Orienteers first with EPO

[The Loofa]

Found this in the Independent today

http://sport.independent.co.uk/general/ ... 798462.ece

You'll find the O reference about halfway through. They seem dead sure orienteers took EPO

So going on to google "orienteering EPO" I found this

http://www.scottish-orienteering.org/in ... be-a-dope/

which at least is written from within our sport and says "many experts now believe that this may have been due to EPO."

and also this

http://www.iht.com/articles/2004/02/21/edwheat_ed3_.php

which is written by the same guy who did the Indie article - in fact its the same article, 3.5 years earlier with some minor changes in word order
("mixture of cross-country running and walking" indeed - off with his head!!)

I knew of those orienteers dying in Sweden, but had never heard of a reason, certainly not for it being EPO related.

Any more expert knowledge out there?

Andy

[mharky]

http://www.nopesport.com/forum/viewtopic.php?t=8149

Blood doping was discovered by a Swedísh scientist.

[graeme]

I dont think it was ever properly explained, orienteering stopped for a while, then resumed as normal when media attention span had passed. Blood doping and/or EPO were floated at the time consistent with the symptoms, but there were no confessions or positive tests. Some form of new tick-borne disease was also feared, but that now seems disproven *. The numbers involved was very small (maybe 3-4 elites + some probably unrelated older guys), so the possibility of it being a statistical fluke can't be ruled out.

* Similarly with Bartonella (see below). Infection rates haven't changed, training efforts haven't changed, so to accept this hypothesis one should average the 4-5 deaths over 20 years - statistically negligible.

The only credible explanations are:

1/ It was triggered by something (e.g. EPO) which has now stopped.

2/ It was a statistical blip with no cause.

[Neil M35]

Between 1979 and 1992, 16 Swedish elite orienteers under the age of 35 died from Sudden Unexpected Cardiac Death (SUCD). 12 of these were found to have Myocarditis (inflammation and degeneration of the heart muscle). Of those 12, 4 were found to have symptoms of Arrythmogenic right ventricular cardiomyopathy (ARVC) – fatty infiltration of the heart muscle which can cause electrical disturbances and rhythm problems in the heart.

What caused the Myocarditis and ARVC is open to question. The numbers of deaths from these diseases are about 30 times higher than would be expected in the general population (but as Graeme says the sample size is very small). ARVC is generally considered to be a congenital disease, and is though to affect between 1 in 3000 and 1 in 10000 of the general population, but in most cases does not progress sufficiently to ever cause the sufferer any problems. High volume endurance training appears to greatly increase the chances of the disease progressing.

Studies in Sweden have linked Bartonella infection to the development of Myocarditis and a possible link to ARVC. Swedish orienteers have a very high rate of Bartonella infection when compared to the general population. This recent paper (I think it is someones phd) gives a fairly comprehensive summary. ( page 47)

http://www.diva-portal.org/diva/getDocu ... lltext.pdf

So most of the orienteers had heart muscle diseases which probably caused their deaths, and there is no suggestion of a connection between EPO and heart muscle diseases. Of course there are still 4 unexplained deaths, and there is a concentration towards the late eighties/early nineties.

Anyway, I suspect a bit of journalistic speculation which has propagated itself. Google the phrase “nocturnal heart attacks” and you end up with multiple versions of the same story – and virtually nothing else. For it to appear capitalised in the Scottish O story is a bit suspicious, especially as I am fairly sure that at least one of the deaths happened to someone out running at the time, which would be consistent with ARVC, and not very Nocturnal. (unless he was night orienteering).

Neil Conway

[Kitch]

Geoffrey Wheatcroft - Distinguished Tour historian
Clearly, however, utterly ignorant of other sports.
arse

[Neil M35]

* Similarly with Bartonella (see below). Infection rates haven't changed, training efforts haven't changed, so to accept this hypothesis one should average the 4-5 deaths over 20 years - statistically negligible.

The only credible explanations are:

1/ It was triggered by something (e.g. EPO) which has now stopped.

2/ It was a statistical blip with no cause.

Agreed that the Bartonella explanation has holes in it, but the Swedish microbiologists are still sticking with it. Possibly the preventative measures taken in 92/93 had an effect (although it appears to have been a bit of a stab in the dark), and we don't know how many cases there have been since then that have not resulted in deaths - perhaps detection is more likely now. Certainly much more is known about ARVC now than 15 years ago.

As for credible explanation (1) - the something is very unlikely to be EPO in the myocarditis cases. In fact, EPO has been shown to have a beneficial effect in the treatment of myocarditis. (if you believe what you can find on the internet).

Perhaps explanation (2) is still the most likely.

None of which has any bearing on whether or not orienteers have ever taken EPO, but I think the much-repeated Geoffrey Wheatcroft allegation is questionable.

[greywolf]

only gosssip of course, but IIRC the suggestion at the time was less to do with EPO and more that the deaths were a result of low tech "blood-boosting" - taking out a few units, freezing the plasma, and then sticking it back in again after a couple of months...

obviously a risky procedure if you miscalculate and stick too much plasma back in...(and even more risky if, like the 1984 US olympic cycling team, you use blood from someone else and they have hep...)

[Kitch]

Its not questionable
its not just unfounded speculation.
it is unfounded and ignorant speculation.

a pure assumption made on ther basis that a number of people died of a cuase that is only common at the broadest and highest level of definition i.e. Heart failure.

If Wheatcroft bothered with the facts (as above) then he would find that most of the deaths relate to a variety of specific cardiac pathologies which are not known to be indicative of either blood doping or use of EPO.


Another point
Work backwards from the result:

Blood thickened to the point where the heart is unable to pump it round the body, causing heart failure.

Increase of red blood cell count is the the cause of blood thickening.

There are 3 ways of increasing red blood cell count.
The original and natural method is altitude training, considered safe as it is a nutural process and therefore better controlled by the bodies regulatory feedback mechanisms to prevent a potentially lethal situation - (thoough presubaly risk of heart failur is raised, but not dangerously)

The first artificial method was blood doping.
Here you take a measure of your own blood (eg 500ml) and store it away. You allow your body to restore your red blood cell count to normal levels naturally. You then take your stored blood an inject it back into yourself which raises the blood cell count (by approx 12% per 500ml added).

The second artificial method is the use of erythropoetin, EPO. EPO is the natural hormone that stimulates production of red blood cells. EPO was first synthesised towards the end of the 80s . Take a dose of EPO and your body will simply produce more red cells, increasing their in the blood. This endocrinological manipulation is unnatural and will tend to override the natural balance mechanisms that would prevent a dangerously high concentration of red blood cells.

The problem in Sweden came to light in 1994.
Altitude training was a recognised form of performance enhancement well before 1994. In international orienteering there was no use of altitude training.
At the risk of defaming people Geoffrey Wheatcroft style... I believe blood doping originated in Finnish cross country skiing, moving from there into cycling - people died. Blood doping surfaced in the 80s.
If this method was availale and there were orienteers mided to use artificial performance enhancing techniques - why no evidence, why no deaths in this period ?

Why suddenly in a sport where there was and still is no consistent use of altitude training and no earlier evidence of blood doping would you suddenly assume that a bunch of athletes would plump for EPO.

Its worth noting that the majority of these athletes were not at international level.
And that raised another thought.
I bet if you did the stats you would find the rate of deaths in orienteering is actually massively high in relation Blood Doping / EPO deaths across sport.

One of the factors in Swedish orienteering was that a couple of deaths of young athletes triggered a search for a cause and a search for evidence. This ended up identifying earlier deaths and pulling them into the statistical pool, and as per Neil's comments these were not all from the same pathologies - so in fact the stats were inflated.

[greywolf]

...I believe blood doping originated in Finnish cross country skiing, moving from there into cycling - people died. Blood doping surfaced in the 80s....

think it was earlier than that - Lasse Viren was widely accused (don't remember much in the way of evidence...) of blood doping in the early/mid 70s, (don't think it was made illegal until the mid-80s).

...but doesn't change the fact that the "couple of tragedies/search for cause/expansion of statistical pool (+ lazy, ignorant journalist a decade later)" has to be a strong favourite amongst explanations