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Exclusive - By Matt McGrath
BBC Radio Five Live science correspondent
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Athletes are using the blood of their team-mates as a means of improving their performance.
A BBC investigation has discovered that illegal blood transfusions are increasingly being used as an effective form of doping.
Blood doping is on the increase, scientists believe
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Athletes in many sports, particularly winter sports, are known to be transfusing blood from their team mates and coaches as a way of boosting their stamina and improving their chances of winning medals.
Despite the bizarre nature of the idea, scientists who specialise in blood doping are certain that athletes are turning to these illegal transfusions in greater numbers than ever before.
Jim Carrabre, chairman of the medical committee of the International Biathlon Union told the BBC that he had no doubts that transfusions were on the up.
Probably 40% of the people I saw were either transfusing saline or using a blood transfusion
Jim Carrabre
International Biathlon Union medical committee chairman
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"Almost the majority of athletes that I saw at [the] Salt Lake City [Winter Olympics in 2002] were showing puncture wounds. The sheer number that I saw made me suspicious," he said.
"I started focusing on the size of the puncture mark. You would use a small gauge needle to check haemoglobin levels, and when I saw the size of the needle marks I was convinced that athletes were using methods to enhance performance.
"Probably 40% of the people I saw were either transfusing saline or using a blood transfusion."
Blood doping began back in the 1960s with athletes withdrawing their own blood, storing it and only re-injecting it prior to competition when their body had already replaced the missing liquid.
The extra blood would give them the competitive boost they needed.
As an athlete you are always going close to the lines of what is forbidden
Marc Mayer
Banned Austrian skier
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The down side of this type of doping was that it needed careful handling of the blood, as well as storage and freezing facilities.
In the modern era, athletes have solved the problem of storage by leaving the blood in the veins of their suppliers until they are ready to transfuse.
Dr Carrabre believes this is what was happening at the Winter Olympics.
"Blood transfusions are easy to do - all you need is a donor. In the case of Salt Lake City there were lots of rumours and suspicions that athletes were transfusing from live donors that were brought over," he said.
"So you didn't have the problem of transporting blood through customs, especially after 9/11 when security was so tight.
"Someone coming over as a tourist when in fact they are a living blood donor for an athlete is a lot easier than trying to bring in frozen blood through customs which would raise a few eyebrows."
Cheater's logic
Transfusions have a certain logic from the cheater's point of view. Erythropoietin or Epo was the drug of choice for endurance athletes in the 1990s.
This drug, originally intended for anaemia patients, works by forcing the body to produce more red blood cells.
I can definitely see in a team right now you have some athletes who are there to provide the blood of the right type to the member of the team that is doing best at the moment
Bengt Saltin
International Skiing Federation medical committee chairman
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With these extra cells, you can run farther, faster and for longer. The drawback, apart from the long term damage to your health, is that Epo can be detected in blood and urine tests.
Since the introduction of these tests at the Sydney Olympics in 2000, the risk of getting caught has grown dramatically.
But if an athlete decides to transfuse blood from a team mate, getting caught is much less of a problem as no effective testing exists to detect foreign blood.
And while the benefits may not be as great or as predictable as using Epo, taking blood from a colleague of the same blood group will definitely boost your performance.
Bengt Saltin, a leading expert on doping matters and chairman of the medical committee of the International Ski Federation (FIS), says the idea of transfusions is bizarre but real.
"I can definitely see in a team right now you have some athletes who are there to provide the blood of the right type to the member of the team that is doing best at the moment. It is a very unhappy situation that can develop," Dr Saltin told the BBC.
Scientists are so concerned about the development that a group of experts in blood doping have written to the World Anti-Doping Agency to express their concern at the prevalence of blood doping in elite sport.
In a letter seen by the BBC, the scientists "beseech the Wada to send the strongest possible message to athletes that it will not tolerate blood manipulation".
They urge the agency to implement post competition blood tests. This, say the scientists, would stamp out the practice in a very short time.
Hope on the horizon
Despite the lack of test for transfused blood at present, steps have been taken to fight this type of sporting fraud.
A group of Australian scientists from the Royal Prince Albert Hospital in Sydney have been funded by the United States Anti-Doping Agency to research an effective test.
Their work has been successful and the method they have devised is currently "in press" with the peer-reviewed journal Haematologica.
Project co-ordinator Michael Ashenden told the BBC that the test can pick up as little as one teaspoon of someone else's blood in the circulation of an athlete.
"The test is based on the same principles that a hospital uses to match people for a transfusion," he said.
"In a hospital they will look for the major blood groups. But there are dozens of other minor blood groups as well, so the chance of you finding someone else who matches you for all these minor blood groups is very remote.
"What our test does is to use a fluorescent marker to detect these little groups. So if your blood has contains one of these groups it will glow.
"If we take a sample from an athlete and some of their cells are glowing and some aren't then we know they are using someone else's blood."
One of the problems for anti-doping until now has been the unreliability of some tests. Dr Ashenden says that this test is different.
"For once I think the scientists are in the prime seat. When you use someone else's blood and infuse it into you, there are no mistakes," he added.
"Our test won't tell you that you have someone else's blood in you unless you do. There are no false positives. It is different, in a certain way it is an ideal test and I'm confident that when it's implemented it will stamp out transfusions from other people."
Everything we can do within our power to stop athletes doing this should be done
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But a key difference with this test is that it needs to be implemented after a competition.
Dr Ashenden is hopeful that this can be in place by the Summer Olympics in Athens next year.
"I would like to think that they can take the steps that are needed. This is a serious problem.
"Doctors will not do transfusions in a hospital setting unless they have no other resort.
"The thought of an athlete sitting in a hotel room doing it, exposing themselves to some drastic health risks, including death, I think everything we can do within our power to stop athletes doing this should be done."
MMIX
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