Hypoxic Devices: Within the Spirit of the Sport?

[MavKikiNYC]

July 26, 2006
Tents Simulating High Altitude Could Be Grounded

By GINA KOLATA
Three of the top United States cyclists in this year’s Tour de France use a special method to enhance their performance, and it is legal. They sleep in altitude tents or altitude rooms that simulate the low-oxygen conditions of high altitude. This prompts the body to make more oxygen-carrying red blood cells and can lead to improved endurance.

The cyclists — Dave Zabriskie, George Hincapie and Levi Leipheimer — are among the athletes featured on the Web site for Colorado Altitude Training, which makes the tents, known as hypoxic devices. Runners, triathletes, skiers, rowers and the Philadelphia Flyers are among the elite athletes who espouse the virtues of the company’s altitude simulation products on the site.

But soon, the altitude tents and rooms may be banned by the World Anti-Doping Agency, or WADA. The agency’s ethics panel recently determined that the tents and rooms violated “the spirit of sport.”

The agency said it would reach a decision in September about whether to include altitude tents and rooms on its List of Prohibited Substances and Methods for 2007. In the meantime, it is eliciting comments from its constituents, which it describes as the Olympic movement, including the International Olympic Committee and “governments of the world.”

The ramifications of banning these hypoxic devices, athletes and trainers say, would be far-reaching, and many are upset that the antidoping agency would even consider such a move. It would mean that for the first time, the question of performance enhancement moves from the use of drugs, like anabolic steroids and human growth hormone, and methods, like blood doping, to something much more nebulous.

“It sets a precedent,” said Doriane Lambelet Coleman, a law professor at Duke and a former elite-level middle-distance runner. “This is the first opinion of this governing body that purports to describe the spirit of sport. If it stands, it will inevitably be used again.”

Because its discussions about the hypoxic devices are still going on, the antidoping agency declined to have its officials interviewed; it referred questions about the “spirit of sport” concept to its ethics advisory panel chairman, Dr. Thomas Murray. He is president of the Hastings Center, a bioethics research institute in Garrison, N.Y. The panel recently the issued a report about “artificially induced hypoxic conditions to modify performance.”

“Speaking personally, it was a difficult call,” Murray said of the altitude tents and rooms. “We have already made a decision that not all technologies are acceptable. So where do we draw the line? That is the debate that WADA is trying to sponsor.”

Not everyone agrees about how effective altitude training really is, but many athletes and trainers are firm believers. Athletes who can afford it, and whose schedules permit it, often sleep at altitude in the mountains and travel to lower altitudes to train. Others use the modern method; they sleep in altitude tents, which start at about $5,000 at Colorado Altitude Training, a major supplier. Or they convert a bedroom, spending about $25,000. Some have even spent millions to convert an entire building.

“Ninety-five percent of the medals that have been won at Olympic Games have been won by people who train at or live at altitude,” said Joe Vigil, who coaches Deena Kastor. She holds the United States women’s record in the marathon. Kastor lives in Mammoth Lakes, Calif., at an altitude of 7,800 feet, and often trains at sea level.

The decision on whether to ban hypoxic devices has taken many athletes and exercise physiologists by surprise, but the antidoping agency has quietly spent the past few years considering the issue, said Dr. Bengt Saltin, director of the Copenhagen Muscle Research Center. Saltin was a member of the agency’s health medicine and research committee until two years ago. “We have discussed the issue a lot,” he said.

In Saltin’s opinion, the altitude tents and rooms are no different from going to a “a suitable mountain area,” only cheaper. Banning the altitude tents or houses, he said, “should not be on the WADA or International Olympic Committee’s priority list.”

That is also the view of the 76 scientists and bioethicists who recently signed a letter to the World Anti-Doping Agency expressing “grave concern” over the proposal to ban the tents and rooms.

The letter’s lead author was Dr. Benjamin D. Levine, director of the Institute for Exercise and Environmental Medicine at Presbyterian Hospital and a professor at the University of Texas Southwestern Medical School, both in Dallas. He said the antidoping agency was starting down a perilous path.

“This is a pretty slippery slope,” he said. “WADA is going to lose their credibility with the scientific community, upon whom they depend to further their mission, by pursuing this. And how to enforce it is a whole different question.”

In addition to Levine’s letter, Center for Sports Law and Policy at the Duke University School of Law recently issued a position paper opposing the notion of banning the altitude tents and rooms.

The key question for Murray, of the Hastings Center, and the WADA ethics advisory panel in preparing their report was how to define what it meant to violate the spirit of sport. They decided that a violation would be a purely passive activity that nonetheless enhanced performance.

“When we think about great performances, we think about athletes who train very hard and are disciplined on top of their natural talents,” Murray said. And most of the legal performance-enhancing equipment, like fiberglass poles for the pole vault, “requires the active engagement of the athlete in learning to use it.”

Others, like Levine, take issue with the notion that being passive is a key distinction. The biological response to training, Levine says, occurs during rest and recovery, and athletes plan those periods as carefully as they do their active training. “It is a very serious error to look at an athlete lying quietly and assume they are ‘passive,’ ” he said.

Levine added that he thought it was problematic to point to altitude tents or rooms when there are other legal and passive measures that athletes use to enhance performance — sitting in a sauna to acclimate to heat and humidity, or wearing a cooling vest or sitting in cold water to cool their bodies before a race in hot weather. Why not ban those practices, too, Levine said.

“The fact that we can think of cases that are difficult does not mean we can’t draw lines,” Murray said. Murray acknowledged that athletes who go to the mountains can get the same effect as sleeping in an altitude tent. But, he said, in his opinion that was not a compelling reason to say that altitude tents were within the spirit of sport. “There are some people who are in a sense geographically fortunate,” Murray said.

Alberto Salazar, a former champion marathoner who coaches elite distance runners for Nike, said that if the World Anti-Doping Agency were to ban altitude tents and rooms, the effect on United States distance runners would be devastating. Nike has outfitted the bedrooms of its athletes to make them altitude chambers, Salazar said, adding that about 40 percent of the athletes increase their red-blood-cell count as a result.

“Altitude training is absolutely essential,” Salazar said. “Any athlete who wants to be competitive in the world scene would have to move to altitude or cheat by using an altitude room or taking illegal drugs.”

Moving to a high altitude is not feasible for many who have jobs and families elsewhere, Salazar said. Of course, he added, runners from Kenya do not have that problem because many of them live at high altitudes.

“We’ve got such small numbers, do we need another handicap?” Salazar said. “Do we need to tell them that the second they graduate from college they have to move to altitude?”

Murray said he knew the issue was fraught, and he welcomed debate.
“Lines can be very difficult to draw, there is no question about it,” he said. But if there are no lines, he added, “whatever you like about the sport will disappear.”

[Drbio]

A non story. Athletes have long known that training in the higher altitudes gives this benefit. This is why the US Olympic villages and complexes are in Colorado. Every nation does this and no drugs etc are used. This is a normal physiological response and there is nothing wrong with it. What a waste of print.

[Smiles]

Doc, that was my exact thought: "What a waste of print"

But at least we're now aware of the rediculous mindset of the WADA.