The importance of investigating Peter Bol's atypical finding for recombinant EPO

Even small amounts of synthetic EPO can aid sporting performance through higher haemoglobin levels in the blood which result in more oxygen going to the cells to enable them to operate more effectively.

In 2015, Mark Daly, a BBC Scotland Investigations Correspondent and a non-elite endurance athlete, by taking 2-3 micro-dose injections of EPO per week, improved his power output on a bike test in seven weeks from 350 watts for about 10-and-a-half minutes to 375 watts for 12 minutes. https://www.bbc.com/news/uk-scotland-32983932

Despite 14 weekly samples taken over 14 weeks, Daly did not elicit an adverse analytical finding via the Athlete Biological Passport.

A Runners World article (20 February 2013) also noted a study (The Pitsiladis study funded by WADA) which found that ten experienced runners improved their 3000m time by an average 6 per cent after four weeks of every-other-day injections from 10:12 before EPO to 9:40 and were still running 9:53 four weeks later with no additional EPO injections.

The simple truth is that detecting synthetic EPO through microdosing remains difficult, despite approved tests for EPO since the Sydney 2000 Olympic Games through various urine, blood and the more recent Athlete Biological Passport (since 2009) which seeks to establish normal or baseline haematological (blood) values from a number of tests to establish natural upper and lower limits for each individual.

However, while, the deputy director of the Athlete Biological Passport at WADA (Dr Reid Aikin) acknowledged at an anti-doping symposium (October 2022) that eliminating the microdosing of EPO was proving difficult, he did note that cheating with EPO was getting harder.

Aikin argued that populations where the passport had been implemented for a long period of time has indicated less use, and that the use of microdosing to avoid passport scrutiny was at least leading athletes to reduce their dose which minimised the benefit.

His observations were supported by anti-doping organizations now having the ability and authority to test the athletes 24 hours seven days a week, thus ending the limited testing window that was from 6am to 10pm.

While a new testing technique for EPO proposes to focus on genetic expressions to prove that EPO has been used, thus avoiding the need for urine and/or blood analysis, for now every case that involves synthetic EPO in urine and/or blood is crucial in terms of the need to investigate.

With reports that Peter Bol had a minor positive for EPO in 2021, although a second laboratory test deemed the same A sample also to be negative, it will be interesting to see what the investigation concludes via a WADA-accredited laboratory with regard to Peter Bol's recent test.

Only then will Sport Integrity Australia proceed to consider whether any anti-doping rule violation has been committed.