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Olympic Preview

An Update on Drug Testing

Drug testing has always generated headlines and controversy at Olympic competitions. Two notable developments are likely to keep doping in the headlines long after the closing ceremony: (1) an ongoing criminal investigation in the United States involving a company that supplied tetrahydrogestrinone (THG) to several world-class athletes and (2) the rumored validation and adoption of a long-awaited test for recombinant human growth hormone (HGH).

THG Alters Olympic Lineups

The fallout from the scandal involving THG, a new synthetic anabolic steroid, has cast a long shadow on preparations for the Summer Olympic Games in Athens. The existence of the previously undetectable steroid was exposed by a track coach who identified Bay Area Laboratory Cooperative (BALCO) as the source of the steroid.

Positive tests for THG among elite athletes thus far appear to be limited primarily to some athletes in track and field events. The International Olympic Committee (IOC) announced in January that it retested samples collected during the 2002 Olympic Winter Games in Salt Lake City and found no positive results. International federations that govern swimming, rowing, track and field, and tennis also retested samples from previous competitions and also found no THG-positives.

According to the United States Anti-Doping Agency (USADA), five US track and field athletes have already been suspended from competition because they tested positive for THG. USADA has notified other track and field athletes that they may have violated sport antidoping rules based not on lab results but on evidence obtained from the ongoing BALCO investigation. (One athlete has already accepted a suspension based on the BALCO evidence.) According to published reports, some who received notifications from USADA failed to qualify for the US Olympic team, while another withdrew because of injuries. Marion Jones, who is reported to be under investigation but has not been charged, qualified to compete in the long jump.

Charles Yesalis, MPH, ScD, professor of health and human development at The Pennsylvania State University in University Park, predicts that there will be more scandals involving modified steroids such as THG. He says in the 25 years that he's tracked ergogenic drug use in athletes, THG is the fifth "designer steroid" that he's seen. "For us not to assume that there will be a 6th, 7th, or 28th, we'd be negligent," he says.

A Test for HGH?

In other drug testing developments, the IOC has said that it will not announce whether or not it will test for HGH during the Athens games. (See "Human Growth Hormone Ramps Up Protein Metabolism," page 11.) Antidoping advocates have long anticipated a test for HGH.

In April, USADA hosted an international conference on HGH testing in Dallas. In a statement released after the conference, Larry Bowers, PhD, USADA senior manager and director for technical information resources, said that several tests are in development and are at different stages of completion. "All of the tests will use blood for measurement as opposed to the traditional use of urine in doping control," Bowers said, adding: "There will be collection of blood for the Athens Olympic Games." If a test is not adopted in time for the Olympics, blood samples can be tested at a later date.

The IOC has made it a practice to clearly post the drugs that are prohibited, but not to disclose the substances that it will test for. "The same was the case for darbepoietin when it was detected in the EPO [erythropoietin] assay to the surprise of some competitors at the 2002 Olympic Winter Games," he said, noting that growth hormone is a prohibited substance, and athletes should not be taking it. "If they choose to do so, they risk being sanctioned," Bowers said.

Prohibited-List Modifications

The World Anti-Doping Agency, the independent international doping group, instituted several modifications to the 2004 prohibited list that will cover the Summer Olympic Games. Notable changes include:

  • A list of all substances that are prohibited, rather than separate groupings of classifications and examples;
  • Cannabinoids and glucocorticosteroids are now listed as substances prohibited in competition for all sports (some sports did not prohibit them during noncompetition times); and
  • Changing the definition of the word "analogue" to cover new designer steroids such as THG. The previous definition of analogues and mimetics was found to be inappropriately restrictive.

Lisa Schnirring

Medical Team Heads to Athens

The official physicians and athletic trainers for the United States athletes in the 2004 Summer Olympic Summer Games in Athens, Greece in August are: David Weinstein, MD, an orthopedic surgeon in Colorado Springs, who will serve as head team physician; Brett Altman, ATC, Newton, Iowa, triathlon and shooting; Gloria Beim, MD, orthopedic surgery, Gunnison, Colorado, cycling and tae kwon do; Aaron Brock, ATC, Downers Grove, Illinois, water polo; Tammy Brockman, ATC, Palm Harbor, Florida, diving; Sheldon Burns, MD, emergency medicine and family practice, Minneapolis, basketball; Vincent Comiskey, ATC, Bonita, California, canoe and kayak; David Craig, ATC, Indianapolis, basketball; Daniel Dodson, ATC, Edmond, Oklahoma, wrestling; Larry Drum, MD, internal medicine, Seal Beach, California, water polo; Robert Frederick, MD, orthopedic surgery, Villanova, Pennsylvania, gymnastics; Sandra Glasson, MD, orthopedic surgery, Virginia Beach, Virginia, soccer; Jo Hannafin, MD, orthopedic surgery, Greenwich, Connecticut, rowing; Emery Hill, ATC, Colorado Springs, volleyball; Marc Jaffee, DC, Basking Ridge, New Jersey, all sports; Donald Kessler, ATC, North Brunswick, New Jersey, rowing; Kathleen Koehler, ATC, Windsor, Colorado, wrestling; David Kuhn, ATC, Fort Wayne, Indiana, swimming; Gary Lang, ATC, Tracy, California, track and field; Elicia Leal, ATC, McKinney, Texas, water polo; Gina Maggio, ATC, San Diego, canoe and kayak; Nick Metskas, ATC, Colorado Springs, volleyball; James Montgomery, MD, orthopedic surgery, Dallas, Texas, headquarters operations; Allison Noggle, ATC, Coronado, California, softball; Julie O'Connell, PT, ATC, Chicago, Illinois, soccer; Steve Paulseth, ATC, Encino, California, beach volleyball; Adam Pecina, ATC, Winston-Salem, North Carolina, tennis; Chrissy Price, ATC, Seattle, basketball; Don Rackey, ATC, Gilbert, Arizona, gymnastics; Jack Ransone, ATC, Wimberley, Texas, track and field; Jasper Richardson, ATC, River Ridge, Louisiana, judo and tae kwon do; Ted Robbins, ATC, New Lenox, Illinois, weight lifting; Scott Rodeo, MD, orthopedic surgery, New York City, swimming and diving; Robert Rodriguez, ATC, Colorado Springs, table tennis and wrestling; Ed Ryan, ATC, Colorado Springs, medical director, archery, badminton; Lonnie Sellers, ATC, Snohomish, Washington, fencing; Steve Simons, MD, family practice, Granger, Indiana, track and field; Casey Smith, ATC, Chandler, Arizona, boxing; Debbie Van Horn, ATC, Colorado Springs, gymnastics; Wendy Veatch, ATC, Westminster, Colorado, swimming; and Scott Weiss, ATC, Long Beach, New York, sailing.

Field Notes

Torch Run Heralds Weight Loss Victory

Few sports medicine physicians have the opportunity to treat Olympic athletes. Many, however, encounter patients whose goals are different, yet intensely ambitious, such as a sedentary person who is on the road to fitness or an overweight patient who is slimming down to achieve a healthy physique.

Dianne Gustafson, a Minneapolis woman, is one such example. This summer, the story of how she successfully achieved her exercise and weight loss goals earned her a spot on the Olympic torch relay team as it passed through St Louis. Gustafson, a 38-year-old staffing specialist at a Minneapolis hospital, was selected to participate based on a short essay about her weight loss that she submitted to a contest hosted by Samsung, one of the torch event corporate sponsors.

She says that a sense of personal responsibility for her health was what inspired her to become active and lose weight. Gustafson remembers that before she decided to lose weight, her personal physician told her that she'd be healthier and feel better if she lost weight, but never framed it as a life-and-death situation.

Gustafson says she joined weight loss programs offered at her workplace, which included on-site Weight Watchers meetings. She also began exercising at a Curves studio. Aside from mild knee and thigh pain when she started running, she experienced no injuries as she became more active.

Some of the keys that she attributes to her success are the camaraderie and support she got in her workplace, diet group meetings, and exercise studio. She also knows that maintaining exercise and a healthful diet aren't always easy. Gustafson exercises almost every day for 30 to 45 minutes and varies her activity by walking, running, and working out at a health club.

Feeling healthier and having clothes fit better are rewards that will last long after her 15 minutes of fame with the Olympic torch. "I just hope someone will look at me and say, 'If she can do it, so can I'—because you can," Gustafson says.