those whose haematocrit values exceeded 52 % for males and 48 % for females. The results of this second phase (third phase now in progress) are reported. Progressive increases have been made in the numbers of countries examined, athletes tested, and tests performed. This retrospective study reveals a reassuring trend in average values for haematocrit and haemoglobin in the entire study population, a minimal number of athletes with excessive values and a consequent low risk of false positive results, an acceptable incidence of relatively high values (50 % for males and 45 % for females), and constant non-elevated haematological profiles for elite athletes. The variability in individual haematocrit levels among all biathletes with a minimum of four observations during the four-year period is also evaluated and discussed.

Haematocrit - blood tests - competition - biathlon - antidoping

References

• 1 Birkeland K I, Donike M, Ljungqvist A, Fagerhol M, Jensen J, Hemmersbach P, Oftebro H, Haug E. Blood sampling in doping control. First experiences from regular testing in athletics.  Int J Sports Med. 1997;  18 8-12
• 2 Browne A, Lachance V, Pipe A. The ethics of blood testing as an element of doping control in sport.  Med Sci Sports Exerc. 1999;  31 497-501
• 3 Duguè B, Leppanen E, Grasbeck R. Packed-cell volume in athletes.  Lancet. 1998;  352 1387-1388
• 4 Fairbanks V F, Tefferi A. Normal ranges for packed cell volume and hemoglobin concentration in adults: relevants to ‘apparent polycythemia”.  Eur J Haematol. 2000;  65 285-296
• 5 Kujala U M, Peltonen J E, Elovainio R O. Hemoglobin and packed-cell volume in endurance athletes prior to rhEPO.  Int J Sports Med. 2000;  21 228-230
• 6 Maes M, Scharpe S, Cooreman W, Wauters A, Neels H, Verkerk R, De Meyer F, D'Hondt P, Peeters D, Cosyns P. Components of biological, including seasonal, variation in hematological measurements and plasma fibrinogen concentrations in normal humans.  Experientia. 1995;  51 141-149
• 7 Manfredini F, Manfredini R, Carrabre J E, Litmanen H, Zhukovskaja L, Dal Follo D, Haberstroh J. Competition load and stress in sports: a preliminary study in Biathlon.  Int J Sports Med. 2002;  23 1-5
• 8 Manfredini F, Tschukin A, Moran M, Mangolini C, Buzzoni D, Haberstroh J. Blood testing in Biathlon: observation of hematocrit values during competitive periods 1994-97.  Int J Sports Med. 1999;  20 403-406
• 9 Marx J J, Vergouwen P C. Packed-cell volume in elite athletes.  Lancet. 1998;  352 451
• 10 Mujika I, Padilla S, Geyssant A, Chatard J C. Hematological responses to training and taper in competitive swimmers: relationships with performance.  Arch Physiol Biochem. 1998;  105 379-385
• 11 Schmidt W, Biermann B, Winchenbach P, Lison S, Böning D. How valid is the determination of hematocrit values to detect blood manipulations?.  Int J Sports Med. 2000;  21 133-138
• 12 Schumacher Y O, Grathwohl D, Barturen J M, Wollenweber M, Heinrich L, Schmid A, Huber G, Keul J. Haemoglobin, haematocrit and red blood cell indices in elite cyclists. Are the control values for blood testing valid?.  Int J Sports Med. 2000;  21 380-385
• 13 Sebastian-Gambaro M A, Liron-Hernandez F J, Fuentes-Arderiu X. Intra- and inter-individual biological variability data bank.  Eur J Clin Chem Clin Biochem. 1998;  36 131-132
• 14 Shepley B, MacDougall J D, Cipriano N, Sutton J R, Tarnopolsky M A, Coates G. Physiological effects of tapering in highly trained athletes.  J Appl Physiol. 1992;  72 706-711
• 15 Tikkanen H O. Packed-cell volume and haemoglobin in elite athletes.  Lancet. 1999;  353 327-328
• 16 Vergouwen P CJ, Collèe T, Marx J JM. Haematocrit in elite athletes.  Int J Sports Med. 1999;  20 538-541
• 17 Videman T, Forsythe K. The ethics of not testing in athletic competition.  Med Sci Sports Exerc. 2000;  32 1361-1362
• 18 Videman T, Lereim I, Hemmingsson P, Turner M S, Rousseau-Bianchi M P, Jenoure P, Raas E, Schonhuber H, Rusko H, Stray-Gundersen J. Changes in hemoglobin values in cross-country skiers from 1987 - 1999.  Scand J Med Sci Sports. 2000;  10 98-102