Following the recent revelations about the use of EPO by Mohammed Mourhit the former World Cross Country Champion the incidence of performance enhancing practices is becoming increasingly worrying. However, It is not just the use of EPO which is cause for concern. Dr Jaque Rogge the IOC?s medical commissioner has commented recently that he is worried about the increasing use of hypoxic oxygen tents. These tents are widely available and are becoming increasingly popluar as athletes attempt to simulate altitude. Although there is nothing in the current rules to prohibit the use of such tents the IOC are due to meet shortly to discuss their increasing concerns with the situation. Indeed Dr Rogge has said that he considers their use to be a ?grey area? and that they push training and preperation too far. Tests have proven that athletes who use the tents regularly are faster and stronger over a range of distances, a 1500m athlete could improve his time by up to 3 seconds. Red blood cell count can increase by around 20% and efficiency improved by 5%. In the seventies blood doping was classed as a ?grey area?, it could not be proven and it was impossible to test for accurately (in much the same way as the use of hypoxic tents) but it was still regarded as immoral. I think the sport has to be careful that it is not seen as being hypocritical in the sense of allowing one process to be outlawed whilst turning a blind eye to one which could be as beneficial, otherwise we risk turning the sport into a science where the athletes who are successful are not those who train the hardest or sacrifice the most but those who have the most up to date scientific information and the best medical backup.
The actual process of using hypoxic oxygen tents is very different to training at altitude. When an athlete goes to altitude he has to cope with a period of ?detraining? whilst his body comes to terms with the changes in enviroment and he cannot carry out his usual regime, this doesn?t happen when using a tent, the athlete can spend all day and night in the tent if he wishes and only train at sea level (living at altitude and training at sea level is proven to be more a beneficial means of using altitude). Furthermore the very latest research carried out suggests that what really gets the genetic response going in the case of hypoxia is intermittent hypoxia. If a subject is exposed to say 1hr of hypoxia then 1hr of normal air in a chamber they get a bigger EPO response than if they were to be exposed to just continuous hypoxia over a period of time. This is different from living high and training low. You could not reasonably create these circumstances in the natural world - even if you had a helicopter and a mountain.
The air which the athlete breathes in an oxygen tent is very different to that at altitude, the oxygen content at altitude is scarce because of an overall reduced atmospheric pressure, whilst in the hypoxic tent the filtration system reduces the amount of oxygen by adding nitrogen to the air being breathed. We then have to ask the question of whether or not this is an artificial performance enhancement.
I do not know how widely used these tents are becoming, obviously their high cost does not put them within everybody?s reach, However Paula Radcliffe is quite open about using the system, at the moment she is not breaking any rules but it could be seen as hypocritical, especially with regard to her very public anti EPO stance.
Even more worrying than the incidence of synthetic EPO are the very latest drugs which can be used to enhance endurance performance by stimulating the kidneys themselves to produce more erythropoietin. This is the body?s natural response to the drug and this is a very similar scenario to the body responing to breathing an artificially synthesised mixture of gases (which occurs using a hypoxic tent). The partial pressure of O2 can be specifically tailored within the tent to give a specific individual the maximum EPO response as individuals vary in their EPO response to different oxygen partial pressures. Practically speaking, it is harder to get this precise control in a high altitude environment because of varying climactic factors.
What this means to those involved in the sport is that further research is essential and we should not be so quick to accept practices without thorough knowledge of their effects on the body and their effects on performance.