An ICEARS member will present their work at the European College of Sports Science Annual Congress, 9-12 July 2008:
Haematological profiles of elite east African athletes over a nine year period. Ojiambo, R., Mohammad, Y., Fudge, B., Kingsmore, D., Parisotto, R., Magnus, L., Pitsiladis, Y.
The World Anti-Doping Agency (WADA) is currently considering use of abnormal blood profiles that can reflect blood manipulation and therefore an anti-doping rule violation. However, chronic altitude exposure also has the potential to influence indirect indices of blood doping. While most Kenyan and Ethiopian athletes live and train in their native east African regions, they must frequently travel to lower altitudes for competitions. There is therefore an urgent need to consider the natural changes in erythropoietic indices from altitude exposure in an attempt to differentiate these responses from blood doping.
Methods: 649 blood profiles collected between 1999 and 2007 from 289 (192 males, 97 females) elite athletes from east Africa were screened using the transversal (2nd generation, n=289; [1]) and longitudinal (3rd generation, n=33; [2]) approaches to erythropoietin (EPO) screening in athletes. Blood indices were compared at altitude and at sea level. Seasonal variations in haematological parameters and urinary test results for EPO were also considered.
Results: Mean haematological indices of elite east African athletes were within published cut-off thresholds for indirect blood markers of doping. The blood profiles of all athletes varied considerably over time (coefficient of variation for haemoglobin, Hb CV: 0.2-11.7%, haematocrit, Hct CV: 2.0-13.9%, Reticulocytes CV: 9.4-74.9%, and OFF-hr CV 3.8-36.5%) and attained peak levels with altitude exposure; peak Hb (range: 170-191 g/L), peak Hct (range: 49-63%). During the assessment period, the Hb cut-off of 170 g/L for males and 160 g/L for females was exceeded at least once (range: 1-4) by 14.2% (n=41) of athletes at altitude, whereas 4.2% (n=12) of athletes exceed the Hb cut-off at sea level. At altitude, 11.1% (n=32) of athletes exceeded the Hct cut-off of 50% for males and 47% for females on at least one occasion compared to 3.5% (n=10) of athletes at sea level. 1.4% (n=4) of athletes exceeded the OFF-hr cut-off of 133 for males and 123 for females at altitude (OFF-hr range: 129-143). No athlete exceeded the OFF-hr cut-off threshold at sea level. For reticulocytes, 4.2% (n=12) of athletes exceeded the > 2.0% cut-off at altitude and 2.1% (n=6) of athletes at sea level. 51.5% (n=33) of the athletes exceed the 1 in 50 cut-off threshold for OFF-hrz scores and Hb z scores and would therefore be deemed “suspicious”. During the study period, 180 urine samples were analysed for EPO with 1 positive test for a female athlete.
Conclusions: A significant number of elite east African athletes tested had substantially elevated haematological parameters and considerable fluctuations from historical baseline values reflecting numerous confounding factors such as ethnicity and altitude exposure.
References 1. Gore et al. Second-generation blood tests to detect erythropoietin abuse by athletes. Haematologica. 2003; 88(3):333-44. 2. Sharpe et al. A third generation approach to detect erythropoietin abuse in athletes. Haematologica. 2006; 91(3):356-63.
