Search

The COVID-19 pandemic has had a significant impact on elite sport by postponing the Olympic Games Tokyo 2020 four months before the original start. This impacted athletes' macro-cycle periodization, psychological stressors and resources. We analyse whether track-and-field athletes were able to maintain their performance levels successfully across the last two Olympic cycles, controlling for age, gender and doping prevalence. For this, worldwide competition results (excluding multi-events & relays) of at least national level since London 2012 and up to Tokyo 2020 were retrieved. Individual performance curves were analysed using hierarchical multilevel modelling. Individual baselines (random intercept) and developments (random slope) were analysed. 2,383 athletes (52% male) recorded 15,766 outcomes since London 2012. The final conditional growth model (ICC = 48%) shows that performances increased in the wake of Olympic games, dropped significantly in 2020 and recovered beyond previous form in 2021. There was no significant difference between men's and women's developments. Age was a significant predictor (b = 0.17, SE = 0.02), but doping violations was not (b = 0.01, SE = 0.03). These results showcase performance trends in international athletics and their variability, present an overall successful periodization to achieve peak performance at Tokyo 2020, and discuss predictions for track and field at Paris 2024., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: A link between androgen use and the risk of cancers, especially prostate and breast cancer, has been suggested. The knowledge about a possible association is limited., Objective: The study aimed to investigate cancer incidence rates, particularly those related to prostate and breast cancer, in male androgen users and compare them to a control group., Methods: We included male androgen users identified through a nationwide anti-doping testing program in Danish fitness centers from 2006 to 2018. We paired each case with 50 male controls of the same age, selected randomly. The cohort was followed from baseline and until 2023. The outcome was the incidence of prostate cancer, breast cancer, or any cancer excluding non-melanoma skin cancer., Results: The study included 1,189 androgen users and 59,450 controls, with a mean age of 27 years at enrolment. During the follow-up period with a mean length of 11 years, 13 androgen users, and 612 controls were diagnosed with cancer. This resulted in an incidence rate ratio of 1.05 (95% CI: 0.55-1.81). None of the androgen users were diagnosed with prostate or breast cancer., Discussion and Conclusion: Male androgen users did not face an increased short-term risk of cancer, neither overall nor related to prostate or breast cancer. Our study indicates that the absolute risk of malignancies in androgen users is comparable to that in the background population. However, we cannot exclude androgens as a cancer risk factor due to the limited sample size, relatively short follow-up period, and subject age., (© 2024 The Authors. Andrology published by Wiley Periodicals LLC on behalf of American Society of Andrology and European Academy of Andrology.)

To prevent athletes from unintentional doping, the anti-doping authorities in Taiwan have launched several sports-prohibited substances inquiry services since 2008. This study aimed to enhance the prevention of sports-prohibited substance misuse by analyzing data collected from major nationwide service systems, enabling the identification of trends in athletes' exposure to drugs and prohibited substances. The study collected over 30,000 data points from three major national anti-doping inquiry systems, spanning from 2008 to 2022. The information of the users consulted products, prohibited substances, and sports disciplines in the data were calculated and categorized. The usage of inquiry systems has shown an increasing trend from 2008 to 2022. Athletes comprised the majority of users (> 40%), significantly outnumbering other user groups (all below 20%). Among the inquiries, Western medicine accounted for the highest percentage (up to 79.6%), and it also contained the majority of the prohibited substances. Interestingly, traditional Chinese medicines had a higher chance (35.9%) of containing prohibited substances, as indicated by the mobile application. The prohibited substances mainly belonged to class S6 stimulants and S9 glucocorticoids. Among the daily medicinal products and nutritional supplements encountered by sports personnel, approximately 30% of them were found to contain prohibited substances. Future educational efforts should focus on raising awareness about traditional Chinese medicines and drugs for the common cold, ADHD, and pain relief, as well as their regulation, to prevent the misuse of prohibited substances., (© 2024 John Wiley & Sons, Ltd.)

Background and Objectives: The use of anabolic-androgenic steroids (AASs) by competitive and recreational athletes has been studied and well documented. There are numerous studies showing its effects on personality traits and risky behaviors like aggression. The relationship between AAS use, aggression, and narcissism is complex and intricate. We examined this relationship in male bodybuilders who use AASs. Materials and Methods: A total of 319 healthy subjects aged 18-44 years (33.4 ± 9.4) who have been regularly training at bodybuilding for at least 3 years participated voluntarily in the study and completed a demographic data inventory, the Five-Factor Narcissism Inventory Short Form (FFNI-SF), and the Buss-Perry Aggression Scale anonymously. Demographic data were given as percentages, comparisons of aggression and narcissism scores according to AAS use were performed by using an independent sample t test, and effects of narcissism and aggression levels on AAS use was assessed by using logistic regression analysis. All analyses were performed by using SPSS Statistics 22.0. Results: Results showed that AAS users had significantly higher scores on the overall FFNI-SF Scale ( p < 0.001) and all sub-dimensions of narcissism ( p < 0.001) and on the overall Buss-Perry Aggression Scale ( p < 0.001) and all sub-dimensions of aggression ( p < 0.001). It was also shown that there were significant and positive correlations between the FFNI-SF overall score ( p < 0.001) and both the vulnerable narcissism and grandiose narcissism sub-dimensions ( p < 0.001) and the scores of the Buss-Perry Aggression Scale ( p < 0.001), physical aggression ( p < 0.001), anger ( p < 0.001), hostility ( p < 0.001), and verbal aggression ( p < 0.001) sub-dimensions. Conclusions: These results show a strong relation between AAS use, narcissism, and aggression in bodybuilders. However, it is not clear whether AAS use leads to aggression and narcissism or whether narcissistic and/or aggressive people tend to use AASs. Furthermore, including a lot of potential third variables shows that it does not have to be either one or the other way around. There is a need to conduct future studies to determine this causality.

Background and Aim: Evidence suggests there has been an increase in anabolic-androgenic steroid (AAS) use among women, driven by the evolving landscape of women's participation in sport. However, the extent of use is unknown. This systematic review aimed to estimate the prevalence of women's AAS use., Method: We conducted a systematic review of peer-reviewed articles in English, focusing on AAS use among women aged 18 and above. We excluded grey literature and studies that measured doping through some form of analysis (e.g. urine or hair). Searched databases were MEDLINE, CINAHL, PsycINFO, SocINDEX, SPORTDiscus, Embase and Cochrane Library. Titles and abstracts for all articles were screened, followed by full-text assessment and data extraction of included articles by multiple authors for accuracy. The pooled prevalence of lifetime use was determined using a random effects model and the risk of bias was assessed using the Joanna Briggs Institute Prevalence Critical Appraisal Tool., Results: Based on 18 studies, participant numbers averaged 669 per study (median = 189; range = 16 to 7051). The overall pooled AAS use prevalence was 4% (95% confidence interval [CI] = 2-9%) with high heterogeneity overall (I 2  = 95%). In the subgroup analysis, AAS use prevalence was 16.8% (95% CI = 11.0-24.9%, I 2  = 44%) in the bodybuilder subgroup, 4.4% (95% CI = 1.2-15.1%, I 2  = 93%) in athletes/recreational gym user subgroup, and 1.4% (95% CI = 0.4-4.7%, I 2  = 96%) in the general population/other subgroup. Meta-regression demonstrated significantly higher AAS use in bodybuilders compared with the other subgroup (P = 0.011)., Conclusion: Anabolic-androgenic steroid use among women appears to be substantially higher among bodybuilders and athletes/recreational gym users than the general female population., (© 2024 The Author(s). Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)

Little evidence based information exists in the medical literature on the mortality of abusers of anabolic androgenic steroids. These individuals range from competitive athletes and body builders to those whose who use physician prescribed mega-doses. Life insurance medical directors have little guidance on how to underwrite these individuals when presented with their applications. A recent article presented a Kaplan-Meir mortality curve accompanied with a control population demonstrating the mortality of these individuals over a 13-year period. Users of non-physiologic doses of anabolic androgenic steroids experience a mortality about two times the expected mortality of the control population. They should be underwritten with ratings commensurate with their anabolic androgenic steroid abuse and demonstrated mortality., (Copyright © 2024 Journal of Insurance Medicine.)

Abstract: Use of prohibited substances and methods (doping) by elite athletes is a complex and multifactorial behavior. Understanding the factors associated with doping behavior is crucial to identifying potential intervention targets to reduce doping among this group. However, there are limited data on the prevalence and correlations of self-reported prohibited substance use among Brazilian Olympic athletes. We present data from a cross-sectional, self-reported online survey. Participants were elite Brazilian athletes who participated in the 2020 Olympic and Paralympic Games. A total of 209 athletes (52.6% females) from both Brazilian delegations were surveyed. The self-reported doping use of prohibited substances or methods was found to be 7.2%. Receiving a recommendation from a medical doctor, even knowing that the substance is prohibited, was associated with an increased risk of self-reported doping use (OR = 17.474; 95% CI = 4.664-65.470, P < 0.001). Nearly 1 in 10 athletes reported use in their careers. Medical recommendation to use substances was the only factor associated with an increased risk of doping among elite athletes., (Copyright © 2024 by the American College of Sports Medicine.)

Objectives: The objectives of this study are to describe the prevalence of therapeutic use exemptions (TUEs) among athletes competing in four Olympic and four Paralympic games. The secondary objective was to present the prohibited substance and methods classes associated with TUEs., Methods: Data from the Anti-Doping Administration and Management System were extracted for this cross-sectional observation study. Eight cohorts were created to include athletes with TUEs who competed in the Rio 2016, Pyeongchang 2018, Tokyo 2020 and Beijing 2022 Olympic and Paralympic games. Prevalence of TUEs and proportion of prohibited substance and methods classes were defined as percentages among all athletes competing at each games., Results: 28 583 athletes competed in four editions of the Olympic games. Total prevalence of athletes with TUEs was 0.90% among all competitors. At the four Paralympic games, a total of 9852 athletes competed and the total TUE prevalence was 2.76%. The most frequently observed substances associated with TUEs at the Summer Olympics were glucocorticoids (0.50% in Rio) and stimulants (0.39% in Tokyo). At the Summer Paralympics, diuretics (0.79% in Rio) and stimulants (0.75% in Tokyo) were the most common. Winter games had somewhat similar trends, although TUE numbers were very low., Conclusions: The number of athletes competing with valid TUEs at the Olympic and Paralympic games was <1% and <3%, respectively. Variations in substances and methods associated with TUEs for different medical conditions were identified. Nevertheless, numbers were low, further reaffirming that TUEs are not widespread in elite sport., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: Determine whether there was an increased incidence of hit-by-pitch events in Major League Baseball (MLB) following the decision to enforce the foreign substance ban for pitchers during the 2021 season., Design: Descriptive Epidemiological Study., Setting: Major League Baseball hit-by-pitch data from publicly available Web sites ( mlb.com and fangraphs.com )., Participants: Major League Baseball players during the 2017, 2018, 2019, 2021, and 2022 seasons., Independent Variables: Hit-by-pitch exposure data by season and individual pitch type., Main Outcome Measures: Hit-by-pitch incidence rates from the 2017 to 2019 seasons (preenforcement) and the 2021 to 2022 seasons (postenforcement). Rates were compared with incidence rate ratios (IRRs)., Results: Hit-by-pitch incidence rate increased from 2.66 to 3.06 per 1000 total pitches (IRR, 1.15 [95% CI, 1.08-1.23]; P < 0.0001) following the enforcement. Incidence rates for 2017, 2018, and 2019 did not differ from each other individually, but incidence rate of all 3 seasons individually were significantly lower than that for the 2021 season ( P < 0.005). Sliders were 29% more likely to hit batters following the enforcement ( P = 0.0015)., Conclusions: Major League Baseball batters were hit by pitches at a significantly higher rate following the league's crackdown on foreign substance use for the 2021 seasons compared with the same time of year during the 2017 to 2019 seasons. This was followed by a slight regression toward preenforcement levels during the 2022 season., Competing Interests: The authors report no conflicts of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Objectives: To assess the prevalence of anabolic steroid use and the level of knowledge on anabolic steroids among the male athletes in Al Madina Al Munawara, Saudi Arabia., Methods: A cross-sectional study was conducted on male athletes randomly selected from the private athletic centers in Al Madina Al Munawara over 5 months. Data were collected from all participants using a self-administered anonymous questionnaire with 33 questions. The questionnaire covered the socio-demographic characteristics of the participants, and their knowledge, attitudes, and use of anabolic steroids., Results: Of the 150 male athletes surveyed, 121 completed the questionnaire (response rate: 80.6%). Over half were aged between 18 and 23 years (56.2%) and were single (79.3%). Thirty-two percent reported using anabolic steroids, mainly to increase muscle mass, following coaches' advice (46.1%). Key sources included the internet (30.7%), coaches (30%), and friends (27.9%), and non-healthcare professionals. The top motivations were price, coach's/physician's advice, and availability. The perceived benefits included increased muscle mass, strength, and endurance, while the perceived adverse effects included kidney/liver damage and sexual problems., Conclusion: One-third of the male athletes surveyed used anabolic steroids, influenced by accessibility and social contact, rather than healthcare guidance. This highlights the need for greater awareness of the long-term health risks, ideally through education provided by sports medicine specialists., (Copyright: © Saudi Medical Journal.)

The use of nutritional supplements can lead to doping risk and no data exist on high school athletes' use of certified third-party tested supplements. A cross-sectional cohort design was developed using an anonymous survey. Descriptive data for supplement use, use of third-party tested supplements, and knowledge in high school athletes were reported. A total of 225 high school athletes, ranging from 14-19 years of age, from a private high school in the western US, were included in the analysis of the results. A total of 94% (n=211) of athletes reported nutritional supplement use within the past year with an average of six (interquartile range: 3-9) individual supplements, ranging from 0-20 supplements per person. Most frequently reported were sports drinks (72%), vitamins (65%), sports bars (60%), protein powder (58%), caffeine (37%, as part of normal beverages, or 13% as a supplement), followed by creatine (23%). A total of 24% claimed to know for sure that all their supplements were third-party tested. In addition, the recognition of third-party testing organization icons was low (46% in supplement users vs. 14% in nonusers). Athletes also scored low in reporting how to find (22%) and how to order (25%) third-party tested supplements. In conclusion, almost all athletes in this study reported the use of multiple nutritional supplements annually. Only one-fourth of the athletes reported consistently using third-party tested supplements. Knowledge of where and how tested supplements could be purchased was limited in this high school athlete population.

Background: Anabolic androgenic steroids (AAS) are traditionally used for the treatment/control of various diseases; however, they are being used for non-therapeutic and indiscriminate purposes to enhance sports performance and physical appearance. This study aimed to assess the prevalence and associated factors of AAS use among professional CrossFit® competitors., Methods: We conducted an observational cross-sectional survey in which an anonymous questionnaire was applied to professional CrossFit ® athletes., Results: The prevalence of AAS usage was 33.3%. Most users were male (74.2%), aged between 30 and 39 years (51.6%), with completed higher education (83.9%), and had been training for more than 5 years (77.4%); the primary motivation for AAS use was performance enhancement (77.4%). Individuals who were older ( p  < 0.05) and more experienced in competitions ( p  < 0.01) are more likely to use AAS. Testosterone was the most employed AAS (71.0%); CrossFit ® athletes typically used an average of 2 different AAS. The majority of users had notably sought advice from a physician (74.2%), and AAS were acquired from either drugstores (80.6%) or through illicit channels (29.0%). Moreover, 61.3% of AAS users reported experiencing adverse effects., Conclusions: Our results demonstrated a higher prevalence of AAS users among professional competitors in CrossFit ® compared to the general population; older age and greater experience in official competitions were decisive factors for a greater inclination toward AAS use. A significant percentage of athletes seek drugs through illegal channels. Despite the majority of users experiencing adverse effects, athletes report satisfaction with use, believing that the benefits still outweigh the drawbacks.

Objective: Medication use among elite athletes has received growing attention over the past decades. However, only limited studies have focused on para athletes, and trends in medication use among this cohort remain unclear. The aims of this study were (1) to describe the pattern of medication use in elite Paralympic athletes, with a particular focus on analgesics, (2) to analyze whether medications declared by athletes were included in the 2018 World Anti-Doping Agency's prohibited list and monitoring program, (3) to report on a variety of novel supplements, and (4) to review whether athlete analgesic needs will be met by the new Olympic & Paralympic Model Formulary., Design: This is a retrospective, descriptive cohort study., Results: Of all athletes who underwent doping control, 21% declared the use of an analgesic medication. Athletes with limb deficiency and para snowboarders declared the most analgesic medications in their respective categories. It was determined that 84% of the athletes' analgesic medication needs were provided from the new Olympic & Paralympic Model Formulary., Conclusions: Analgesic use among athletes who participated at the 2018 PyeongChang Winter Paralympics was high. Para snowboarders and athletes with limb deficiency declared the most analgesics. The new Olympic & Paralympic Model Formulary adequately addressed the medication needs of the athletes attending the 2018 games., Competing Interests: Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Athletics is a highly diverse sport that contains a set of disciplines grouped into jumps, throws, races of varying distances, and combined events. From a physiological standpoint, the physical capabilities linked to success are quite different among disciplines, with varying involvements of muscle strength, muscle power, and endurance. Thus, the use of banned substances in athletics might be dictated by physical dimensions of each discipline. Thus, the aim of this investigation was to analyse the number and distribution of adverse analytical findings per drug class in athletic disciplines. The data included in this investigation were gathered from the Anti-Doping Testing Figure Report made available by the World Anti-Doping Agency (from 2016 to 2018). Interestingly, there were no differences in the frequency of adverse findings (overall,~0.95%, range from 0.77 to 1.70%) among disciplines despite long distance runners having the highest number of samples analysed per year (~9812 samples/year). Sprinters and throwers presented abnormally high proportions of adverse analytical findings within the group of anabolic agents (p < 0.01); middle- and long-distance runners presented atypically high proportions of findings related to peptide hormones and growth factors (p < 0.01); racewalkers presented atypically high proportions of banned diuretics and masking agents (p = 0.05). These results suggest that the proportion of athletes that are using banned substances is similar among the different disciplines of athletics. However, there are substantial differences in the class of drugs more commonly used in each discipline. This information can be used to effectively enhance anti-doping testing protocols in athletics., (© 2021 The Authors. Drug Testing and Analysis published by John Wiley & Sons Ltd.)

Background: Doping is a practice that is present in many sports and organizations, including mixed martial arts and the Ultimate Fighting Championship (UFC). The aim of this study is to explore the epidemiological patterns of doping among UFC athletes., Methods: We screened the official United-States-Anti-Doping-Agency® (USADA) website, the annual USADA reports and the official UFC website for information on fighters and anti-doping rule violations (ADRVs). Our dataset included gender, age, weight class, testing numbers, date of ADRV, type of ADRV, and duration of suspension. Appropriate statistical tests were conducted to assess for statistical significance., Results: USADA tested 1070 UFC athletes 2624 times as of late 2015 up till the end of 2019 (N = 1070). A total of 209 adverse findings were recorded; out of which, 102 ADRVs were committed by 93 athletes (8.7%) from all weight divisions. This constituted an adverse finding rate of 16.55 per 1000 test and an ADRV rate of 8.08 per1000 test. Mean age of sanctioned athletes was 32 years. Use of anabolic steroids was significantly the most common ADRV recorded (p = 0.018). The men's heavyweight division had an ADRV rate of 19.3 per 1000 tests, significantly higher than that of women's bantamweight division at 2 per 1000 tests (p = 0.03), women's featherweight division at 0 per 1000 tests (p = 0.009), and men's flyweight division at 3 per 1000 tests (p = 0.035). ADRV rate showed a significantly increasing trend among men's weight divisions (p < 0.001)., Conclusion: Doping is present in mixed martial arts. Increasing testing numbers, raising awareness and education on the risks of doping, and conducting further research on the issue is key to help resolve this problem., (© 2020 John Wiley & Sons, Ltd.)

Purpose: Previous research has found that male users of androgens are diagnosed approximately twice as often with infertility. We therefore set out to investigate the fertility in men using androgens., Methods: The study included 545 males who tested positive for androgens in an anti-doping test program in Danish fitness centers during the period from January 3, 2006, to March 1, 2018. The confirmed androgen users were matched by birth year with 5450 male controls. We followed this cohort from 10 years prior to testing positive until the end of follow-up in May 2018., Results: During the 10-year period prior to testing positive, the group of androgen users experienced a 26% lower fertility rate than the controls (rate ratio [RR] 0.74; 95% CI, 0.60-0.90; P = 0.0028). However, in the years following the doping sanction, they made a significant catch-up, and at completed follow-up the total fertility rate was only 7% lower than expected (RR 0.93, 95% CI, 0.84-1.03). The prevalence of assisted reproduction was 5.69% in the group of androgen users and 5.28% in the control group (P = 0.69)., Conclusion: Androgen use was associated with a temporary decline in fertility and most androgen users achieved parenthood without any help from the health care system. Overall, the fertility rate and the prevalence of assisted reproduction among androgen users were close to those in the background population., (© The Author(s) 2020. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Purpose: Although endogenous testosterone levels are demonstrated to be affected by both acute exercise and resistance training, the dynamic regulation of androgen production after physical activity is still a matter of debate. This meta-analysis was designed to assess whether physical exercise acutely affects testosterone levels in men., Methods: The literature search was conducted to identify longitudinal trials evaluating the acute change of both total testosterone (TT) and free testosterone (fT) after physical activity in adult men. Sensitivity analyses were performed considering the sample collected (blood or saliva), the intensity of the physical exercise and the interval between the end of the exercise and the sample collection., Results: Forty-eight studies were included in the analysis, accounting for 126 trials. A total of 569 patients were enrolled (mean age 29.7 ± 13.1 years). The physical activity increased acutely TT (standardized mean difference 0.74, 95%CI: 0.56, 0.91 nmol/L), considering both serum and saliva samples (p < 0.001). Testosterone increased after moderate (p < 0.001) and high-intensity (p < 0.001) exercises, but not after mild physical activity (p = 0.19). Moreover, the testosterone increase was evident when measured immediately at the end of the exercise and within 30 min (p < 0.001), but not after 30 min (p = 0.930). Similar significant results were obtained considering fT, while SHBG did not change after physical activity (p = 0.090)., Conclusion: The comprehensive evaluation of the acute physical activity effect on testosterone levels identified a clear increase after exercise, irrespective of the sample collected. The main determinant of this fluctuation was the exercise intensity, with a mechanism that seems to be mostly SHBG independent. In particular, moderate/intense physical activity resulted able to increase endogenous androgenic production, albeit acutely and transitory., Trial Registration Number: PROSPERO registration ID: 157348.

Objectives: The study investigated the moderating role of achievement goals and motivation regulations on the association between self-reported nutritional supplement (NS) use, doping likelihood, and self-reported doping behaviour among competitive athletes., Method: Four hundred and ninety seven competitive team sport athletes (64% males; M age=23.54 years, SD=5.75) completed anonymous questionnaires measuring self-reported use of prohibited substances and licit NS; beliefs about the "gateway" function of NS; achievement goals; and motivational regulations., Results: Hierarchical linear regression analysis showed that self-reported doping was associated (Adjusted R 2 =33%) with NS use, a stronger belief that NS use acts as a gateway to doping, amotivation, controlled motivation, mastery approach, and performance avoidance goals. Higher likelihood to use doping substances in the future was associated (Adjusted R 2 =41.7%) with current NS use, stronger belief that NS act as a gateway to doping, autonomous motivation, and performance avoidance goals. A series of moderated regression analyses showed that NS use significantly interacted with mastery approach, mastery avoidance, performance avoidance goals, autonomous motivation controlled motivation, and with amotivation in predicting self-reported doping. Finally, NS use significantly interacted with mastery approach goals, performance avoidance goals, and controlled motivation in predicting future doping likelihood., Conclusions: Achievement goals and motivational regulations are differentially associated with both doping likelihood and self-reported doping, and may account for the observed association between self-reported NS use and doping substances; thus, providing an alternative explanation to the "gateway hypothesis" that emphasizes the role of motivation., (Copyright © 2019 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Background: Determining the prevalence of doping in sport might be useful for anti-doping authorities to gauge the effectiveness of anti-doping policies implemented to prevent positive attitudes toward doping. Using questionnaires and personal interviews, previous investigations have found that the prevalence of doping might be different among different sports disciplines; however, there is no sport-specific information about the proportion of adverse and atypical findings (AAF) in samples used for doping control. The aim of the present investigation was to assess the differences in the frequency of adverse analytical and atypical findings among sports using the data made available by the World Anti-Doping Agency., Methods: The data included in this investigation were gathered from the Testing Figures Reports made available annually from 2003 to 2015 by the World Anti-Doping Agency. These Testing Figures Reports include information about the number of samples analyzed, the number of AAFs reported, and the most commonly found drugs in the urine and blood samples analyzed. A total of 1,347,213 samples were analyzed from the individual sports selected for this investigation, and 698,371 samples were analyzed for disciplines catalogued as team sports., Results: In individual sports, the highest proportions of AAF were 3.3% ± 1.0% in cycling, 3.0% ± 0.6% in weightlifting, and 2.9% ± 0.6% in boxing. In team sports, the highest proportions of AAF were 2.2% ± 0.5% in ice hockey, 2.0% ± 0.5% in rugby, and 2.0% ± 0.5% in basketball. Gymnastics and skating had the lowest proportions at (≤1.0%) for individual sports, and field hockey, volleyball and football had the lowest proportions for team sports (≤1.4%)., Conclusion: As suggested by the analysis, the incidence of AAF was not uniform across all sports disciplines, with the different proportions pointing to an uneven use of banned substances depending on the sport. This information might be useful for increasing the strength and efficacy of anti-doping policies in those sports with the highest prevalence in the use of banned substances., (© 2019 Published by Elsevier B.V. on behalf of Shanghai University of Sport.)

Doping is recognized as one of the most important problems in sports, but a limited number of studies have investigated doping problems in youth athletes. This study aimed to evaluate doping tendency (potential doping behavior (PDB)) and correlates of PDB in youth age swimmers. The participants were 241 competitive swimmers (131 females; 15.3 ± 1.1 years of age, all under 18 years old). Variables included predictors and PDB (criterion). Predictors consisted of sociodemographic factors (gender and age), sport-related variables (i.e., experience in swimming and sport achievement), variables explaining coaching strategy and training methodology, consumption of dietary supplements (DS), knowledge about doping, and knowledge about sports nutrition and DS (KSN). In addition to the descriptive statistics and differences between genders, a multinomial regression using PDB as the criterion (negative-, neutral-, or positive-PDB, with a negative-PDB as the reference value) was calculated to define associations between predictors and criterion. With only 71% of swimmers who declared negative-PDB results indicated an alarming figure. Boys with better KSN were more negatively oriented toward positive-PDB (OR: 0.77, 95%CI: 0.60-0.95). In girls, lower competitive achievement was evidenced as a risk factor for neutral-PDB (OR: 0.39, 95%CI: 0.24-0.63). Also, higher neutral-PDB (OR: 0.88, 95%CI: 0.81-0.96) and positive-PDB (OR: 0.90, 95%CI: 0.83-0.99) were identified in girls who began with intensive training in younger age. Because of the alarming figures of PDB, there is an evident need for the development of systematic antidoping educational programs in youth swimming. In doing so, focus should be placed on girls who began intensive training at an earlier age and those who did not achieve high competitive results.

Background: The increasing use of doping by youth is a growing public health concern. The present study aimed to calculate robust estimates of the prevalence of doping among French high school students and study factors related to the use of licit vs. banned agents., Methods: The European School Project on Alcohol and other Drugs (ESPAD), a nationally representative school-based survey, was distributed across France from April to May 2015, generating a final sample size of 6642 students. Multilevel modelling was used to examine covariates of doping to enhance athletic performance in sport in this population., Results: Overall, 2.3% of students used banned agents, and 6.1% used licit and banned substances to improve athletic performance. Significant gender differences existed for both, with males more prone to doping than females. Our findings provide support for the existing gateway hypothesis that nutritional supplementation leads to doping banned agents. Multilevel modelling revealed the presence of both school and class-level influences on individual use of licit substances, vs. solely class-level factors impacting the use of banned agents, suggesting a strong peer-effect., Conclusions: These findings support the need to engage in early doping prevention through high schools. Programmes should draw attention to the role of licit substances, including nutritional supplementation, in the progression to using banned agents and encompass the continuum of adolescent risk taking through a behaviour-based approach to doping prevention., (© The Author(s) 2019. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.)

The use of doping substances and methods is prevalent not only among elite athletes, but also among amateur athletes and other athletes. However, the abuse of substances and methods of doping has been associated with the occurrence of numerous adverse health effects. Cardiovascular effects are the most deleterious. The objective of this manuscript is to study through a review the literature, adverse cardiovascular effects after the abuse of substances and doping methods in athletes. Three major classes of products have more cardiovascular side effects; they are anabolic, stimulants and narcotics. It is possible to predict their use according to the desired objectives. Anabolic doping is used by sportsmen who practice strength sports, stimulants are used by those who practice speed sports, while endurance sportsmen prefer products that improve the transport of oxygen. Cases of myocardial infarction, hyperlipidemia, hypertension, venous thrombosis, arrhythmogenesis, heart failure and sudden cardiac death have been observed. The doping substances of varied nature seem to have adverse cardiovascular effects whose physiopathology remains a research and investigation track. Further randomized trials are needed to better understand the interaction of these doping substances taken in a combined way in athletes.

Sports-specialized newspapers are one of the print media with the highest number of readers in Spain. However, little is known about the health coverage in this type of print press. The aim of the study was to analyze any health-related material in sports newspaper coverage and describe the main characteristics. This is an observational and cross-sectional study, performed in relation to the three most read daily Spanish sports newspapers (MARCA, AS, SPORT). A descriptive analysis was conducted to assess the health-related materials selected after a careful search over a period of 30 days. During this time, a total of 815 units of analysis were identified. On average, 14.79% ( n = 645 pages) of the full content ( n = 4362) included health-related material. The Liga BBVA section was the most frequent to contain health-related content by a significant margin ( p = 0.01). The main covered topics were injuries to soccer players (52%), doping (21%), and other diseases in athletes or their relatives (8.6%) with no significant differences ( p = 0.10). Photographs (87.4%) were the most frequent visual material used in the health content, followed by infographics (12.6%). Press releases were the most frequent source of information (58%). Spanish sports newspapers include a high proportion of health-related material, especially in terms of providing detailed descriptions of athletes' sport injuries, mainly related to soccer.

This article questions organizations' (clubs, teams, etc) responsibility in doping use from the case of anti-doping rules violations (ADRVs) sanctioned by the Union Cycliste Internationale in professional cycling. We built a database with 271 caught riders among 10 551 professional riders employed from 2005 to 2016 in the three first world divisions. We developed a time-discrete event history model with a multilevel perspective to consider if the ADRV is related to the characteristic of a rider's career path (level 1) and/or the team by which the rider is employed (level 2). Our results confirm two hypotheses: Beginning a career before 2005 or after the age of 22 increased the risk of being caught. Each additional year in the pack increased the risk, despite the fact that a sanctioned rider's career duration average is 7.8 years (3.9 for the others). These caught riders have experienced a more tumultuous career with team changes and an interrupted path. A 2.45 Median Odds Ratio led us to assert a team effect on ADRV. By a team residual effect calculation, we identify 17 teams with a significant effect within the 129 that experienced an ADRV. Our results allow us to emphasize that to understand doping we must take into account work and employment condition, as well as team's organization. This approach completes the dominant "methodological individualism" perspective that considers athletes as analytical units and provides guidelines to the anti-doping bodies that focus their action on individuals., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The text sets out to examine so-called "interdisciplinary" research practices when researchers work on health issues. The article specifies the author's approach, which departs from both a normative posture and a purely epistemological approach, instead opting to study an interdisciplinary act in progress. Based on an ANR report led by Trabal, Collinet and Terral (2014), the research presented mobilizes the latest developments in socio-informatics to examine forms of interdisciplinarity in two areas - doping and obesity. It appears that the research on doping is marked by strong asymmetries between disciplines, and that "true" interdisciplinarity is often postponed when it does not seem to lend itself to a simple mode of coordination. In the case of obesity, we observe that practices are marked by staging and display work; the demand for interdisciplinarity is combined with a desire to structure a professional identity. In all cases, we were able to identify some trails that have been blazed to enable researchers to respond jointly to disciplinary and interdisciplinary injunctions. The promise is an interesting figure that relies on a postponement of proof, made possible by weak codification of interdisciplinarity., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Objectives: Determine whether career paths of elite male professional riders explain the risk of being sanctioned for an Anti-Doping Rules Violation through the International Cycling Union., Design, Methods: A discrete-time logit model explored the link between career path and ADRV risk in a database of 10,551 riders engaged in the first three world divisions (2005-2016), including 271 sanctioned riders., Results: Despite a longer career (7.8years), sanctioned riders have a precarious path. The odds of finding a sanctioned rider within those who experienced a career interruption is 5.80 times higher than for a non-caught one. 61% of the caught riders have experienced a team change. The odds of finding a caught rider within those who experienced such a change is 1.35 times higher. 44% of caught riders start before 23years, vs 34% for non-sanctioned ones. The odds of being sanctioned are 1.69 times higher for doped riders beginning before 23. The odds of finding a sanctioned rider are 1.94 times higher among those starting their careers before 2005 (establishment of Pro Tour), than those who started in 2008 or after. In that year, the Cycling Anti-Doping Foundation and the biologic passport were both launched., Conclusions: Caught riders could have extended their more precarious careers with doping. The post-2005 generation effect could mean that riders are cleaner or slicker at hiding doping. The higher risk of being caught for riders starting after 23 might indicate that an early professional socialization reduces the risk by teaching them to be cleaner, or better at hiding doping., (Copyright © 2018 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Background : Doping behavior, including the misuse of performance-enhancing drugs, is currently a serious problem in sports, and the efficacy of preventive efforts directly depends on information regarding the associations among different precipitating factors (PF) and doping behavior. This study aimed to establish the PF of potential doping behavior (PDB) in competitive swimmers. Methods : The study included 301 swimmers from Slovenia (153 females, 16.4 ± 2.4 years), tested during the 2017 National Championship. Variables were collected by previously validated questionnaires, which included questions on sociodemographics, sports-related factors, consumption of dietary supplements, knowledge of doping, factors of hesitation, and doping-related factors (i.e., number of doping tests, opinion about the presence of doping in sport). The PDB (positive, neutral, or negative intention toward doping) was observed as a criterion, while other variables were included as predictors in multinomial regression analyses (with "negative" as reference value), which additionally controlled for gender and age category (cadet-, junior-, and senior-level) as confounders. Results : The results confirmed higher susceptibility to doping in males (positive: odds ratio (OR): 2.77, 95% confidence interval (CI): 1.27⁻6.04), those swimmers who reported higher alcohol consumption (neutral: OR: 2.18, 95%CI: 1.06⁻4.16, positive: OR: 2.14, 95%CI: 1.05⁻4.37), and those regularly used dietary supplements (positive: OR: 3.62, 95%CI: 1.25⁻10.52). Competitive achievement in Olympic- (neutral: OR: 0.57, 95%CI: 0.41⁻0.81, positive: OR: 0.59, 95%CI: 0.39⁻0.88), and non-Olympic disciplines (positive: OR: 0.54, 95%CI: 0.35⁻0.83) was protective against PDB. Swimmers who were more concerned about the negative social consequences of doping behavior (i.e., condemnation by family and friends) were less likely to declare a positive intention toward the PDB (family condemnation: OR: 0.69, 95%CI: 0.56⁻0.86, friends' condemnation: OR: 0.65, 95%CI: 0.52⁻0.80). Conclusions : The results of the study provide more precise insight into the specific factors associated with PDB in swimming. The established precipitating factors should be incorporated into targeted anti-doping campaigns in this sport.

Background: Anabolic-androgenic steroids (AAS) are said to be frequently used by both professional and amateur athletes. In addition to having a negative impact on health, steroids defy the concept of fair play. The aim of the study was to evaluate the scale of the problem related to using anabolic-androgenic steroids (AAS) by gym athletes and to analyze possible causes., Methods: The study involved 435 participants aged between 18-66 (mean age 27.49±7.48). Out of them, 61.4% were male and 38.6% were female. The subjects were divided into two groups: Group A included 154 (35.4%) amateur and recreational athletes and group B included 281 (64.6%) professional athletes concerned with fitness, bodybuilding and powerlifting. A survey prepared by the authors was conducted in the study, and it consisted of 23 closed questions about AAS use, body confidence, and exercise dependence. In addition, a stadiometer and a body composition analyzer were utilized to take necessary measurements., Results: Between 1-23% of group A participants admitted to using AAS. For group B, it was between 7-30%. Males were reported to use AAS more frequently than females in both groups. With regard to group A, differences in body confidence and exercise dependence were found between males using and not using AAS. Exercise dependence was reported to be different between group A and group B participants. This was true for both males and females. Also, it was shown that group A and group B females differed in terms of metabolic age, body mass and body composition (fat mass, fat-free mass, muscle mass, and total body water)., Conclusions: Most gym athletes do not use AAS. Amateur athletes tend to use AAS more frequently than professional athletes. Factors that contribute to AAS use are: male gender, low body confidence, young age, and long training.

Objectives: This preliminary study examined whether implicit doping attitude, explicit doping attitude, or both, predicted athletes' vigilance towards unintentional doping., Design: A cross-sectional correlational design., Methods: Australian athletes (N=143;M age =18.13, SD=4.63) completed measures of implicit doping attitude (brief single-category implicit association test), explicit doping attitude (Performance Enhancement Attitude Scale), avoidance of unintentional doping (Self-Reported Treatment Adherence Scale), and behavioural vigilance task of unintentional doping (reading the ingredients of an unfamiliar food product)., Results: Positive implicit doping attitude and explicit doping attitude were negatively related to athletes' likelihood of reading the ingredients table of an unfamiliar food product, and positively related to athletes' vigilance towards unintentional doping. Neither attitude measures predicted avoidance of unintentional doping. Overall, the magnitude of associations by implicit doping attitude appeared to be stronger than that of explicit doping attitude., Conclusions: Athletes with positive implicit and explicit doping attitudes were less likely to read the ingredients table of an unknown food product, but were more likely to be aware of the possible presence of banned substances in a certain food product. Implicit doping attitude appeared to explain athletes' behavioural response to the avoidance of unintentional doping beyond variance explained by explicit doping attitude., (Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Background: Doping in sports compromises fair play and endangers health. To deter doping among elite athletes, the World Anti-Doping Agency (WADA) oversees testing of several hundred thousand athletic blood and urine samples annually, of which 1-2% test positive. Measures using the Athlete Biological Passport suggest a higher mean prevalence of about 14% positive tests. Biological testing, however, likely fails to detect many cutting-edge doping techniques, and thus the true prevalence of doping remains unknown., Methods: We surveyed 2167 athletes at two sporting events: the 13th International Association of Athletics Federations Word Championships in Athletics (WCA) in Daegu, South Korea in August 2011 and the 12th Quadrennial Pan-Arab Games (PAG) in Doha, Qatar in December 2011. To estimate the prevalence of doping, we utilized a "randomized response technique," which guarantees anonymity for individuals when answering a sensitive question. We also administered a control question at PAG assessing past-year use of supplements., Results: The estimated prevalence of past-year doping was 43.6% (95% confidence interval 39.4-47.9) at WCA and 57.1% (52.4-61.8) at PAG. The estimated prevalence of past-year supplement use at PAG was 70.1% (65.6-74.7%). Sensitivity analyses, assessing the robustness of these estimates under numerous hypothetical scenarios of intentional or unintentional noncompliance by respondents, suggested that we were unlikely to have overestimated the true prevalence of doping., Conclusions: Doping appears remarkably widespread among elite athletes, and remains largely unchecked despite current biological testing. The survey technique presented here will allow future investigators to generate continued reference estimates of the prevalence of doping.

Background: The sanction that an athlete receives when an anti-doping rule violation has been committed depends on the specific circumstances of the case. Anti-doping tribunals decide on the final sanction, following the rules of the World Anti-Doping Code., Objectives: To assess the athletes' degree of fault based on the length of sanctions imposed on them to feed policy-related discussions., Methods: Analysing data from the results management database of the World Anti-Doping Agency for anonymous information of anti-doping rule violations in eight selected sports covering the years 2010-2012., Results: Four out of ten athletes who committed an anti-doping rule violation received a suspension that was lower than the standard. This is an indication that tribunals in many instances are not convinced that the athletes concerned were completely at fault, that mitigating circumstances were applicable, or that full responsibility of the suspected violation should not be held against them. Anabolic agents, peptide hormones, and hormone modulators lead to higher sanctions, as do combinations of several anti-doping rule violations., Conclusions: This first analysis of information from the World Anti-Doping Agency's results management database indicates that a large proportion of the athletes who commit anti-doping rule violations may have done this unintentionally. Anti-doping professionals should strive to improve this situation in various ways.

Background: The use of nutritional supplements (NS) places athletes at great risk for inadvertent doping. Due to the paucity of data on supplement use, this study aimed to determine the proportion of Ugandan athletes using nutritional supplements and to investigate the athletes' motivation to use these supplements., Methods: A cross-sectional study was conducted in which an interviewer-administered questionnaire was used to collect data from 359 professional athletes participating in individual (boxing, cycling, athletics) and team (basketball, rugby, football, netball, and volleyball) sports. The data were categorized, and a Chi-square test was used for statistical analysis., Results: Of the 359 athletes, 48 (13.4%) used nutritional supplements. Carbohydrate supplements, energy drinks, vitamin and mineral supplements, fish oils, and protein supplements were the most common supplements used by athletes. NS use was significantly more common among athletes who played rugby and basketball ( X 2 = 61.101, p < 0.0001), athletes who had played the sport for 5-10 years ( X 2 = 7.460, p = 0.024), and athletes who had attained a tertiary education ( X 2 = 33.377, p < 0.0001). The athletes' occupation had no bearing on whether they used supplements. Nutritionists/dieticians, retail stores and pharmacies were the most common sources of NS products, whereas health practitioners, online media and teammates were the most common sources of information regarding NS. Most athletes used NS to improve their physical performance and health., Conclusions: Compared to NS use by athletes elsewhere, NS use among Ugandan athletes was low. However, determinants of athlete NS use in the current study (category of sport and duration of time spent playing the sport) are similar to those reported elsewhere.

Introduction: The objective of this paper was to review our knowledge of athletes who have, are believed to have or have attempted to engage in blood doping to enhance their performance at an Olympic Games., Evidence Acquisition: The paper focused on the Games from Munich 1972 to London 2012 and the author had a medical role at each of the Olympics that is discussed., Evidence Synthesis: The study revealed that Olympic athletes have benefitted from manipulating their blood by re-infusion of autologous or infusion of homologous blood and by administering erythropoiesis stimulating agents, notably the three generations of erythropoietins. Fifty seven athletes have been sanctioned with 12 athletes forfeiting 17 Olympic medals including 12 gold medals because of blood doping. Until 1986, the infusion of blood was not prohibited in sport but considered unethical. Erythropoietin was prohibited by the International Olympic Committee's Medical Commission in 1990., Conclusions: There has been a change as to how Olympic athletes have enhanced performance by blood doping, commencing with blood infusion and later administering erythropoiesis stimulating agents and significant advances have occurred in detecting such misuse. Currently, the hematological component of World Anti-Doping Agency's athlete biological passport is an important but not infallible mechanism to identify athletes who cheat by blood doping.

Detection of testosterone and/or its pro-drugs in the gelding is currently regulated by the application of an international threshold for urinary testosterone of 20 ng/mL. The use of steroid ratios may provide a useful supplementary approach to aid in differentiating between the administration of these steroids and unusual physiological conditions that may result in atypically high testosterone concentrations. In the current study, an ultra-high performance liquid chromatography tandem mass spectrometry (UHPLC-MS/MS) method was developed to quantify testosterone (T) and epitestosterone (E). The method was used to analyze 200 post-race urine samples from geldings in order to generate the ratios for the reference population. Following statistical analysis of the data, an upper limit of 5 for T:E ratio in geldings is proposed. Samples collected from 15 geldings with atypical urinary testosterone concentrations (>15 ng/mL) but otherwise normal steroid profile, had T:E ratios within those observed for the reference population. The applicability of an upper T:E ratio to detect an administration was demonstrated by the analysis of a selection of incurred samples from testosterone propionate, dehydroepiandrosterone (DHEA), and a mixture of DHEA and pregnenolone (Equi-Bolic®) administrations. These produced testosterone concentrations above the threshold of 20 ng/mL, but also T:E ratios above the proposed limit of 5. In conclusion, consideration of the T:E ratio appears to be a valuable complementary aid to evaluate whether an atypical testosterone concentration could be caused by a natural biological outlier as opposed to the administration of these steroids. Copyright © 2016 John Wiley & Sons, Ltd., (Copyright © 2016 John Wiley & Sons, Ltd.)

Horseracing has been called 'one of the first quintessentially modern sports'. Its urge towards standardization, its mathematically set odds, its concern with weights, and its pioneering embrace of drug-testing reflect an empirical temperament crucial to its transformation from a gentleman's pastime to a global industry funded by wagering. Ironically, in the late nineteenth century, it was modern science itself, and in particular the purification and synthesis of the drugs of nature, that turned the doping of racing animals - a practice recorded in antiquity - into an organized criminal enterprise. This paper presents original research into the history of racing chemistry in Australia in the context of developments in the field worldwide. Using a case-study approach based on extensive archival materials, it reveals unpublished diaries kept by an analyst working at Sydney Racing Laboratory in the 1950s that document conflicts between scientists over identification of performance drugs in racing animals. The author presents evidence that augments and revises earlier narratives concerning the history of the establishment of laboratory control at Australian racetracks and the removal of the country's first official analyst for racing, Miss Jean Kimble. The Kimble case illustrates the inevitable political, professional, and personal pressures that bear upon drug-testing in sports, and also conflicts between scientists over standards and priorities. Copyright © 2016 John Wiley & Sons, Ltd., (Copyright © 2016 John Wiley & Sons, Ltd.)

In recent years, the potential for anabolic steroid abuse in equine sports has increased due to the growing availability of designer steroids. These compounds are readily accessible online in 'dietary' or 'nutritional' supplements and contain steroidal compounds which have never been tested or approved as veterinary agents. They typically have unusual structures or substitution and as a result may pass undetected through current anti-doping screening protocols, making them a significant concern for the integrity of the industry. Despite considerable focus in human sports, until recently there has been limited investigation into these compounds in equine systems. To effectively respond to the threat of designer steroids, a detailed understanding of their metabolism is needed to identify markers and metabolites arising from their misuse. A summary of the literature detailing the metabolism of these compounds in equine systems is presented with an aim to identify metabolites suitable for incorporation into screening protocols by anti-doping laboratories. The future of equine anti-doping research is likely to be guided by the incorporation of alternate testing matrices into routine screening, the improvement of in vitro technologies that can mimic in vivo equine metabolism, and the improvement of instrumentation or analytical methods that allow for the development of untargeted screening, and metabolomics approaches for use in anti-doping screening protocols. Copyright © 2016 John Wiley & Sons, Ltd., (Copyright © 2016 John Wiley & Sons, Ltd.)

Anabolic steroids are banned substances in equine sports. Gas chromatography-mass spectrometry (GC-MS) has been the traditional technique for doping control analysis of anabolic steroids in biological samples. Although liquid chromatography-mass spectrometry (LC/MS) has become an important technique in doping control, the detection of saturated hydroxysteroids by LC-MS remains a problem due to their low ionization efficiency under electrospray. The recent development in fast-scanning gas-chromatography-triple-quadrupole mass spectrometry (GC-MS/MS) has provided a better alternative with a significant reduction in chemical noise by means of selective reaction monitoring. Herein, we present a sensitive and selective method for the screening of over 50 anabolic steroids in equine urine using gas chromatography-tandem mass spectrometry (GC-MS/MS). Copyright © 2016 John Wiley & Sons, Ltd., (Copyright © 2016 John Wiley & Sons, Ltd.)

The artificial increase of the physical capability of horses using drugs is well known in racing and other equine sports. Both illicit and therapeutic substances are regarded as prohibited substances in competition in most countries. Some countries make distinctions for a few, specific drugs which are, however, allowed for use in other countries. The primary objective in the case of doping control is the detection of any trace of drug exposure, either parent drug or any of its metabolites, using the most powerful analytical methods which are generally based on chromatographic/mass spectrometric techniques. Of major concern in horseracing is the absence of a single organization regulating the anti-doping framework; instead of this, individual racing authorities provide rules and regulations often resulting in variations in the applied doping control programmes of different countries. The aim of this paper is to review the recent literature (approximately from 2012 to mid-2016) to highlight the numerous and diverse challenges faced in doping control of racing and equestrian sports, including the detection of designer drugs (anabolic steroids or stimulants) and of other emerging prohibited substances, such as peptides and noble gases in horse urine and plasma. Moreover, the application of 'omics' techniques (especially of metabolomics) deserves attention for establishing possible fingerprints of drug abuse as well as the evolution of instrumental analysis resulting a powerful ally in the fight against doping in equine sports. Copyright © 2017 John Wiley & Sons, Ltd., (Copyright © 2017 John Wiley & Sons, Ltd.)

Religiousness is known to be specifically associated with substance abuse, but there is an evident lack of studies investigating the association between religiousness and doping behavior as a specific type of substance abuse in athletes. This study aimed to provide evidence for possible gender- and sport-specific associations between religiousness and doping behavior among team-sport athletes of both genders. The participants were 886 athletes (21.9 ± 3.8 years of age; 352 females) involved in four sports: volleyball (n = 154; 78 females), handball (n = 206; 68 females), soccer (n = 316; 110 females) and basketball (n = 230; 96 females) from Croatia and Slovenia (all traditionally Roman Catholics). The data were collected using a previously validated structured questionnaire that examined sociodemographic, sport- and doping-related factors. In addition, religiousness was captured by the Santa Clara Strength of Religious Faith questionnaire (SCSRF). Gender-stratified simple logistic regressions were applied to determine associations between covariates and doping behavior (criterion). There was no significant difference in potential doping behavior between males and females (OR 1.06, 95 % CI 0.76-1.46), while females reported higher religiousness (SCSRF: 23.11 ± 3.23 and 25.46 ± 7.2 for males and females, respectively; t test = 1.82, p < 0.05). Younger female athletes and those with higher SCSRF score are found to be less prone to doping behavior. When models were adjusted for personal opinion about doping presence in sport and age, the SCSRF remained a significant predictor of potential doping behavior (OR 0.95, 95 % CI 0.91-0.99). For males, the belief that doping was present in sport was strongly associated with a higher likelihood of doping. Our results suggest that highly religious females involved in three of the studies sports (i.e., volleyball, handball and basketball) show a weaker tendency toward doping. Meanwhile, there is no evidence that religiousness influences doping behavior among male team-sport athletes. Therefore, sport-specific and gender-specific approach in studying possible relationships that exist between religiousness and different types of misusing substances in sport is warranted.

Purpose of Review: During the last decades androgens have been used illicitly by athletes of both genders. Because of some obvious ethical limitations, mechanisms underlying the performance-enhancing effects of these hormone or drugs, as well as the magnitude of their effects, have been poorly addressed. This review aims to combine findings from field and from the laboratory to provide new insights into the ergogenic properties of endogenous or exogenous androgens on female athletes., Recent Findings: Results obtained from recent neuropsychological studies indicated that testosterone, and not the sex chromosomes, is responsible for the sexual differentiation of visuospatial neural activation. These findings could explain how males and hyperandrogenic females benefit from androgens performance-enhancing effects in sports where visuospatial abilities are closely linked to better performance. Another study conducted on elite female athletes showed that, in some athletic events, where muscle power is of critical importance, individuals with the highest free testosterone concentration significantly outperformed competitors with the lowest free testosterone concentration., Summary: In some sport events, female athletes with high or very high androgen levels (whether it is from endogenous or exogenous origin) have an estimated competitive benefit of 2-5% over those with androgen levels within the normal female range. These findings are to be taken into account in the actual controversy about eligibility of females with hyperandrogenism to compete in women's sports.

Every year, the World Anti-Doping Agency (WADA) publishes the main statistics reported by the accredited laboratories, which provide very valuable information for assessing changes in the patterns of doping in sports over time. Using the information provided since 2003 as the basis for the analysis, the evolution of doping/anti-doping figures over the last decade can be examined in reasonable detail, at least in reference to samples analyzed and categories of substances more commonly found in athletes' samples. This brief analysis of the WADA statistical reports leads us to the following outcomes: the increase in anti-doping pressure from 2003 to 2015, as evidenced by increased numbers of samples analyzed and banned substances, has not directly produced a higher frequency of adverse/atypical findings. Although this could be interpreted as steady state in the capacity to detect doping through this whole period, it also resulted in a significant increase in the absolute number of samples catalogued as doping (from 2247 in 2003 to 5912 in 2015). Anabolic agents have been the most common doping substances detected in all statistics reports while the remaining groups of substances are much less frequently found in doping control samples. Given that one might have expected the enhancement of the anti-doping programme led by WADA over this last decade to have increased the percentage of adverse/atypical findings, the fact that it did not might indicate the need to take another step in sampling strategies, such as 'more intelligent testing' based on the differences in the prevalence of doping substances among sports. Copyright © 2017 John Wiley & Sons, Ltd., (Copyright © 2017 John Wiley & Sons, Ltd.)

In 2009, the Japan Anti-Doping Agency (JADA) established the "Sports Pharmacist Accreditation Program" to prevent doping in sports. Since then, anti-doping activities in Japan have been attracting attention. In this study, we investigated research about the current status of doping from 2007 to 2014 in Japan to make anti-doping activities more concrete, and we also discussed future anti-doping activities by pharmacists. In Japan, bodybuilding was the sporting event with the highest number and rate of doping from 2007 to 2014. Many of the positive doping cases were detected for class S1 (anabolic agents), S5 (diuretics and masking agents), and S6 (stimulants). Within class S1, supplements were the main cause of positive doping. Within class S5, medicines prescribed by medical doctors were the main cause of positive doping. Within class S6, non-prescription medicines (e.g., OTC) were the main cause of positive doping. When we looked at the global statistics on doping, many of the positive doping cases were detected for class S1. On comparing the Japanese statistics with the global statistics, the rate of positive doping caused by class S1 was significantly lower, but that caused by classes S5 and S6 was significantly higher in Japan than in the world. In conclusion, pharmacists in Japan should pay attention to class S1, S5, and S6 prohibited substances and to the sport events of bodybuilding. Based on this study, sports pharmacists as well as common pharmacists should suggest new anti-doping activities to prevent doping in the future.

Background: The GH-2000 score has been developed as a powerful and unique technique for the detection of growth hormone misuse by sportsmen and women. The score depends upon the measurement of two growth hormone (GH) sensitive markers, insulin-like growth factor-I (IGF-I) and the amino-terminal pro-peptide of type III collagen (P-III-NP). With the collection and establishment of an increasingly large database it has become apparent that the score shows a positive age effect in the male athlete population, which could potentially place older male athletes at a disadvantage., Methods: We have used results from residual analysis of the general linear model to show that the residual of the GH-2000 score when regressed on the mean-age centred age is an appropriate way to proceed to correct this bias. As six GH-2000 scores are possible depending on the assays used for determining IGF-I and P-III-NP, methodology had to be explored for including six different age effects into a unique residual. Meta-analytic techniques have been utilized to find a summary age effect., Results: The age-adjusted GH-2000 score, a form of residual, has similar mean and variance as the original GH-2000 score and, hence, the developed decision limits show negligible change when compared to the decision limits based on the original score. We also show that any further scale-transformation will not change the adjusted score. Hence the suggested adjustment is optimal for the given data. The summary age effect is homogeneous across the six scores, and so the generic adjustment of the GH-2000 score formula is justified., Conclusions: A final revised GH-2000 score formula is provided which is independent of the age of the athlete under consideration.

In cooperation with the Sports Association of the Palatinate (SBP), a survey was conducted on substance use by recreational and amateur athletes. Distribution of the online questionnaire took place by means of chain-referral sampling, and questions on substance use were presented using the randomized response technique (RRT) to protect the anonymity of respondents and prevent socially desirable answers. The estimated lowest limit for the population share for use of prohibited substances during the last season (4%) and for lifetime use (3.6%) did not differ significantly. Approximately 21% of respondents had used substances for training or competitions that were taken for a purpose other than performance enhancement (e.g., to improve their mood or to help with recuperation from a minor injury or illness) in the last year. 49% had done so at some point in their life., Competing Interests: The authors have declared that no competing interests exist.

The two major objectives of this study were (i) to assess variables that predict the use of analgesics in competitive athletes and (ii) to test whether the use of analgesics is associated with the use of doping. A questionnaire primarily addressing the use of analgesics and doping was distributed among 2,997 triathletes. Binary logistic regression analysis was performed to predict the use of analgesics. Moreover, the randomised response technique (RRT) was used to estimate the prevalence of doping in order to assess whether users of analgesics have a higher potential risk for doping than non-users. Statistical power analyses were performed to determine sample size. The bootstrap method was used to assess the statistical significance of the prevalence difference for doping between users and non-users of analgesics. Four variables from a pool of 16 variables were identified that predict the use of analgesics. These were: "version of questionnaire (English)", "gender (female)", "behaviour in case of pain (continue training)", and "hours of training per week (>12 h/week)". The 12-month prevalence estimate for the use of doping substances (overall estimate 13.0%) was significantly higher in athletes that used analgesics (20.4%) than in those athletes who did not use analgesics (12.4%). The results of this study revealed that athletes who use analgesics prior to competition may be especially prone to using doping substances. The predictors of analgesic use found in the study may be of importance to prepare education material and prevention models against the misuse of drugs in athletes.

Background: The aim of this report was to estimate the prevalence of meldonium use in athletes competing in the Baku 2015 European Games to contribute to the surveillance of substances on the 2015 World Anti-Doping Agency (WADA) Monitoring Program. Meldonium is reported to be used by athletes to potentially enhance personal performance and shorten the recovery period after physical activity., Methods: Three sources of data were reviewed to determine the prevalence of meldonium use during the Games including: (1) athlete self-reported declarations of drug and supplement use; (2) declarations from National Olympic Committee medical teams of the list of medicines that they imported into Azerbaijan as part of their stock of drugs for administration; (3) results from the antidoping laboratories reporting the detection of meldonium., Results: Meldonium was declared as imported into Azerbaijan by 2 of 50 National Olympic Committee medical teams at the Games, but athletes from 6 countries declared the use of meldonium. Only 23 of the 662 (3.5%) athletes tested from 8 to 28 June 2015 declared the personal use of meldonium, which included 13 competition winners. However, 66 of the total 762 (8.7%) athlete urine samples analysed during the Games and during precompetition tested positive for meldonium. Meldonium use was detected in athletes competing in 15 of the 21 sports during the Games., Conclusions: This study highlights the widespread and inappropriate use and prescribing of this prescription drug in a generally healthy athlete population. Subsequent to these findings, WADA has included meldonium as a prohibited substance on the 2016 List of Prohibited Substances., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

To design effective and commonly accepted public health policies against performance-enhancing drugs (PED), it is important to understand general population attitudes. This article elicits PED attitudes in the Berlin population and compares response rates of former athletes (N = 496) with those of non-athletes (N = 1686). In addition, exploiting the natural experiment of the division of Germany, by comparing East (N = 687) to West Berliners (N = 1315), the article studies the long-term impact of state socialisation on PED attitudes. Former West German amateur athletes are a statistically significant 6ppt more likely to believe that athletes can be successful without doping. Former GDR amateur athletes are 8ppt more likely to believe that doping is inevitable in professional sports., (© The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.)

Purpose: This study assessed the prevalence of physical and cognitive doping in recreational triathletes with two different randomized response models, that is, the Cheater Detection Model (CDM) and the Unrelated Question Model (UQM). Since both models have been employed in assessing doping, the major objective of this study was to investigate whether the estimates of these two models converge., Material and Methods: An anonymous questionnaire was distributed to 2,967 athletes at two triathlon events (Frankfurt and Wiesbaden, Germany). Doping behavior was assessed either with the CDM (Frankfurt sample, one Wiesbaden subsample) or the UQM (one Wiesbaden subsample). A generalized likelihood-ratio test was employed to check whether the prevalence estimates differed significantly between models. In addition, we compared the prevalence rates of the present survey with those of a previous study on a comparable sample., Results: After exclusion of incomplete questionnaires and outliers, the data of 2,017 athletes entered the final data analysis. Twelve-month prevalence for physical doping ranged from 4% (Wiesbaden, CDM and UQM) to 12% (Frankfurt CDM), and for cognitive doping from 1% (Wiesbaden, CDM) to 9% (Frankfurt CDM). The generalized likelihood-ratio test indicated no differences in prevalence rates between the two methods. Furthermore, there were no significant differences in prevalences between the present (undertaken in 2014) and the previous survey (undertaken in 2011), although the estimates tended to be smaller in the present survey., Discussion: The results suggest that the two models can provide converging prevalence estimates. The high rate of cheaters estimated by the CDM, however, suggests that the present results must be seen as a lower bound and that the true prevalence of doping might be considerably higher.