How world class athletes can take drugs… and get away with it
Eight of the most explosively gifted sprinters in the world are settling into their blocks on the start line of the 100m final at a major championship. The tension is almost unbearable; the rewards for success are huge.
To the spectators in the stadium and millions of fans watching on TV around the world, it is a spectacle without equal in sport.
But what very few of them will even suspect is that it is statistically likely that at least one of those runners will have a genetic make-up allowing him to take performance-enhancing steroids for his entire career — and never fail a drug test.
Science fiction? Far from it.
Now imagine the starting blocks of a swimming final at a significant international event in Asia — the 2014 Asian Games in Incheon, South Korea, for example.
It is quite feasible that half of the athletes about to dive into the water — perhaps as many as six out of eight depending on whether they are Chinese, Japanese, Korean or from another background — also have bodies that naturally allow them to take drugs but not get caught.
Astonishing though it sounds, significant numbers of sportsmen and women are born to dope, and get away with it. The proportion ranges from around one in 10 of those with European ancestry to one in five with African heritage, and up to a staggering two-thirds of people in some Asian countries, notably Korea.
These shocking statistics, largely unknown to followers of sport, go part of the way to explaining the vast difference between the numbers of elite athletes who are taking banned performance-enhancing drugs and the numbers being caught.
The most common type of drug test globally analyses urine to compare levels of testosterone (T) and another hormone, epitestosterone (E) to give a T/E ratio. This test can signify the use of all kinds of illegal drugs, including anabolic agents, which are the most commonly found drugs in dopers, 50 per cent of positive drug tests being for steroids — or artificial testosterone.
When the T/E ratio exceeds four to one, it signifies possible doping. But people who have the ‘doping with impunity’ gene variant — carriers have two copies of a particular version of a gene called UGT2B17 — do not return positive tests, even if they have been doping.
The gene variant keeps the T/E level low, naturally. That means huge swathes of the population have a licence to dope.
Christiane Ayotte, a veteran in the fight against doping, says this is both shocking and frustrating because tests exist which could catch more drug cheats — including those whose genetic make-up enables them to dope with impunity — but these tests are not used by all anti-doping organisations or national sports federations.
Ayotte said last week: ‘I am sure many people will be shocked by the fact that sportsmen and women can be doping under the radar.
‘It would not be scientific to guess how many of all the tests in the world are still simple urine screening tests, which allow those with this gene to pass tests, but it remains the most common testing procedure.
‘That is frustrating because it would not be so difficult to introduce other layers of testing, not just the T/E ratio, to catch people. But too many [anti-doping] organisations and federations don’t do it. We need to change this.’
Ayotte has served in the past as the International Olympic Committee’s overseer of doping laboratories, has worked on the medical commission of athletics’ world governing body, the IAAF, and runs a laboratory accredited by the World Anti-Doping Agency (WADA) in Canada.
Official figures on global testing in sport in 2012, collated by WADA, show that anabolic agents — steroids to you and me — remain the most commonly found illegal drug in the cheats’ armoury.
More than half of all positive tests in the world in 2012, or 50.6 per cent, were positive for anabolic agents, which placed them way ahead of the next most common category of banned drug, stimulants, which were responsible for 15.5 per cent of failed tests.
Steroids may seem ‘old school’ but even some of the most high-profile cases of recent times have involved them, including the positive test just a few weeks ago of American’s former world 100m champion, Tyson Gay.
He was caught because the testing used on his sample was a more advanced test, known as a carbon isotype test. These are not ‘standard’ and are typically used when a T/E ratio test has already flagged up a problem. An athlete with the ‘lucky’ gene make-up would not fail a T/E test in the first place and so would not expect to be subjected to more advanced testing.
A landmark Swedish study found that the ‘doping with impunity’ gene variant occurs in 66.7 per cent of Asian populations and almost 10 per cent of Caucasians. That study, partially funded by WADA, recommended that ascertaining every individual’s gene make-up would help to close the loophole open to those born to dope.
But such additional profiling of athletes would be expensive, and possibly controversial among those who would regard it as a further invasion of privacy, and does not happen.
As the umbrella body that encourage national doping agencies and governing bodies to do more testing and more complex testing, WADA face an uphill task. Wholesale changes in the WADA code, to be updated by 2015, will address this, as part of a wide range of new ‘smart’ testing.
A WADA spokesman says: ‘The idea behind this better practice [from 2015] is that, at present, some anti-doping organisations do minimal or no testing for the prohibited substances or prohibited methods which are performance-enhancing in particular sports.’
Another study into the ‘doping with impunity gene’, which looked at football players and was published in the British Journal of Sports Medicine (BJSM), found that up to 81 per cent of some Asian populations had the ‘impunity’ gene variant, although this varied between countries.
Around 30-40 per cent of Japanese and Chinese have the gene, and almost double that in Korea.
The BJSM work found the levels to be 10 per cent in Caucasians and seven per cent in Hispanic populations.
The BJSM, like the Swedish scientists, also recommended that athletes should have an ‘endocrinological passport’ to prevent them exploiting the gene loophole. Ayotte echoes this, saying: ‘The best way forward would be to have subject base profiles.’
She explained that much like the biological passports increasingly common in sports like cycling, where an athlete’s blood is monitored over years, base profiles would flag up individual’s genetics that could be relevant.
David Epstein, an American is an expert on genetics in sport and the author of The Sports Gene, published in America earlier this month and in Britain this week. His fascinating book delves into various ways that genetics influence sporting ability.
‘If we really wanted to be technologically savvy about drug-testing, we’d have to have genetically personalised testing,’ he told The Mail on Sunday. ‘And if I were an athlete bent on cheating, and I was aware of that gene, I would certainly get tested for it [to confirm an advantage on the testers].
‘If I were doing the drug testing, I would want to do carbon isotope ratio testing on everyone, to get around this problem and look straight for synthetic testosterone, but that test is costly and laborious and is infrequently done.’
It is impossible to know how many athletes are doping but passing tests because they have the ‘impunity’ gene. But certainly official WADA statistics show that certain major accredited labs in some Asian countries are returning many fewer negatives than counterparts elsewhere.
Of 267,000 drugs tests conducted globally last year, 1.19 per cent had ‘adverse’ findings — or were positive — with a further 0.57 per cent ‘atypical’ and needing further investigation.
Rates of adverse findings were broadly in line with this at London’s major laboratory (0.74 per cent adverse findings), and in Sydney (0.76 per cent), Paris (1.97 per cent) and Stockholm (0.14 per cent). But the corresponding numbers in Tokyo were 0.16 per cent, and 0.34 per cent in Beijing and 0.48 per cent in Seoul.
It is impossible to know how many athletes are doping but passing tests because they have the ‘impunity’ gene. It may just be coincidental that laboratories in the regions where the gene is most common are finding fewer cheats. Or it may not…