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The `Black Eye’ of Environmental Contamination, Part Two

(This is the second in a series we are doing on environmental contamination. Click here for part one.)

Like a Matryoshka doll of conjecture and supposition, the very real threat of environmental contamination in the horse racing industry’s testing protocols can play out like a game that becomes ever more intricate with each layer unpeeled.

In part one of this series, we looked at a growing understanding of the array of possible contaminants in the backstretch environment coupled with ever more sensitive testing methodologies.

But go deeper, and what emerges are questions surrounding things like metabolism rates and pathways of exposure, chemical stability and analytical sensitivity, burdens of proof and innocence.

So, what do some industry experts posit as possible solutions to the kinks bedeviling the current testing infrastructure?

For some, the first port of call belongs in the medication rule books–more specifically, the arcana of testing thresholds.

These thresholds are permissible amounts of a legal therapeutic medication in a given sample–designed to be an indication, regulators say, that it was administered at the proper time and at the proper dose, and that the horse was not racing under the influence of a performance-enhancing dose of something.

The Association of Racing Commissioners International (ARCI)’s “Endogenous, Dietary, or Environmental Substances Schedule” is a list of 10 substances with their associated testing thresholds. Caffeine has a threshold of 100 ng/ml in blood, for example. For morphine, it’s 30 ng/ml in urine. The Racing Medication & Testing Consortium (RMTC)’s “Controlled Therapeutic Substances Schedule” is a list of another 28 regulated medications with associated thresholds.

Nevertheless, there are all sorts of other substances of both horse and human use found frequently in the backstretch environment for which there are no such thresholds.

Because of this omission, Steve Barker, former director of the Louisiana State University Equine Medication Surveillance Laboratory, says he believes the industry needs to convene a team of experts, including pharmacologists, to establish a more sweeping and comprehensive set of testing thresholds.

This list would take into account the ubiquity of substances across the nation’s backstretches, as well as to determine levels below which they have no pharmacological effect–in other words, amounts that don’t enhance the performance of a horse.

“We need a veterinary pharmacologist review to say, ‘this is what the drug does, and yes it has the potential to be a sedative or be a stimulant–all these things, it has the potential to be–but at these levels, it does nothing,'” says Barker.

“This need not be so damaging to the integrity to racing, but it is damaging,” Barker says, adding that in some cases where thresholds are already in place, they may need to be raised to take into account the additional threat of environmental contamination.

Some experts, however, urge caution.

“It is not an unreasonable suggestion on the face of it,” says RMTC executive director and chief operating officer Mary Scollay, regarding an across-the-board look at thresholds.

But Scollay warns that the industry needs to be careful not to adopt more permissive rules that result in the sport’s integrity being even further eroded.

Indeed, there are various reasons why the RMTC hasn’t already established testing thresholds for medications, permitted and otherwise, including how the use of a particular drug in close proximity to a race may be deemed ethically objectionable.

“You’ve got to think about the other people in the race,” says Scollay. “Can they legitimately feel like their horse had a fair shot and was not at a chemical disadvantage?”

A broader snag appears to concern the term “performance enhancing”–a phrase tossed around like a tennis ball, but one that can have a kaleidoscopic set of interpretations and permutations.

“When you have a horse that wins by half a nose, and if that horse ends up having some sort of a drug in its system, how can you say with certainty that there was no performance-effecting thing going on?” says a director of a U.S. laboratory, who asked to remain anonymous due to their company’s involvement in ongoing litigation.

“Performance is more than about speed, right?” says the director. “It’s about focus. It’s about determination. It’s about drive. It’s about a whole bunch of things.”

“No one size fits all”

University of Kentucky professor Scott Stanley agrees that the nailing down of thresholds can be a complicated task. He pointed to scopolamine–a substance that can appear in jimson weed, a potential feed contaminant made infamous by Justify’s positive test following his 2018 GI Santa Anita Derby win.

According to Stanley, not only can scopolamine appear at different levels in the jimson weed’s stem, leaf or seed, but these levels can also be altered by the conditions in which the plant grew, like a bad drought season.

“So now I’m supposed to establish a threshold for potential exposure that may shift and change on the fly, depending on the season and the environment, and whether the horse was exposed to this over several days or a single time,” Stanley says.

“Not one size fits all,” he says, adding that the determination of legitimate instances of environmental contamination is a similar scientific minefield. “We don’t necessarily know how, when and why the contamination happens. And it’s rarely the same every time.”

The problem, says Stanley, is racing’s current “hardline regulations, which are appropriate 99% of the time,” he says. “We need to have more modernized rules that can address situations like this.”

Over the past few years, many regulators have modified their rules to better take into account the threat of environmental contamination. In recent years, the Kentucky Horse Racing Commission (KHRC) altered its absolute-insurer rule to allow trainers with a medication positive to provide rebuttal during hearings, for example.

But as it currently stands, a positive finding almost always triggers a formal regulatory process that critics argue too often ends in unnecessary penalties when environmental contamination is to blame. On top of that are the not-inconsiderable costs that aggrieved connections can amass if they choose to legally defend their reputations.

Which is why Stanley suggests that a non-prosecutorial “initial review” first take place before any regulatory action occurs, if indeed environmental contamination appears a genuine possibility.

An initial review–conducted by an independent panel of experts with no skin in the outcome–would afford regulators a needed window with which to investigate cases that defy simple explanation and without the regulatory clock ticking.

Back in 2013, 48 California-based horses tested positive for Zilpaterol–then a Class 3 medication that is also used as a supplement for weight gain in livestock. The contamination was traced back to a batch of contaminated sweet feeds.

Zilpaterol is the “perfect example” of the need for such a review system, Stanley says. “We would never have considered Zilpaterol when it happened as a contamination exposure issue.”

A non-prosecutorial initial investigation would also afford regulators the opportunity to determine whether a positive is intentional or inadvertent, and thus give them avenues to embark upon formal regulatory proceedings or dismiss the case altogether without penalty if environmental contamination is proven.

If the preponderance of evidence supports that the positive finding did not affect the horse’s performance, and that it was outside the trainer’s control, “then the horse shouldn’t be disqualified,” Stanley says.

“There’s no room for error”

There are other ways to modernize the regulatory framework, especially when it comes to detection limits and screening limits for which there can be much variability between laboratories, say experts.

A detection limit is the lowest level at which a laboratory can detect with confidence a certain substance. That different laboratories often have different detection limits for substances is a problem primarily for those without established testing thresholds–in other words, the “non-threshold” substances.

In a nutshell, what this means is that one laboratory might be able to accurately detect a substance at a lower level than another, making the playing field less than fair for trainers across the country, say experts.

A similarly problematic paradigm exists when it comes to screening limits, typically higher than the detection limit, and what is in essence an established cut-off limit for detection.

Screening limits differ from testing thresholds in that they aren’t permissible amounts of a regulated drug–rather, as Scollay puts it, they are levels that trigger further analysis.

And while the RMTC has recommended screening limits for certain substances–less than a dozen, says Scollay–in an effort to “harmonize” practices across different laboratories, “to a large extent, it’s unknown” just how much variability in testing for non-threshold substances there is, she admits.

“They screen for so many substances,” says Scollay. “Until a certain substance gets on our radar screen and we have a discussion, we don’t really know how the labs respond.”

On a more fundamental level, trainers, regulators and scientists emphasize the need for a wholesale revision of management practices across the nation’s backstretches and testing areas. “Equine environments aren’t pristine and never will be, but we must do something,” says Barker.

Some look to the trainers to make their barns as contaminant-free as possible, ensuring that all medications are handled cleanly and professionally, for example, and that staff don’t urinate in the stalls. “If you can’t housebreak the help, you probably shouldn’t have a trainer’s license,” says Scollay.

But many horsemen are in turn highly critical of the tracks themselves and argue that facilities across the nation don’t take nearly enough rigorous care to ensure the ship-in stalls, the receiving barns, and the test areas are clean.

“I have on occasion complained to management because you ship into some stalls on race day and you’ll find manure from the day before or bandages that haven’t been thrown in the trash,” says trainer Graham Motion. “In many countries it wouldn’t be acceptable.”

Indeed, in the United Kingdom, horses typically are stabled at the racetrack only for the day of the race. When they leave, the racetrack must clean the empty boxes to one of two levels of cleanliness, or else face a possible fine. A similar punitive set of standards in the U.S., says Motion and others, could help fix a glaring problem.

“The levels we’re being tested at nowadays are so minuscule, there’s no room for error here,” Motion says. “Like we’re being held to high standards as trainers, which is a good thing, so should they be held to high standards as well.”

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The `Black Eye’ of Environmental Contamination

Over the past year or so, a series of high-profile positives attributed to environmental contamination have dogged racing’s highest-profile trainer, Bob Baffert.

Last week, the California Horse Racing Board’s Board (CHRB) conducted a hearing into the Dextrorphan positive incurred by the Baffert-trained Merneith (American Pharoah) in July. Connections had attributed the positive to cross-contamination stemming from Merneith’s groom, who took DayQuil and NyQuil, both of which contain Dextrorphan.

Before that were the positives from Arkansas in May, when the Grade I-winning Gamine (Into Mischief) and Charlatan (Speightstown) subsequently tested positive for Lidocaine–an issue of cross-contamination, Baffert argued, from a stable employee wearing a pain-relieving Salonpas patch.

And before that was, of course, 2018 GI Santa Anita Derby-winning Justify (Scat Daddy)’s scopolamine positive, attributed to hay contaminated with scopolamine-laced Jimson Weed.

By virtue of Baffert’s prominence within the sport, the issue of environmental contamination has been well laundered for a sun-lit public airing, with talk turning to medication smeared walls, urine-soaked bedding, contaminated hay and feeds, and backstretch workers taking all sorts of legal and illicit drugs.

While the issue is a bit of a complicated acronym soup involving things like testing thresholds, screening and detection limits, clearance times and ever more sensitive testing methodologies, expert opinion appears to be drawn into two broad camps.

On the one hand are those who believe adjustments need to be made to account for the inherent risks from inadvertent drug contamination. On the other are those who advocate a hardline stance, warning that a rule relaxation invites cheating.

Still, most agree that the industry needs to make fundamental revisions to the current status quo to avoid an ongoing string of contentious drug positives that further erode public trust in the sport.

“We can’t live with rules that we’ve been using for 30, 40, 50 years,” says Scott Stanley, a professor at the University of Kentucky. “We’ve got to think outside the box and move forward. Racing keeps giving itself a black-eye.”

“I won’t say there’s lots and lots”

There have been a good 20 years of research illustrating the where and what of environmental contamination–some have helped answer lingering questions, even if others have also somewhat muddied the waters.

The International Conference for Racing Analysts and Veterinarians at the turn of the millennium unveiled a series of papers showing how even low-level exposures to naproxen, ibuprofen, isoxsuprine and flunixin–all of them commonly used therapeutic medications in racing–could result in a subsequent medication violation.

In what some regard a seminal 2008 study, Steven Barker, former director of the Louisiana State University Equine Medication Surveillance Laboratory, analyzed the test barn and the receiving barn stalls at a Louisiana racetrack.

Barker found the presence of nonsteroidal anti-inflammatory drugs like flunixin, phenylbutazone and naproxen in the soil in stalls, on stall surfaces, in the circulating dust, and in accumulated pools of water on the backstretch. All of the samples collected contained cotinine, the predominant metabolite of nicotine and a biomarker for exposure to tobacco smoke.

None of those drugs Barker detected, however, were at concentrations sufficient to trigger a positive test.
A few years ago, Charles Town suddenly found itself at the center of a series of naproxen positives, mostly among horses shipping in. Naproxen is a nonsteroidal anti-inflammatory commonly found in drugs like Aleve and nicknamed the poster-child of stall contamination.

In response to this rash of positives, researchers swabbed 21 ship-in stalls at Charles Town and discovered high levels of naproxen in four stalls and reportedly low-levels of the drug in almost all.

Besides naproxen, the researchers discovered things like acepromazine and glycopyrrolate, along with traces of common human substances like metoprolol, a blood-pressure medication, and methadone and tramadol, which are opioid and opioid-like pain-medications respectively. Only four of the 21 tested stalls swabbed clean.

Other studies show more pointed findings, including a potential connection between bedding soaked with contaminated urine and an elevated risk of a positive test.

In this French study from 2011, horses administered flunixin orally and intravenously were housed on three different levels of bedding: one deep and one thin bedded stall (both of them stripped completely daily), and another stall managed the usual way (just the muck and wet patches removed).

A full day after the drug was administered, one horse was moved to a stable in which no horse had been given flunixin.

The only horse that subsequently tested clean was the horse moved to an uncontaminated stall, while the thinly bedded stall stripped daily constituted the highest risk of a positive test.

As a result of a number of positives for typically human-use antihistamines and anti-inflammatories, the British Horseracing Authority (BHA) embarked last year upon a series of different studies to determine the threat of environmental contamination in the UK.

One study involves the swabbing of racetrack stabling, another the boxes at private training yards, while the third study looks at the potential relationship between bedding contaminated with low levels of medications and the risk of a positive finding.

According to David Sykes, no results are currently ready for public consumption, but he did say that they had found “very low levels” of medications in the racecourse stables. “I won’t say there was none,” he says. “But I won’t say there’s lots and lots.”

The question now is: What does the gestalt of these studies reveal?

“Put down that golf club”

According to Barker, they illustrate just how prodigiously substances exist in and on the bedding, walls, dirt, dust, feed and water tubs of the backstretch environment–even in the feed vanned into the track. Then there’s the human element.

“The horses’ environment also includes veterinarians. It also includes other humans, grooms and trainers and riders. Even the public that bring things into their environment,” he says. More pointedly, they illustrate how “the environment of the horse can contaminate the horse at levels that can be detected,” he says.

Given how prevalent contaminants exist in the environment, however, why aren’t drug violations a more common occurrence?

Outside of a cluster of positives that can be traced back to something like a batch of contaminated feed, “It can be a random thing,” says Barker, pointing to a lightning strike quality to the event, with a very specific chain of circumstances that lead to a positive finding.

The horse must be exposed to a high enough quantity of a substance close enough to a race, for example. Just as importantly, perhaps, is that a test is conducted in the first place. “How many horses aren’t being tested?” Barker wonders.

On the flip side of the same coin are those experts who argue that the link between the environment and the test tube is far from clear.

“My definition of environmental contamination is exposure to a substance that has the potential to result in a detectable concentration in a horse, and that that exposure occurred beyond the control of the trainer,” says Mary Scollay, executive director and chief operating officer of the Racing Medication and Testing Consortium (RMTC).

“Some of the things that are being posited as environmental contamination I disagree with because I believe they’re preventable,” she adds. “What I feel has not been adequately demonstrated is the link between what’s in the environment and what’s in the horse.”

For one, the concentrations being detected in the backstretch environment are typically at miniscule amounts, Scollay says. As an example, she points to a calculation that Stanley made of Barker’s 2008 data: That a horse needed to consume 32 tons of dirt to obtain the equivalent of a single dose of phenylbutazone.

(In response, Barker emphasizes how his original study was intended primarily to detect background levels in the backstretch environment, and that subsequent studies–the French study in particular–have made the connection between contamination and a risk of a positive finding).

There are other variables, like the manner by which contaminants enter the horse’s body, as their metabolism processes substances differently depending on how it’s introduced into the system. “Not everything that enters the mouth gets absorbed,” Scollay says.

The connection therefore between a backstretch worker taking a drug–whether legal or illicit–and a positive finding in the horse they have contact with is similarly dependent upon the substance, location and levels of exposure, says Scollay. “Once again, there’s no blanket answer.”

Some substances are much more stable in the environment than others, meaning that they maintain their chemical make-up–and therefore their pharmacological potency–for long periods of time. This is borne out, say experts, in how widely used medications like furosemide are inconsistently detected in the environment.

At the end of the day, however, some trainers are able to operate large barns in multiple jurisdictions without falling foul of the regulators, says Scollay. While the “lightning strike” analogy is applicable in some cases of environmental contamination, she adds, “If you get struck by lightning twice, then I’m going to suggest you put down that golf club.”

“Horse manure”

Another key component of this issue is how testing methodologies are becoming ever more sensitive–with some laboratories proving more sophisticated than others. Indeed, the naproxen positives at Charles Town coincided with state regulators switching the drug testing contract to the “highly capable” Denver-based Industrial Laboratories, according to the authors of the 2018 study.

“What’s been the real problem here is we came from a period of time when most of these kinds of residues simply were not being detected before in horses,” says Barker.

“Our methodology was not broad based to cover all possible drugs. Sensitivity of instrumentation was not nearly what it is today–the sensitivity has really increased,” he adds. Indeed, “There’s the ability to test some of these drugs to zeptogram levels.”

To put that into perspective, a picogram–a larger unit of measurement than the zeptogram, and one more commonly referenced–is the equivalent of one second in 32,000 years. A femtogram–the next unit of measurement down from the picogram–is the equivalent of one second in 32 million years.

This basis of comparison is one frequently raised by advocates of the horsemen, and critics of the current testing system. But other experts object to the quantification of testing methodologies in this manner.

“It all sounds very dramatic,” says the director of a U.S. laboratory, who asked to remain anonymous due to their company’s involvement in ongoing litigation. “But it’s kind of misleading.”

To make their point, the lab director says that the amount of a particular substance in a single sample is a fraction of what’s in the body as a whole, and that a horse has, on average, 50 liters of blood in its body. Fifty liters, therefore, is the equivalent of 50,000 milliliters.

“The key term is per milliliter,” says the lab director, pointing to betamethasone, a steroid medication, which has an RMTC testing threshold of 10 picograms per milliliter.

“We’re not saying that the horse can only have 10 picograms of betamethasone in its system,” says the director. “We’re saying you can have 10 picograms per milliliter times 50,000 milliliters, and that’s how much drug you can actually have present in the horse.”

The lab director also takes issue with the argument that a positive finding at a low-level is inherently innocuous, as that assertion fails to take into account origins of dose and administration.

“The people that say the concentration is so low, it has to be environmental contamination–that’s the biggest load of horse manure that I can think of. Obviously, the level cannot tell us anything of how it got into the horse and at what level,” the lab director says.

“People have this perception that the technology can capture everything and anything, and so, ‘you guys are finding things all the time,'” says the lab director. “Keep in mind, 99% of the horses test clean. If it was that easy to contaminate your horse, we would be seeing a whole lot more cases than we actually are.”

In part two we look at possible solutions to the problem, with experts zeroing in on testing thresholds, screening and detection limits along with formal regulatory processes.

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