More Contador

[Note up front, this one is a long one. Hang in there, or read it as time permits.]

A few days into the “Contador Scandal” and there’s a whole lotta shakin’ goin’ on. Theories on how the clenbuterol detected in a sample given by Alberto Contador during the second rest day of the 2010 Tour de France abound. It was the beef. Or maybe he received a transfusion of blood, taken when he had been using clenbuterol during his preparation for the race. Or maybe a supplement he was using was contaminated. Or maybe a bunch of Nazi frogmen held him to the ground while he was injected with clenbuterol as a dastardly way of defeating the seemingly invincible young Spaniard. Got your own theory? Who knows? It might be true.

But what we do know is that the lab found a trace of the substance in Contador’s sample. How it got there, well, only Alberto knows for sure. And maybe even he doesn’t really know. But somehow, it got there. But how just much was there?

Well, according to news reports, the concentration was estimated at 50 picograms/milliliter. While that sounds like an incredibly tiny amount (because it is an incredibly tiny amount), in a comment on the previous post, Larry points out that the RadioShack rider Fuyu Li was banned for having a result that was estimated to be in a range between Contador’s result and double Contador’s result. Li is out for two years, and the likelihood that he will be hired by a ProTour team when his suspension is done is roughly nil, at least in my estimation.

[Why are these results estimates? Perhaps because the test involved is more of a qualitative test, meaning that it’s designed to determine the presence of clenbuterol, rather than the exact amount. How the estimates are arrived at is a bit of a puzzle to me at the moment, as is the question of how accurate the estimates may be. But for a substance like clenbuterol, the amount isn’t the issue under the current WADA rules. The presence is all that matters.]

Other athletes have received two-year bans for having results estimated to be less than Contador’s result. In all those cases, the athletes received the minimum ban under the World Anti-Doping Agency’s “strict liability” rules.

 What is “strict liability”? In a nutshell, it means that if a banned substance is found in you, and it’s not a naturally-occurring substance subject to certain cutoffs or threshold values, you’re guilty. Doesn’t matter how it got there, the athlete is responsible for the banned substance being there.

Why does strict liability exist? I’ve seen a number of comments on Twitter that suggest it’s the fault of people busted for doping in the past few years. No, actually, it isn’t. What might be the fault of those who loudly proclaim their innocence, only to sheepishly admit their guilt some time later, is the attitude that “well, they all say that, and they’re all guilty.” So if/when an innocent athlete is wrongly accused, his or her protestations of innocence are not believed.

Strict liability exists, as several sources within the anti-doping establishment have told me, to make prosecuting and deciding doping cases faster and easier. Under strict liability, the adjudication system doesn’t have to consider an athlete’s intent. And, except perhaps for the sake of leniency in the cases of inadvertent exposure, the system doesn’t need to consider how it got there. It’s been found, therefore the athlete is guilty, and it’s the athlete’s responsibility to explain why the positive test occurred and why the athlete’s punishment should be reduced. In rare cases, where labs have violated certain procedures, athletes have escaped punishment.

Whether or not the banned substance is found in an amount that might give an athlete a benefit doesn’t matter. Whether it’s clenbuterol — which is not naturally present — or testosterone — which is, but for which (theoretically) it’s possible to determine whether or not the testosterone is naturally-occurring or artificially made — or any other banned substance, if your sample produces a positive test result, you’re presumed guilty and have to explain how the banned substance came to be in you.

If the anti-doping authorities find that it’s through no fault of the athlete, they may reduce the ban imposed. Except in very rare cases, a ban will be imposed regardless of whether the athlete was at fault, but it could be so short as to nullify results from the event where the positive test occurred, and allow the athlete back into competition when the next season starts — or sooner.

If that leaves you thinking that it’s possible for an innocent athlete to be subject to severe penalties, that’s true. Which brings me back to Alberto Contador, the (for now, anyway) 2010 Tour de France champion. Rumor has it that he’s worked out a settlement with the International Cycling Union (UCI), in which Contador will receive only a three-month suspension (machine translation here) and be eligible to compete in the 2011 season.

If so, this would qualify as one of the shortest bans for this type of case. What’s also interesting to note is that in the Li case, the same Dr. Douwe de Boer wrote a report for Li’s defense which suggested the same thing as Dr. de Boer’s report for Contador did. The athlete’s result was due to unintentional exposure via contaminated food. Both Dr. de Boer’s Contador report and the UCI press release about the positive test result give the estimate of 50 pg/ml. Dr. de Boer’s report goes further, saying that on the day afterwards, Contador tested positive again, this time for concentration estimated to be 20 pg/ml. Dr. de Boer explains that this is due to the half-life of the drug, which makes sense.

But here’s the next problem for Contador. The second result for clenbuterol that Dr. de Boer mentioned is from an in-competition test, even if the original result is arguably an out-of-competition result. Dr. de Boer’s explanation sounds reasonable, but by the letter of the law, it may not matter. With the in-competition result, Contador faces the loss of his 2010 Tour title. And under normal circumstances, an automatic two-year “vacation” from the peloton.

Contador’s explanation was, “it’s the steaks a friend brought over from Spain.” This isn’t making Alberto very popular with the cattle industry in his native land. (And I would suggest he not take up a second career as a matador, because you never know what might happen to AC in a bull ring.) Various posts have suggested that this explanation doesn’t wash. Most cases of clenbuterol poisoning have come from eating contaminated liver, the critique of Contador’s theory goes.

And the Spanish cattle industry is rather tightly regulated. But, even in a tightly regulated industry, there could still be a rogue rancher or two who might break or bend the rules and give banned drugs to his cattle. Just look at the whole problem with salmonella in eggs in the US. Food production is a (supposedly) regulated industry here, and yet, a massive number of eggs were contaminated.

Others have suggested that Contador received a transfusion after the previous day’s racing or during the rest day, because a test for plasticizers (compounds that make plastic tubing and other items flexible) shows a higher than normal level day before Contador tested positive for clenbuterol. Interesting test, and interesting theory. The rest day “top up” is a fairly well-known and oft-rumored phenomenon, at least in years past. But for this theory to be true in Contador’s case, he would have had to be using clenbuterol during preparation for the Tour, and there had to be traces of it in his blood, enough to be detected by the anti-doping lab in Cologne, Germany, where the samples were analyzed. (That said, Cologne is one of four WADA-accredited labs that can detect very low levels of clenbuterol.)

Ross over at The Science of Sport points out another theory, which is the possibility that such a level could come from taking a tablet form of clenbuterol.  Quoting Dr. Robert Greene, who points out:

… a therapeutic oral dose of 20 micrograms would yield a MAXIMUM plasma level of 100 pg/ml – just twice the level found in Contador’s urine.

But then Ross concludes:

So, interestingly, it is not entirely inconceivable that the low concentrations came from the acute ingestion of the drug.  The problem with this is the timing – I appreciate that these athletes would try anything to get an edge.  But taking only 10 to 20 micrograms of clenbuterol would offer so little benefit that I’m skeptical that they’d try it.  There are other more effective substances that could be taken in low amounts.  But the point is, the low concentration is not only explainable by a transfusion theory.

[Tip o’ the hat to MikeG]

Or by contaminated beef, for that matter. And he’s right, there are more effective ways of doping that can be done in low amounts which would give more bang for the buck/euro.

Why would Contador use clenbuterol? Well, one off-label use is to aid in weight loss, though Contador doesn’t look like someone who needs to shed any excess pounds. Another supposed use is to increase strength, but for that, the drug needs to be used for a period of six weeks or more.

Given Contador’s stature in the cycling community and the half-life of the drug, I can’t see how he could use it during extended training periods, without eventually being detected. Unlike many domestiques who aren’t routinely targeted out-of-competition, Contador is a heavy-hitter in the sport, and is surely watched very closely, and tested more often than your average Jacques D’omestique.

Supposing he did use clenbuterol on the second rest day of the Tour. Why would he have done so? Weight loss during the Tour usually isn’t something riders need any help with. Given the amount of calories the riders need each day, the problem is more how to keep the riders taking in enough calories so they are properly fueled and don’t lose weight. Strength? Well, if it really does take six weeks to get the strength gains, one day during the Tour isn’t going to help.

Stimulant? I don’t see why he’d be using a stimulant on an off day. Seems like that makes more sense on a race day. Then again, maybe `berto and his buddies hit the disco after a hard day of racing and needed a little “pick me up.” 😉

Masking agent? Maybe, but for what?

Juliet Macur in today’s New York Times points to another possibility, noting that clenbuterol is

a drug that boosts metabolism but can also increase aerobic capacity and the ability to process oxygen.

Well, that at least makes some sense, given they were in the mountains and the ability to process oxygen better would be a competitive advantage.

Of course, Alberto could have asthma. But that seems pretty unlikely. If he did, he would have a prescription for some type of asthma medication and a therapeutic use exemption (TUE). And if that were the case, we wouldn’t be talking about a positive test at all.

So the question still is: Why was clenbuterol found in Contador’s sample, and how did it get there?

Under WADA rules, it’s the athlete who needs to explain the positive test. Contador’s team believes the result is from contaminated meat. Or contaminated something. And, according to their approach, they say it’s clear from the results that Contador had something that was contaminated. And they’re pointing the finger at the beef.

Is the contamination theory possible? Consider this from an ESPN.com article by Bonnie D. Ford:

In a 2009 scholarly paper co-authored by Prof. Wilhelm Schaenzer, the Cologne lab director, he and two other German experts concluded: “With a detectability of clenbuterol at this low concentration, positive findings in residue analysis and doping control could be due to the consumption of trace amounts found in [livestock] feed or principally also in the water supply. Threshold concentration amounts for clenbuterol in doping control have, therefore, to be considered in the future.” Catlin agreed, saying he thinks the rules are too strict.

[Hat tip to Jeff for the link.]

The best way to prove this theory is to find the source of the contamination. But like the Wendy’s commercial of the 1980s said, “Where’s the beef?”

Seems Contador and company have gotten some samples from the same butcher and want to analyze them. I’m a bit skeptical that this approach will work. First, they would have to find meat from the same animal. Then, they would need to get it tested and for the results to show contamination. And even a month after Contador’s friend purchased the steaks, it’s hard to believe that anything from the same animal would still be at the butcher. (Though, I suppose that some could have been frozen and still around.) Possible, I suppose. But a long-shot. Who knows? Maybe they succeeded in their quixotic quest.

As “M” points out in a comment on the previous post, Contador’s team only has to prove that their story is more probable than any other explanation. In other words, that it is 51 percent likely that the culprit was contaminated beef, as opposed to 49 percent likely that he took a pill or received a transfusion of tainted blood. (There’s a new idea for the 80s band Soft Cell. Release a new version of the song “Tainted Love” and change the lyrics to “Tainted Blood.”)

Can they do it? Maybe.

The test that indicates the possibility of a transfusion has not been certified yet for use as an anti-doping screening test. In comments to the previous post, Jeff linked to a study related to this test. It’s not clear to me that the developers of the test have ruled out the possibility of other non-medical devices (Camelbak hydration systems use a flexible tubing and flexible bag, for example, that might contain the same kind of compound) being the source of the plasticizers detected. If they haven’t, and other devices can cause false positive results, then there’s a real problem with using the test to sanction an athlete. Unless Contador’s biological passport, or other tests, reveal the possibility of blood doping, the anti-doping authorities might be wise to avoid trying to use a currently unapproved testing method to convict an athlete of doping.

If the rumors are true, and the UCI hands down a three-month ban, we can take it that Contador’s defense team convinced the UCI that his theory is correct. Or we can suspect that there might be some other motives for letting Contador go free. It’s not in the Tour organizer’s interest to have yet another doping cloud hanging over their big event. It’s not in the UCI’s interest, either. Perhaps the two sides got together and agreed to let the Spanish rider go.

It could also be that the UCI is now taking a more progressive approach to sanctions, and moving more in the direction of considering whether the athlete benefited from the drug, even if inadvertently exposed, or whether the athlete received no benefit. Arguments can be made both ways, based on the estimated concentration of clenbuterol in Contador’s sample. But if they are taking a more progressive approach, Contador’s may well be the first of many cases where the length of the suspension will be decided on the merits of the case, rather than on arbitrary rules.

It could be that it’s plain old politics and favoritism. Which would be no surprise. Like all organizations, the UCI has its share of politics and politically-charged issues.

It could also be that, since Contador worked with Lance Armstrong (kind of, maybe) at the 2009 Tour, that maybe Contador saw something that could be useful to the authorities. Lance Armstrong is the Great White Whale that numerous Captain Ahabs within the anti-doping world would like to land. Remember back in the days of the Floyd Landis case? Landis was offered a deal early on to spill his guts on what Armstrong had done during his 7-straight Tour victories. The offer supposedly went like this: you give us the info on Lance and we’ll see to it that you serve the shortest suspension in history. (Three months for clenbuterol seems to fit that bill, doesn’t it?)

Contador is expecting that his case will be resolved soon. CyclingNews.com reports that he expects the case to wind up in about eight or ten day’s time. How does he feel about a possible ban. Susan Westermeyer quotes Contador as saying:

“That’s something that I cannot contemplate, especially when you know that you haven’t done anything wrong. I don’t know what is going to happen but I know that it is difficult to be banned when you haven’t done anything wrong. It is really hard to accept that I may be banned.”

I can imagine that it would. For what it’s worth, publicly WADA says they are satisfied with how the UCI is conducting the investigation. As Shane Stokes at VeloNation.com reports, WADA’s David Howman said, regarding the Contador investigation:

“… in this case, we have been satisfied to date with how results management is progressing.”

However, I wouldn’t be too surprised if the UCI does hand Contador a three-month sanction, that WADA would file an immediate appeal to the Court of Arbitration for Sport challenging length of the suspension. If the UCI does give Contador such a penalty and WADA doesn’t challenge the decision, we might be able to suspect that Alberto will be chatting with Jeff Novitzky and company. Somewhere, Captain Ahab must have sighted the Great White Whale again. Will he finally land the big fish? Only the shadow knows for sure.