Peter Bol drug test: What is EPO and why is it used by athletes to enhance performance?

Sport and athletics fans have been left in shock this week after West Australian Olympic hero Peter Bol was suspended from competition for failing a doping test.

Terms such as EPO, Erythropoietin, blood cells, A samples, B samples and ranking bands have been bandied around the endurance runner as he fights for his career and reputation, but just what has the 800m star been accused of?

What is EPO and why is it used by athletes?

EPO is the shortened term for Erythropoietin, which is a natural hormone produced by the human kidney to stimulate the production of and protection of red blood cells.

Red blood cells are vital carriers of oxygen around the body, feeding the muscles so they can produce the energy they need to move, including running.

Erythropoietin is then activated when the body senses low oxygen levels.

Synthetic versions of the hormone have been created for those suffering from anaemia as a result of chronic kidney failure.

However, athletes have been banned from using synthetic EPO in competitions because it can improve performance by making oxygen distribution and use more efficient, boosting endurance beyond normal human conditions.

When was EPO first seen, how does it affect performance and what are the long-term health effects?

The use of EPO, commonly referred to as “blood doping”, rose in prominence in the 1980s as endurance cyclists looked for an edge.

The practice was banned in the 1990s, but the first anti “blood doping” tests weren’t rolled out until the 2000 Olympics in Sydney.

Despite the ban, many athletes have been caught out, enticed by the improved endurance and power of muscles fuelled by extra red blood cells.

But there are serious health risks, including hypertension, high blood pressure, from thickened blood due to more cells, and it can make athletes more likely to use steroids to enhance effects.

Thickened blood can also lead to clots and heart attacks.

Why would a runner use it?

Dozens of cyclists have been caught using it, especially in high-stakes endurance road races such as Le Tour de France, including in 1998 when an entire team was disqualified for having 100s of doses in their team car.

But EPO is also enticing for runners because it can make them run faster for longer, handing them a winning edge for any race length, from Marathons to 400m and 800m races.

EPO can improve the recovery of muscles which comes in handy for big events such as the Olympics, where runners need to run multiple times in a short period.

How is it taken and how is it detected?

Synthetic versions of Erythropoietin can be injected much like insulin, making it relatively simple to use, but there are multiple ways it can be detected.

A General Practitioner can authorise blood tests to check on EPO for everybody, but athletes, for the most part, are tested through urine samples as a direct test to identify the presence of EPO.

But they also give a blood test that can show sustained use of EPOs, which is known as an indirect test.

There are five bands, or categories, that show how high the levels are, and Bol is reportedly only just in the lowest band.

The substance is detectable for up to a week after being injected and tests are very thorough but false positives are possible in post-exercise, protein-rich urine, or in the case of contamination.

A third detection method in the pipeline will look for the effects of EPO in the body’s cellular anatomy as the practice is stamped out.