In Lab Variability, Horse Racing Playing Catchup With Human Sports

The European Athletics Championships of 1966 constituted the first major international sporting event where human athletes were officially drug tested.

Driving this watershed moment was growing alarm that more and more athletes were turning to performance-enhancing drugs with near impunity and no small amount of personal risk.

Several amphetamines were found in the system of Danish cyclist Knud Enemark Jensen after he collapsed mid-race at the 1960 Rome Olympics, fracturing his skull. He later died in hospital. Seven years after that, British cyclist Tommy Simpson collapsed and died during the Tour de France. A post-mortem revealed that Simpson had taken a cocktail of amphetamines and alcohol, a lethal combination in the extreme heat and duress of the mountainous race.

At the time, drug testing in sports was rudimentary compared to today's standards. It wasn't until a German biochemist and former competitive cyclist called Manfred Donike appeared on the scene in the 1960s and '70s that drug testing really started marching towards modernism.

Donike was instrumental in developing one of earliest sports laboratories for drug testing research ahead of the 1972 Munich Olympics. By the 1983 Pan American Games, he had helped develop a portable laboratory which detected 19 positives and caused a score of athletes to flee the event. At the 1994 Asian Games at Hiroshima, Japan, his laboratory confirmed the presence of a relatively rare anabolic steroid in 11 Chinese athletes.

Human athletes were tested at the 1966 European Athletic Championships in Budapest | Getty Images

While Donike's lab was getting pretty good at catching drug-abusing athletes, other international laboratories charged with the same objective were struggling to play catch up–a precursor to where horse racing finds itself today.

“And that was really the beginning of the impetus to talk about harmonization of the lab results on the human side,” said Dr. Larry Bowers, who sits on the Horseracing Integrity and Welfare Unit's (HIWU) advisory council, courtesy of a 25-year career in anti-doping.

International Standard for Laboratories

Bowers initially served as the director of the International Olympic Committee (IOC)-accredited laboratory at Indiana University. He later became the chief science officer at the U.S. Anti-Doping Agency (USADA).

Bowers was also instrumental in developing the World Anti-Doping Agency (WADA) “International Standard for Laboratories,” which first went into effect in 2002. The ISL built off a broad global set of laboratory standards, gearing it specifically towards anti-doping efforts in the human sports world.

In terms of Bowers's work for HIWU, this particular entry on his resume has proven valuable indeed.

That's because Bowers's efforts to bring performance parity to all international drug testing labs in human sports parallel in many ways HIWU's more contemporary efforts among its contracted laboratories–efforts that have encountered several high profile snags.

Over the past year or so, the Racing Medication and Testing Consortium (RMTC) suspended accreditation of both the University of Illinois Chicago's (UIC) Analytical Forensic Toxicology Laboratory and the University of Kentucky Equine Analytical Chemistry Laboratory (UK-EACL).

The former's suspension was due in part to failures in identifying intentionally spiked samples–the latter's reportedly due to a long list of operational and managerial failures under former lab director Scott Stanley.

Earlier this year, the RMTC fully revoked its accreditation of the Chicago lab.

After an unusually high number of total carbon dioxide (TCO2) cases emerged out of the Pennsylvania Equine Toxicology and Research Laboratory (PETRL), the facility was required to upgrade its TCO2 testing equipment, bringing it up to par with the other labs. Many of those initial cases were ultimately dropped due to the questions marks surrounding the results.

Dr. Larry Bowers | Paul Gilham/Getty Images

What these issues relay is the story of a sport years behind its human counterparts in bringing all its different drug testing facilities onto the same performance page.

Earlier this year, however, HIWU took a major step forward when instituting its new HISA Equine Analytical Laboratory (HEAL) accreditation standard program, which builds off the work of Bowers and others decades ago to ensure different laboratories were finding what they were supposed to, when they're supposed to, how they're supposed to. No easy feat.

“The proficiency testing program is really the hard part to implement,” said Bowers.

“There's quite a bit of work to do administration studies, then process the samples, divide them up into various and sundry things and get them out. So yes, it's a bit of a challenge,” Bowers added, with no small understatement.

Single, Double-Blinds

In a single-blind test, a substance has been added to a sample and the lab is required simply to identify it. The single-blind sample is known to the lab (but not of course the substance).

In a double-blind test, a substance has been added to a sample that is included among a batch of routine samples, and the labs have no idea which of them is the culprit. “It's supposed to come into the lab as part of the sample flow and treated just like any other sample,” said Bowers.

Prior to the implementation of WADA's international laboratory standards, the IOC typically issued just the one single-blind test a year among its stable of global labs, said Bowers, and no double-blinds–hardly the highest bar to clear.

“Laboratories have self-interest at heart and they don't want to lose their accreditation. So, if you just send them a single-blind, the day that you send them that sample, they're probably performing the best that they can possibly perform,” said Bowers.

“If what you want to know is the best the lab can do [that day], the single-blind is a good assessment,” said Bowers. “If you want to know what the lab does routinely, then a double-blind is a much better assessment of lab performance.”

Under Bowers's new set of standards, proficiency tests were significantly ramped up. The issuance of single-blind tests increased from once to typically three times a year. For the first time in human sports testing, international labs were sent double-blind tests.

But just as double-blind tests offer a much tougher bar to clear for laboratories, they're just as hard to administer properly.

For example, “how do you insert a sample somewhere into the line where they normally get samples from so that they don't realize it's a proficiency testing sample?” said Bowers.

Another problem was just what to spike the tests with?

Athletes were abusing all manner of new and unusual drugs that regulators didn't always know how to get, how to test, nor understand how they behaved in the human body. “As you know, you put a drug into an animal and it can metabolize into other things,” said Bowers.

Part of the problem was that some cheats approached the manufacture of performance enhancing drugs like DIY enthusiasts.

BALCO building | Justin Sullivan/Getty Images

“Not all the drugs that are being used by people who are doping humans-and I suspect horses as well–come from the pharmaceutical industry. Some of them are made in rogue labs and things like that,” said Bowers.

Just take the infamous and widespread doping operation through the Bay Area Laboratory Co-operative (BALCO). “The guy [Victor Conte] that was supplying the drugs to the athletes was actually synthesizing them or making them in his garage,” said Bowers.

As such, “It was much more challenging than what I had anticipated when we started in order to get a good set of samples for both single and double-blinds.

What happens, however, when a human sports testing lab can't meet its performance goals? It turns out the loss of accreditation isn't confined to horse racing's stable of laboratories.

Suspensions

Just as Bowers and his team were adapting to the challenges of administering a new quality assurance program, the labs themselves had to adapt to a much more rigorous set of requirements. Easier said than done.

“Having a lab is a huge financial investment. And so, you don't want to willy-nilly say, 'You made one little mistake, you're done.' But on the other hand, if you continually make mistakes, we used to say, `We don't want to falsely accuse people,'” said Bowers. “If you do that, that makes people have doubts about the program.”

As lab performance standards evolve, however, so must the laboratories themselves. Over just the last decade or so, WADA has issued accreditation suspensions to several laboratories around the world, including ones in Rio de Janeiro, New Dehli and Bloemfontein (in South Africa).

As per WADA's press releases, it's not always clear for what the labs were suspended–often for vaguely worded “non-conformities” with international lab standards. But occasionally, more detailed accounts slip out.

In 2015, WADA revoked full accreditation of Moscow's laboratory following the exposure of Russia's institutionalized doping program to ensure a medal bonanza during the 2014 Sochi winter Olympics.

Sydney Olympics in 2000 | photo by Joe McNally/Getty Images

As part of Russia's doping scheme, Russian officials conducted a clandestine nighttime exchange, swapping out through a mouse hole drilled into the lab's wall the tainted urine samples from their athletes and replacing them with clean samples.

Despite these serious infractions, the lab was still allowed to perform the necessary processes related to its Athlete Biological Passport (ABP) program because it's “practically impossible for laboratories to interfere with the blood variables of [these] samples,” according to WADA.

But then in 2020, WADA suspended the lab again, barring them from performing the ABP tasks as well on account of the “intentional alteration and deletion of laboratory data prior to and during the time it was being forensically copied by WADA,” which was “a serious violation of the Code of Ethics of the ISL.”

Interestingly, just as Bowers sought to bring performance uniformity between the labs, he still needed individual facilities to maintain a certain amount of drug testing latitude.

“It became clear that we couldn't require labs–at least on the human side–to use the exact same methods because that would give us all exactly the same blind spots and so on,” said Bowers.

Which is where the BALCO scandal comes in.

BALCO

Between the late 1990s and 2003, businessman and former musician Victor Conte funneled to dozens of successful athletes including baseball players (like Barry Bonds), footballers (like Bill Romanowski) and track and field stars (like partners Tim Montgomery and Marion Jones) a new designer anabolic steroid called tetrahydrogestrinone (THG).

Conte's confidence and brazenness came from the fact the commonplace testing procedures among the labs made THG highly difficult to detect. “And that's why [Conte] was able to get away with it, knowing this major approach of all the laboratories,” said Bowers.

WADA, however, worked with Don Catlin, who was developing a new way to test for THG out of his lab at the University of California, Los Angeles-one that could be replicated across all the labs.

“It was only after we switched to this different technology that it became very easy to detect the compound and then the BALCO scandal ensued,” said Bowers, who explained that THG was fairly stable, meaning that it was excreted in the urine in the same form that it was administered.

“That made detection a lot easier than having to work through a lot of metabolites and then make those compounds,” said Bowers. “We saved ourselves a few steps there in trying to move things forward, shall we say.”

The BALCO scandal, said Bowers, was a learning curve for regulators for many reasons, perhaps none more so than in learning the legal, ethical and practical finer points of trying to unravel a large and far-reaching doping network.

“It was a very interesting time. We were trying to be very careful because as you can imagine, we really didn't know who might be involved in the whole thing, other than Conte. It was a whole question of, 'who could you tell?'” said Bowers.

Crossover, Human and Equine Sports

To some extent, said Bowers, “HIWU has benefitted from the BALCO scandal in trying to figure out where the lines get drawn on investigations, with testing and everything else.”

In other ways, “They're working through the same stages that WADA was in 2003 or so,” Bowers added. This includes the establishment of an independent group of lab experts to help oversee the HEAL accreditation process and program.

Horse headed to the test barn | Coady Photography

Under HEAL, the remaining four labs used by HIWU are now sent a minimum 15 single-blind tests and five double-blind tests. They're also running a sample exchange program “whereby samples that are reported as negative in one laboratory are sent to other laboratories to be re-analyzed,” according to HIWU's latest annual report.

Bowers's work with HIWU isn't his first instance of professional overlap with horse racing.

“When I first got involved in the lab in Indianapolis, I used to talk with the [British] horse racing lab all the time about steroids and steroid metabolites they were seeing,” said Bowers, who added that Equipoise–otherwise known as boldenone–is an anabolic steroid that made its way from the sport horse world to human athletics.

“It's really good to share information across the spectrum,” Bowers added. “And I think that's happening more today than it has in the past.”