The prevalence of doping in elite sports is relevant for all those involved in sports, particularly for evaluating anti-doping policy measures. Remarkably, few scientific articles have addressed this subject so far, and the last review dates back to 1997. As a consequence, the true prevalence of doping in elite sports is unknown. Even though it is virtually impossible to uncover the exact prevalence of a prohibited activity such as doping, various methods are available to uncover parts of this particular problem, which enables the circumvention (to a certain degree) of the issues of truthfulness, definition problems and the limits of pharmacological evidence. This review outlines the various methods that exist and presents the scarce data available in this area. It is concluded that a combination of questionnaires using the Randomised Response Technique and models of biological parameters is able to provide the statistical possibilities to reveal accurate estimates of this often undisclosed practice. Data gathered in this way yield an estimation of 14–39 % of current adult elite athletes who intentionally used doping. These period prevalences have been found in specific sub-groups of elite athletes, and the available data suggest that the prevalence of doping is considerably different between sub-groups with varying types of sport, levels and nationalities. The above-mentioned figure of 14–39 % is likely to be a more accurate reflection of the prevalence of intentional doping in elite sports than that provided by doping control test results (estimate of doping: 1–2 % annually) or questionnaire-based research (estimations between 1 and 70 % depending on sport, level and exact definitions of intent and doping). In the future, analytical science may play a more important role in this topic if it may become feasible to detect very low concentrations of prohibited substances in sewage systems downstream of major sporting events. However, it is clear that current doping control test results show a distinct underestimation of true doping prevalence. It does not seem feasible to distil better estimates of the prevalence of doping based on performance indicators or ego documents because of the various existing effects that influence athletic performance. Such information can only be used as extra information to augment the accuracy of prevalence rates that have been found by using other techniques. True doping prevalence studies have been scarce in elite sports so far. With the correct application of the available scientific methods, preferably using harmonised definitions of the terms ‘doping’ and ‘elite sports’, more information on this topic may be gathered in a relatively short time. This would assist anti-doping professionals in the future in order to evaluate the effects of possible anti-doping measures, and better anti-doping policies would serve athletes who compete without doping. The existing anti-doping measures seriously impact the lives of elite athletes and their immediate entourage, which imposes a moral burden to evaluate these measures in the best possible way.

/pdf/prevalence-of-doping-use-in-elite-sports-a-review-of-numbers-24yxoyxex9.pdf

Prevalence of Doping Use in Elite Sports: A Review of Numbers and Methods

The effect of live high-train low on hemoglobin mass (Hbmass) and red cell volume (RCV) in elite endurance athletes is still controversial We expected that Hbmass and RCV would increase, when usin

https://www.physiology.org/doi/pdf/10.1152/japplphysiol.01284.2005

Live high-train low for 24 days increases hemoglobin mass and red cell volume in elite endurance athletes

To engage in this debate we will address the following questions: what is the change in performance after adaptation to living high and training low (LHTL); what physiological mechanisms could be responsible; what is the evidence that a change in red cell volume (RCV) is one such mechanism; and what

https://www.physiology.org/doi/pdf/10.1152/japplphysiol.00820.2005

Point: positive effects of intermittent hypoxia (live high:train low) on exercise performance are mediated primarily by augmented red cell volume.

Oxygen is essential for life, and the body has developed an exquisite method to collect oxygen in the lungs and transport it to the tissues. Hb contained within red blood cells (RBCs), is the key oxygen-carrying component in blood, and levels of RBCs are tightly controlled according to demand for oxygen. The availability of oxygen plays a critical role in athletic performance, and agents that enhance oxygen delivery to tissues increase aerobic power. Early methods to increase oxygen delivery included training at altitude, and later, transfusion of packed RBCs. A breakthrough in understanding how RBC formation is controlled included the discovery of erythropoietin (Epo) and cloning of the EPO gene. Cloning of the EPO gene was followed by commercial development of recombinant human Epo (rHuEpo). Legitimate use of this and other agents that affect oxygen delivery is important in the treatment of anaemia (low Hb levels) in patients with chronic kidney disease or in cancer patients with chemotherapy-induced anaemia. However, competitive sports was affected by illicit use of rHuEpo to enhance performance. Testing methods for these agents resulted in a cat-and-mouse game, with testing labs attempting to detect the use of a drug or blood product to improve athletic performance (doping) and certain athletes developing methods to use the agents without being detected. This article examines the current methods to enhance aerobic performance and the methods to detect illicit use.

/pdf/erythropoiesis-stimulating-agents-and-other-methods-to-2bpuwer5h6.pdf

Erythropoiesis-stimulating agents and other methods to enhance oxygen transport

In this article, we explain and reflect critically upon the athlete whereabouts reporting system in top-level sports initiated by the World Anti-Doping Agency (WADA). This system makes it compulsor...

/pdf/elite-athletes-duty-to-provide-information-on-their-3gjnl72z7l.pdf

Elite athletes' duty to provide information on their whereabouts: justifiable anti-doping work or an indefensible surveillance regime?

ObjectiveThere is widespread public concern about fairness in sports. Blood doping undermines fairness and places athletes' health at risk. The purpose of this study was to examine the prevalence of abnormal hematologic profiles in elite cross-country skiers, which may indicate a high probability of

Inggard Lereim

Papers

Abnormal hematologic profiles in elite cross-country skiers: blood doping or?