Forensic Nursing Chronicles

Lance Armstrong is an unprecedented seven time tour de France winner. Recently there has been an allegation that Armstrong used EPO is 1999, and that allegation is denied by Armstrong.

Although the report seems credible to the tour de France director, disciplinary action is unlikely. There were A and B samples of urine, and the B samples were not tested until last year. There was no test available to check for EPO until 2001.

The problem arises that it could not be confirmed that the urine samples were indeed Armstrong’s. The company that issued the allegations state the urine was Armstrong’s, although the company that actually did the testing stated that it could not confirm the positive result was that of Armstrong.

Samples from testing must be carefully marked using a system to avoid any question of matching the wrong specimen with the wrong athlete. When there is a question about that confirmation, it becomes unlikely that there will ever be total credibility and validity with these specific samples.

Tests designed to check for EPO were not used until 2001. I wonder why the specimens were only assessed last year? If these results had been found in 2001, the findings would have been more credible. For these results to be made public at this late date, with questionable confirmation of the source of those specimens, does not encourage further investigation. I do not believe that anyone will be able to prove the allegations beyond the shadow of doubt.

Manufactured EPO has slightly different characteristics than what is naturally produced in the body. Although the manufactured EPO has the same effect, the amount of sugars attached to the hormone do vary.

Thus, the manufactured EPO has a slightly different charge and weight than natural EPO and the urine test can detect if someone recently ingested EPO (within 2 – 4 days). Blood testing is more costly, but can detect the effects of EPO use over time (used at the 2002 Olympics). Because EPR causes abnormally fast erythrocyte production, this enhanced time-based blood test would identify “suspicious” scenarios. There is at least one new form of EPO that is now undetectable with the urine test alone.

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