As with any athletic event focusing on the extremes of human exercise performance, the Winter Olympics have allowed the ugly head of cheating in sport to rise again. Recently, police raided the Austrian ski teams residences in Torino on suspicion of blood doping to improve athletic performance. What is blood doping anyway and how does it improve athletic performance? This article provides some basic information on blood doping, explains the mechanisms for its ability to greatly improve exercise performance and provides pros and cons for its use.

Doping in sports

Although the word hints at a relationship, doping actually has nothing to do with "dope" (the street word for marijuana). If this were the case, it may be that snowboarders would be under investigation instead of skiers!

Doping for exercise performance improvement refers specifically to "blood doping" - a means of cheating by artificially boosting red blood cell counts.

The doping procedure works like this:

A doctor draws up to 4 units (about 4 pints) of blood from the athlete's body - essentially making him/her anemic (low blood cell count)

The withdrawn blood is then centrifuged (spun very quickly) to separate the red blood cells (RBCs) from the other main component of blood plasma.

The athletes RBCs are "stored" under refrigerated conditions (the shelf life of RBCs is about 40 days)

The anemic condition stimulates the athlete's body to increase production and release of a hormone called EPO (erythropoietin)

EPO stimulates the replenishing of the "lost" RBCs

The athlete is given about 4 weeks to fully replenish their RBC count to pre-drawing levels

The athletes stored RBCs are then re-infused into the athletes body, boosting the RBC level higher

Why do athletes participate in blood doping and what is the logic behind it?

Quite simply - blood doping can quite significantly improve performance in long duration, endurance-type exercise such as cross-country skiing, skating and running.

The logic for its use it to boost the oxygen carrying capacity of the blood above normal levels providing more oxygen to the working muscles - allowing for a greater power output and a decreased susceptibility to fatigue.

RBCs contain a protein called hemoglobin the primary transporter of oxygen from the lungs to the rest of the body including the working muscles. So if you boost the number of RBCs you also boost the amount of available hemoglobin to bind and deliver oxygen.

The pros to blood doping use:

It is highly effective and is estimated to improve endurance exercise performance at the elite level by about 4%

It boosts VO2 max (maximal oxygen uptake) and reduces lactate buildup

The ergogenic (exercise performance boosting) effect with blood doping is immediate, making it ideal for a pre-main event performance - making pre-event detection more difficult

It may be easier to regulate hematocrit (percent composition RBCs of total blood volume) a tightly regulated ceiling is placed on this value and is used for detection of both blood doping (and EPO use)

It probably decreases the perception of effort during exercise allowing for improved performance

The cons to blood doping use:

The blood doping process is quite laborious and quite severely decreases the training capacity of the athlete in the first few weeks after blood donation as the athlete is essentially anemic and cannot exercise as hard.

1. Health risks

With the increase in hematocrit the heart needs to work much harder to pump the higher viscosity blood - increasing the risk of overload damage to the heart such as myocardial infarct (heart attack)

There is an increased risk of developing life-threatening blood clots (stroke, heart attack, lung clot)

Blood doping involves transfusion using needles and sometimes donor blood, so there is a greater risk of infections such as hepatitis A and B and even AIDS

Since the athletes RBCs are externally stored, there is a greater risk to the athlete if this has been done incorrectly (e.g. storage at the incorrect temperature, tampering, confusion/mislabeling)

2. Status risks

Detection of the use of blood doping may defile the athletes reputation

Detection may result in him or her being banned from competition, as sport regulating agencies such as the IOC and several cycling governing bodies strictly forbid it.

Actually, blood doping in sports has become less popular recently due to the increased availability of recombinant erythropoietin (rEPO) which as explained in an article on this website produces exactly the same effect as blood doping but is easier, less riskier and more effective (boosts endurance performance by about 6%).

In conclusion, this article has shown that although blood doping and rEPO may quite significantly boost endurance exercise performance, it carries with it risks to the athletes health and status. It is unfortunate, but with increases in modern technology and molecular biology, it is likely that even these forms of cheating will someday be replaced with safer and less detectable methods.