Ask Vest Christiansen, Aarhus University & John Gleaves, California State University
From time to time a good colleague of Ask has suggested that the time he spends on the bike equals wasted time. It could have been spent more productively reading books and writing articles (or even better: writing books). In academia it can be hard to counter such arguments. It doesn’t sound completely valid to say something like: “You know, I prefer the feeling of wind in my face while sitting on my bike with the firm knowledge of having a hobby that can easily take the surplus of money I should have, rather than sitting at my desk and bringing knowledge to the world and merit to my institution.” But having spent time in Southern California, not only researching and teaching together with John Gleaves, but also riding bikes, it has become clearer how such a hobby can bring new insights and opportunities for research and knowledge.
On the Saturday morning ride with the local bike club Ask happened to be riding next to a fellow rider, John McKinley, same age as him. After hearing that Ask is from Odense, Denmark he replied that he rode there in 1988 when the junior world championships was held in that city. He also explained that he stopped his career as a cyclist in the early 1990s partly because he didn’t have the talent, partly because he was repelled by the use of primarily amphetamines he experienced in European Kermesse races where there was no testing. The freaky coincidence of riding next to someone in Southern California who had not only been in Odense of all places, but also experienced the mad town races in Holland and Belgium was interesting enough. But there was more. John’s brother Scott was a much bigger talent and had had a short professional career, riding one year with the 7-Eleven Team and the next with its renamed Motorola team before quitting the European cycling and returning to compete as a professional in the US for an additional three years. At one point in 1993, he teamed up with a notorious Italian rider who had come to the US after some drug problems in Italy. The Italian took Scott to Ferrara, Italy, and introduced him to Michele Ferrari to do a fitness test. After the test Ferrari told him that he had talent, and that by changing his training programme Scott could improve his performance by 10%. But, the doctor continued in a matter of fact way, if he included a medical programme on top of that he could improve his performance by 30%! Like his brother, Scott did not like the idea of submitting to a medical programme and had consequently already accepted to quit European cycling. So he kindly turned Ferrari’s offer down.
In itself the story doesn’t bring much new knowledge about neither the use of drugs in cycling in the early 1990s nor Michele Ferrari’s role in this. Scott McKinley had his encounter with Ferrari the year before Gewiss-Ballan dominated many races and famously shattered everyone and took all three podium spots at the Flèche-Wallonne race. It was also the year before the notorious interview in L’Equipe where Ferrari said that “EPO isn’t dangerous. It’s the abuse that is. It’s also dangerous to drink ten litres of orange juice”.[1] But even if, the story as such brings nothing new, it adds some flesh and blood (excuse the pun) to hear the story from someone that close to it – and to hear it while riding a bike. When Ferrari gave the interview to L’Equipe, Scott McKinley had quit the European scene and had no quarrels in telling about his experience on an internet-blog some years later. The blog was later picked up by David Walsh and reprinted in From Lance to Landis (2007; 54-56).
We have also had opportunity to ride with John’s colleague and training partner Matt Englar-Carlson. He went to college with another cyclist, Caleb Banta-Green, who is now a drug epidemiologist at the University of Washington. The four of us met at a research symposium on California State University, Fullerton in mid-February, focussing on drug prevention in sport. While Banta-Green hasn’t studied doping, he has looked intensively into the use of recreational drugs such as heroin, marihuana, cocaine and also so-called study drugs – performance enhancers for the competition in society at large. And he has spent a lot of time speculating on how to deal with the problem of achieving reliable prevalence data – a problem that has riddled doping research for decades as well. Like athletes, drug users do not want to be identified and they do not want to reply to surveys. So it is not easy to find out how many of them there actually are. Having accurate numbers is necessary in order to understand the scope of the problem. That is well known. But such numbers are equally important if we want to measure the impact and efficiency of the prevention strategies or educational campaigns that are launched. Survey data has several major weaknesses. Not only are surveys expensive, but because of the social stigma of drug use there is a significant response bias connected with them. It does not take a professor’s IQ to quickly figure out how to manipulate them. Other indirect indicators of drug use such as the disclosure of trafficking or ‘consequence’ data such as emergency department visits, drug treatment admissions, or fatal overdoses also have their weaknesses. Banta-Green was grappling with these severe data limitations for several years, when he became aware of potential to use sewage water for his analyses. Metabolites of drug use show up in sewage water and waste water plants already routinely collect samples of their inflow for their own regulatory and quality control purposes. These samples are typically collected over a 24-hour period, and automated equipment is used to generate a sample that is representative of the entire day. Bingo! Here was the data source. Reliable, cheap samples of waste water covering large populations could be used to determine drug use in a much more precise manner than previously. And apparently it works: “We have demonstrated the validity of data collected from 96 cities in [the state of] Oregon for discerning rural and urban patterns of drug use, using the geographic and spatial data that is available in wastewater. The total population served by the 96 participating treatment plants was 2,478,168 approximately 65% of the state’s population.” The researcher analysed the sewage water in Oregon for methamphetamine and cocaine. They found that the spatial data for cocaine “were significantly different across different types of community. Larger loads were significantly more likely to occur in more urban areas. In contrast, methamphetamine was present at quantifiable concentrations in raw influent from every treatment plant location, urban or rural” (Banta‐Green and Field, 2011). Also, they could identify differences between weekdays and weekends, and the impact of visitors on popular tourist sites. On another occasion the group studied the use of so-called study-drugs (Adderall and Ritalin) on four student dorms in connection with a college campus, and found that while the use was rather constant throughout the academic year, there were clear spikes of especially Adderall during exam-periods, particularly during the final week of the second semester (Burgard et al., 2013b).
While the analytical methodology is very sensitive, there are obviously also some limitations. Some compounds of relevant drugs are difficult to detect, some may metabolises too quickly in the body and in sewage water (EPO for instance got a very short half-life), and some are consumed at such low levels that they cannot be detected (See for example Banta‐Green and Field, 2011; Burgard et al., 2013a; for a more thorough discussion). But at the same time it is obvious that the method could be applied to a sport context as well. There are no unsurmountable technical obstacles involved in taking samples from waste water from for example the Olympic Village at the Olympic Games or a rider hotel at the Tour de France. Such places are connected to the waste water system by usually just one pipe. Estimates of drug use that would come out of this would of course involve the whole population staying in the village or the hotel respectively and not just the athletes (but if one favours the health argument in the anti-doping debate it might be beneficial to know what trainers and other officials are doing as well). On the other hand the quantifiable measure of athletes’ (and their entourage’s) drug excretion that this would result in would not constitute a threat to individual privacy and it would not be impacted by self-report bias.
As Banta-Green and Jennifer Field state: “Wastewater drug testing is a potent new tool that supports drug epidemiology with a direct measure of drug use for a potentially far broader and more representative proportion of the population than has been possible up to now” (Banta‐Green and Field, 2011). Interesting stuff!
So, even if one cannot write or read when riding a bike, the activity is not a complete waste. It can open up new ways to insights, new approaches to research, and bring you in contact with people you did know would be relevant to meet before you met them. Adding to this, the fact that you get to explore new places, meet new people, feel the wind in the face, and the benefit of many trips to the bike shop shows that carving out a time for recreation in between articles and lectures is a worthwhile endeavour.
References
Banta‐Green, C. & Field, J. 2011. City‐wide drug testing using municipal wastewater. Significance, 8, 70-74.
Burgard, D. A., Banta-Green, C. & Field, J. A. 2013a. Working upstream: How far can you go with sewage-based drug epidemiology? Environmental science & technology.
Burgard, D. A., Fuller, R., Becker, B., Ferrell, R. & Dinglasan-Panlilio, M. J. 2013b. Potential trends in Attention Deficit Hyperactivity Disorder (ADHD) drug use on a college campus: wastewater analysis of amphetamine and ritalinic acid. Sci Total Environ, 450-451, 242-9.
Walsh, D. 2007. From Lance to Landis: inside the American doping controversy at the Tour de France, Random House LLC.
[1] Since then Ferrari has several times drawn attention to the fact that the quote was taken out of its context and exaggerated. What Ferrari was guilty of, and which gave him a dismissal notice from Gewiss-Ballan the day after the interview, was simply to paraphrase Paracelsus’ (1493-1541) dictum that “All things are poison, and nothing is without poison; only the dose permits something not to be poisonous” ("Alle Ding' sind Gift, und nichts ohn' Gift; allein die Dosis macht, daß ein Ding kein Gift ist."), quoted from http://en.wikipedia.org/wiki/Paracelsus