A scientific study has found that doping is far more common in professional sport than the rates suggested by blood and urine tests of the athletes. The study found that at least 30% of athletes in the 2011 International Association of Athletics Federations (IAAF) World Championships and 45% of athletes at the Pan-Arab Games in 2011 claimed to have taken doping drugs or used other doping methods. Only a fraction of these cases were detected by biological tests: At the World Championships, 0.5% of biological tests showed positive for doping agents; this figure rose to 3.6% for the Pan-Arab games.
Dr Harrison G Pope, director, Biological Psychiatry Laboratory at McLean Hospital in Belmont, Massachusetts, and Professor Rolf Ulrich from the University of Tübingen in Tübingen, Germany, together with an international group of seven other authors, conducted the study on behalf of the World Anti-Doping Agency (WADA) in 2011.
The scientists used a -randomised response method" to question a total of 2,167 participants at the World Championships in Daegu (South Korea) and the Pan-Arab Games in Doha (Qatar), asking whether they had taken doping drugs or used other banned doping methods before the competitions. This method ensured the anonymity of the respondents and allowed them to answer honestly without fearing negative consequences.
"The randomised response method is used for sensitive topics. In a direct face-to face interview, respondents would be strongly motivated to provide socially desirable responses, even if these responses were not true. Anonymity gives protection, allowing the respondents to answer honestly," explains Ulrich, head of the cognition and perception research group at the department of psychology at the University of Tübingen.
In the study, six interviewers, who collectively spoke ten languages, attended the competitions and personally asked 2,320 athletes to participate. More than 90% agreed. The athletes were asked on a mobile device to answer one of two questions – an unobtrusive question about a birthdate or a sensitive question about whether they had engaged in banned doping in the past 12 months. The two questions were selected at random. Therefore, if an athlete answered "yes," the investigators could not tell whether the athlete was answering "yes" to the unobtrusive question or "yes" to the sensitive question – thus guaranteeing the athlete's anonymity.
However, even though the investigators could not ascertain which of the two questions had been answered by any individual athlete, they could use statistical methods to closely estimate the percentage of athletes in the overall study group who had answered yes to the doping question. The investigators also took into account different scenarios that might have caused incorrect responses. For example, the fastest responses were not included because the respondents might not have read the text thoroughly.
"Overall, this study suggests that biological tests of blood and urine greatly underestimate the true prevalence of doping," emphasises Pope, who is also a professor of psychiatry at Harvard Medical School. "As we note in the paper, this is probably due to the fact that athletes have found various ways to beat the tests."
Tests immediately before and during a competition find evidence of doping on average of only 1%-3%. However, doping agents are often no longer biologically detectable at this time if they have been taken long before. Somewhat better results are achieved with the "biological passport," which tracks the athlete's medical data and offers a higher detection rate of about 14%. The passport employs long-term documentation which can reveal deviations that could be caused by the abuse of doping agents. Doping agents are defined as all items listed by the WADA on the "List of Prohibited Substances and Methods."
The current publication of this paper, after a lengthy release procedure, is a credit to the commitment of Professor Georg Sandberger, lawyer and former executive vice president of the University of Tübingen. He represented the scientists in order to reach a publication agreement between them, WADA, and the IAAF. The study had already been discovered by the media in 2015, without any intervention by the authors, at the time that systematic doping was reported in Russian athletics. The British Parliament's committee on culture, media and sport then organised a hearing on the subject, during which parts of the study were made public without the consent of the authors.
The authors hope that publication of the complete study, together with the detailed statistics provided in its appendix, will stimulate further research on doping elite athletics. "The study brings opportunities for a constructive debate regarding new strategies for combating doping. The randomised response method is a good way to make informed statements about the actual spread of doping," says Ulrich.
Abstract
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.
Authors
Rolf Ulrich, Harrison G Pope, Léa Cléret, Andrea Petróczi, Tamás Nepusz, Jay Schaffer, Gen Kanayama, R Dawn Comstock, Perikles Simon
[link url="https://www.sciencedaily.com/releases/2017/08/170829090950.htm"]McLean Hospital material[/link]
[link url="https://link.springer.com/article/10.1007%2Fs40279-017-0765-4"]Sports Medicine abstract[/link]