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For Cyclists, an Injection of Controversy
By Samuel Abt International Herald Tribune

Tuesday, August 6, 1991
The shadow of the syringe has fallen across professional bicycle racing.
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The top-ranked team in the sport admits that it gave regular injections, legal but unpublicized, to its riders in the Tour de France. The rare announcement was designed to explain the team's withdrawal but raised new questions.
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According to the PDM team, its doctor injected all nine riders with liquid food before they were forced to quit the Tour with body pains and high fevers. The injections were never made public as a possible cause of the withdrawals or as part of the team's routine medical treatment.
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The organizers of the Tour have accepted findings that the liquid food was probably contaminated. The team, based in the Netherlands, quit the three-week race near its halfway point, on July 15 and 16.
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A viral infection was first suspected, but PDM's management insisted that food poisoning was the problem. Now, in a team study made public during the weekend, strong suspicion has fallen on injections of Intralipid, an over-the-counter food supplement containing lecithin, a derivative of egg yolk, and soybean oil.
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The use of hypodermic needles summoned up dramatic connotations in the popular mind, officials and observers of the sport admitted ruefully on Monday. "If it comes out of a syringe, the public thinks it probably has to be dope," said David Walsh, an Irish journalist and the biographer of two of his country's leading bicycle riders.
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"You're not dealing with a doping scandal here," insisted a PDM rider who spoke only on condition of anonymity. "What happened was defensible.
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"But something went wrong somewhere."
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He and others were quick to deny that there was anything sinister in the common, if unpublicized, practice of injections. "Whatever it looks like," Walsh said, "many teams prefer injections to pills or syrup because injections work faster."
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That was supported by the coach of a professional team, who also insisted on anonymity. "Too many pills upset the stomach," he said. "So one injection is better than 20 pills."
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"Of course," he added, "nobody needs to take 20 pills either.
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"With injections, however, there's a psychological advantage for some riders. It hurts, so they can think they're getting something that the other riders don't have. Many traditional teams create a feeling with their riders that if they don't have injections, they feel less confident."
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Another team coach, Jan Raas of Buckler, confirmed that injections were not uncommon. "But not food supplements with us, no, no, no, no," he said. "Some vitamin injections, sometimes glucose but not more than that."
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Injections by riders without benefit of medical advice was standard when Raas was in his heyday as a rider a decade ago. He won 10 stages in the Tour de France and was world road-race champion in the late 1970s. "In my time there were no team doctors," he said. "Doctors are better because you can trust them."
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Medical practice was often dispensed then by soigneurs, as they are called in French - often mechanics or masseurs.
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"I never did injections myself because I was a little bit afraid of them, always," Raas continued. "I took vitamin pills and iron pills."
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Do some riders still inject themselves? "It's a good question," he said. "I don't know."
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At a news conference near the end of the Tour, PDM officials strongly denied that drugs had been involved. The French press and television made such suggestions immediately after the withdrawals, with the daily sports newspaper l'Equipe talking openly about doping or blood packing gone wrong.
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"We reject any insinuations about drugs," said Manfred Krikke, the manager of the PDM team. He and PDM's medical authorities said salmonella was the prime suspect.
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"There is absolutely no drug use involved," added Professor Jacques van Rossum of the department of pharmacology at the University of Nymegen in the Netherlands.
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Since no PDM riders failed any of the four drug tests administered to them, the Tour's doctors did no further investigating.
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In a telephone conversation from the Netherlands on Monday, Krikke offered two possible reasons for the contamination. One was that the food supplement, which was injected three times during the race, had been stored in high heat in a car. The other was that the needle used might have contained air, which he called a "good growing ground for bacteria."
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He described the supplement as "standard food in hospitals, used for patients who have stomach problems or are in a coma." Its use has been discontinued by PDM, he added.
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Jan Gisbers, the team's coach, explained that the use of food supplements in forms other than injections had been standard practice for the last half-dozen years at least.
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"You have to do it," he said, "because of the calories a rider burns. In a heavy racing day, he needs more than 6,000 calories, sometimes 9,000 to 10,000." Professional riders eat big breakfasts, usually based on carbohydrates, and big dinners, usually based on proteins. During a daily stage they consume one or two lunches, which are eaten on the fly from canvas bags packed with small sandwiches, pastries and fruit.
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The average rider will also drink up to a dozen bottles of liquid in a race, mainly water but increasingly high-energy compounds.
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Gisbers added that not all nine riders had received three injections in their arms during the Tour. "Some got two shots, some three," he said. "But the last time, they all received it." That was at Rennes, a day before the first rider fell sick.
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The team's physician, Dr. Wim Sanders, refused to comment when he was reached in the Netherlands.
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Both Krikke and Gisbers stressed their opposition to banned drugs.
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"We don't want to be involved with drugs," Krikke said. "We have a very strict policy to work along UCI lines on banned substances." He spoke of the 3,600 drugs outlawed by the International Cycling Union, known as the UCI from its French initials.
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Among the riders forced to quit were Erik Breukink, a Dutchman, and Raul Alcala, a Mexican, early favorites in the Tour, which was won by Miguel Indurain, a Spaniard. Other PDM riders affected included Sean Kelly and Martin Earley, both Irishmen.
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From his home in England, Earley reported Monday that he was feeling better and had raced Sunday in the Wincanton Classic but had to drop out after 100 miles (161 kilometers). He hoped to be back at full strength for the next major races in August.
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"They told us it was a salmonella bacteria," he said. "To me, where it came from doesn't really matter that much. I was out of the Tour and that was the biggest shock. It was a terrible thing and that's it."
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Asked if he had any doubts about the team's future medical policy, he was hesitant. "I have no idea," he finally answered. "I'm not a doctor. I can't say I won't listen to the doctor. What would you do?"
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