Monday, July 18, 2016

A less glamorous side of Olympic life: Peeing in a cup under watchful eyes

© The Washington Post 7/18/16, 11:30
By Rick Maese

July 16 EUGENE, Ore. 

Emily Infeld disappeared into a tent. She had placed second in the 10,000- meter race at the U.S. Olympic track and field trials, earning a spot on the U.S. Olympic team. 
Her adrenaline was still rushing, but she knew that wasn't what was needed at that particular 
moment. 

She had been met by a young man in a blue shirt 
shortly after she crossed the finish line. He introduced himself and asked her to sign a piece 
of paper acknowledging that they had met. Then 
he followed her around the track, toward the television cameras, past the reporters, into the 
awards ceremony and a news conference. He 
couldn't take his eyes off her the entire time, 
finally escorting her into the tent, through a pair 
of double doors, one of which had a sign identifying it as a restricted area. 

This is how it starts, the complicated, precarious 
system of drug-testing elite athletes. It's a 
system that has been in the spotlight this year, 
with charges of a massive, state-sponsored 
doping program by Russia that has cast a long 
shadow in the run-up to next month's Summer 
Olympics. The goal of the testing system is to 
ensure that athletes are clean, competition is 
above-board and the Rio de Janeiro Games 
feature competitors armed only with their 
training, smarts and whatever genetic gifts have 
been bestowed upon them. 

Everything hinges on the test. The step-by-step 
process of testing athletes' blood and urine reveals all the possible pratfalls. American athletes, the U.S. Anti-Doping Agency and the U.S. Olympic Committee hope it also illustrates 
why the program in place in the United States is 
a far cry from the one that landed the All-Russia 
Athletic Federation and the Kenyan track and 
field team in hot water that could exclude them 
from the Olympics. USADA conducted more 
than 10,500 tests last year for the USOC, and 
with the help of Olympic athletes, they described 
the procedure in intimate detail for this article. 

It's a process that usually starts right when the 
competition ends or at unannounced visits to an 
athlete's home or training facility, when the athlete must submit a urine or blood sample and 
sometimes both. The doping control officer has 
one objective: He or she must witness every step. "It was a little weird at first, and I was a little 
self-conscious when I was younger," said Infeld, 
26, a Georgetown University graduate who will be competing in her first Olympics. She recalls 
having submitted to at least five tests this year; 
USADA records say she has been tested a total of 
10 times in her career. "I don't really care at this 
point," Infeld added. 

Tests become routine 

To aspire to the Olympics is to surrender a degree of privacy and autonomy. Athletes in the 
drug-testing pool must submit "whereabouts," 
which is essentially their anticipated location, at 
all times, in case USADA plans a surprise test. 
They must make themselves available 24 hours a 
day, seven days a week, 365 days out of the year. 
They go online to fill out their whereabouts quarterly, providing training times, competition 
schedule and any other travel plans. They can 
then use an app on their smartphone to provide 
daily updates. Some choose to be very specific 
with what they share. 

"That's the hardest part," said English Gardner, a 24-year-old sprinter who will represent the 
United States in the women's 100 meters in Rio. 
"Saying I'm going to the grocery store to pick up 
eggs for breakfast. But first I have to tag in and 
tell USADA I'm going." 

Three missed tests count the same as a positive 
and can result in a suspension. For Gardner, it's 
all pretty routine. She said the officers came 
almost weekly last fall, often at dawn. She doesn't mind. "I'd rather they test me more," she 
said. "I'm clean. I have nothing to hide." 

The doping control officers show up with a testing kit and an iPad. The entire process is 
paperless. If they intend to draw blood, they will 
be accompanied by a phlebotomist, and if they're 
testing a minor, they will have a chaperone on 
hand for an extra set of eyes. 

The tests are never random. If an athlete is 
receiving increased testing, it's not by accident. 
And if they're being tested for blood, in addition to urine, it's likely because they compete in a 
sport, such as cycling or track, in which abuse 
often involves substances that are easier to 
identify in blood. 

"The idea of just choosing people off a list and 
showing up is not in my opinion an effective way 
of allocating resources," said Matt Fedoruk, USADA's science director. 

The test itself is the same whether it takes place 
at an athlete's home or at a competition. The 
doping control officer offers three sealed cups 
and three sealed Styrofoam kits, allowing the 
athlete to inspect each for tampering before choosing one. The kit has a bar code and seven- 
digit identification number that will be essential 
for tracking purposes. 

After a detailed explanation and clicking some 
boxes on the iPad, the officer and athlete will 
visit a restroom together. An important key to 
the whole process: The officer must have a clear visual of the specimen collection. 

"I know some of the guys have honestly spilled 
pee because their hands are shaking. It is pretty 
weird," said Nathan Adrian, a three-time gold 
medalist and defending 100-meter freestyle 
champion heading to his third Olympics. 

Athletes are required to pull their shirt up to 
mid-torso, drop their pants to their knees and 
roll up their sleeves to their biceps. "In case I 
have something in my shirt or something," 
Infeld said. 

There are products on the market that aid athletes in hiding urine samples on their body. 
In 2005, Minnesota Vikings running back Onterrio Smith was famously caught with a 
Whizzinator, a kit that includes dried urine and 
a fake penis, commonly used to cheat drug tests. 
More recently, a World Anti-Doping Agency 
investigation found an unnamed Russian athlete 
who, according to a WADA report issued last month, "used a container inserted inside her 
body (presumably containing clean urine). When she tried to use the container it leaked on 
to the floor and not into the collection vessel." 

With the doping control officer just a couple of 
feet away, the athlete must fill the cup with at 
least 90 milliliters of urine, about the size of a 
perfume bottle. 

"It's hard," Infeld said, "especially when you run 
a long race like that. You sweat a ton." 

After her second-place finish earlier this month, 
Infeld initially failed to provide 90 milliliters, 
which meant she had to drink more water and 
wait several minutes until she was ready to 
return to the restroom with the doping control 
officer. 

That process can take one minute or more than 
an hour depending on the athlete and his or her 
hydration level. Once the cup is filled, the athlete then divides the urine into two glass bottles — 
"A" and "B" samples — from the Styrofoam kit. 
The bottles each have a locking mechanism with 
metal teeth that can be opened only with a special tool at the testing lab. The athlete is 
instructed to tighten the lid. 

Then, for the first time, the doping control officer is allowed to touch the bottles, ensuring 
the lids are locked into place to prevent leaking 
or tampering. 

Distrust and whispers

With 2,500 Olympic athletes in the drug-testing 
pool at any given time , USADA needs a deep 
roster of doping control officers. USADA, which 
is headquartered in Colorado Springs, is a nonprofit agency that receives $9 million in 
federal grant money annually; it took in an additional $3.7 million from its contract last 
year with the USOC. It has 52 doping officers on 
staff, spread across the country. 

 Most are part-time contractors, and many have 
other careers. Regular 6 a.m. wakeup calls and 
open bathroom visits tend to breed some familiarity between officer and athlete. American athletes say they trust the system in 
the United States. They often tweet out notices 
when they're woken early in the morning for a 
test or visited at practice, often employing a 
hashtag such as #CompeteClean OrGoHome.

That comfort doesn't always extend to other 
nations or international competition. They also 
know that many athletes have used performance-enhancing drugs and never turned 
in a positive test — Americans included. 

"I've never seen anything fishy with my own 
eyes, but you never know what goes on behind 
closed doors," said runner Jeremy Wariner, a 
three-time Olympian and four-time medalist. 
"With what's coming out now, it's an unfortunate situation." 

 Wariner, who failed to qualify for the Rio Games, has been tested 71 times by USADA and 
many more times competing overseas. Distrust 
and whispers can be inherent in a sport in which 
a tenth of a second can have a profound impact 
on money, fame and legacy. But Wariner says 
sound testing can alleviate that and at least 
provide the semblance of a balanced playing 
field. 

The doping control officer tries to assuage any 
concerns on the front end. The athlete places the 
bottles into plastic bags and then back into the 
Styrofoam box. The bags are sealed, and then 
the box is, too. 

After the athlete clicks a few more boxes on the 
iPad and offers a signature, the information is 
instantly transmitted to USADA and the testing 
lab, and the athlete receives an email. 

The officer then usually will pack the kit into a 
gray UPS envelope labeled "biological sample." At a big event like the Olympic trials, USADA 
officials will pack up to 24 kits into a blue bag, a 
plastic seal locking the zippers into place to prevent tampering. 

If there's blood involved — it's typically less than 
a tablespoon, so it won't affect competition or 
training — the samples are shipped in a box 
along with cooling packs and a thermometer. 
The blood must stay between 35 and 46 degrees 
to remain viable for testing and arrive at the lab 
within 36 hours of being drawn. 

Trying to keep pace 

Nestled in the foothills of the Wasatch mountains in Salt Lake City sits a nondescript 
brick office park with no signage out front. The 
UPS deliveryman arrives at least once every day 
and must get buzzed inside. Most doors in the 
space require a key card for entry, cameras are 
situated on the ceiling inside, and there's 24- hour security on hand, too. 

The Sports Medicine Research and Testing 
Laboratory is one of two labs in the country 
accredited by the World Anti-Doping Agency 
and one of only 34 in the world. It processes 
20,000 drug tests in a year for a variety of sports organizations, including around 5,000 for 
USADA. 

Once the UPS shipment is unpacked, the "B" 
sample heads straight to storage and the "A" 
sample is prepped for testing. The Sports 
Medicine Research and Testing Laboratory is 
about the size of a tennis court, with wires, tubes 
and high-tech equipment spread across the 
room. As Daniel Eichner, the lab's executive 
director, says, "The work we do is important but 
not always the most glamorous."

Each sample goes through a variety of tests as 
technicians check for steroids, hormones, 
masking agents, stimulants, blood doping and gene doping. They're looking for traces of any of 
the items included on WADA's list of banned 
substances. 

While most positive tests are still the result of an illegal substance, the labs and USADA are 
increasingly relying on athletes' biological 
passports to identify suspicious changes in an 
athlete's biochemistry. Using previous urine and blood tests as a baseline, they can spot 
biomarkers that act as red flags and could 
indicate an athlete has used a performance- 
enhancing drug, even if a specific substance 
wasn't detected in testing. 

As drug testers try to keep pace with drug users, 
the WADA list of banned substances changes 
every year. In 2006, for example, the section 
pertaining to growth hormones listed five 
banned substances. Ten years later, that same 
section specifies more than 30. 

"In the last 10 years, we've made efforts to be a lot more proactive," said Eichner, who was 
formerly the science director at USADA. "We 
look at the scientific and the medical literature 
and try to predict the substances that may be 
used in the future." 

The lab technician doesn't know the source of 
any sample. There is no name attached to the kit 
— just the bar code and seven-digit ID number. 
They will run the sample through every test and 
report the results without ever knowing whether 
they had caught an aspiring college athlete, a 
veteran Olympian or perhaps just received a 
surprise quality-control sample from WADA to 
make certain the lab is doing its job. 

"That's all we'll ever receive, just a unique ID 
code," Eichner said. "It's important for us to 
maintain our independence in that way. We're 
neutral." 

The doping scandal that has enveloped the 
Russians involves allegations of a state- sponsored program that centers on misconduct 
at the Russian lab during the Winter Olympics in 
Sochi in 2014. The Moscow lab was suspended 
by WADA and lost its accreditation in April. 

In the past few months alone, WADA has suspended the accreditation of the lab in South 
Africa — previously the only accredited lab in 
Africa — in addition to labs in Beijing; Madrid; 
Almaty, Kazakhstan; and Lisbon. The lab in Rio 
de Janeiro, which will need to process thousands 
of tests during the Olympics, was suspended in 
June because of "nonconformity with International Standards for Laboratories" but 
still could be given a green light to continue 
testing before the Rio Games begin Aug. 5. 

At the U.S. lab in Salt Lake City, after tests are 
run, the results are uploaded instantly to WADA 
and then dispersed to USADA and in short order communicated to the athlete. The "B" sample, 
meanwhile, lives on. 

The samples USADA collects during competitions remain at the lab for up to 10 years 
and can be analyzed down the road for new substances or as technology improves. They're 
locked in secure rooms inside industrial refrigerators that are kept at minus-112 degrees. 
At any time, USADA can call them out to be retested. 

U.S. athletes who say they have nothing to hide 
don't mind the prospects of future testing. If 
anything, they just wish other countries had a 
system and resources that matched the one here. 

"I'm happy they're trying to crack down elsewhere," Infeld said. "I don't think they're 
cracking down as heavily as they should. The 
more they do it, the more people they'll catch. 
But I know I can only control me and my 
training. I just have to do my best at that." Barry Svrluga contributed to this report. 

Rick Maese is a sports features writer for The Washington Post. 
Follow @RickMaese



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