Analysis of doping control test results in individual and team sports from 2003 to 2015

The purpose and effectiveness of doping testing in sport

Maintaining an effective testing program is critical to the success and credibility of the anti-doping movement. However, a low detection ratio compared to the assumed real prevalence of sport doping has led some to question and criticize the effectiveness of the current testing system. In this perspective article, we review the results of the global testing program, discuss the purpose of testing, and compare benefits and limitations of performance indicators commonly used to evaluate testing efforts. We suggest that an effective testing program should distinguish between preventive testing and testing aimed at detecting the use of prohibited substances and prohibited methods. In case of preventive testing, the volume of the test program in terms of number of samples, tests and analyses is likely to be positively related to the extent of the deterrent effect achieved. However, there is a lack of literature on how the deterrent effect works in the practical context of doping testing. If the primary goal is to detect doping, the testing must be risk- and intelligence-based, and quality in test planning is more important than quantity in sample collection. The detection ratio can be a useful tool for evaluating the effectiveness of doping testing, but for the calculation one should take into account the number of athletes tested and not just the number of collected samples, as the former would provide a more precise measure of the tests' ability to detect doping among athletes.

DOPING CONTROL IN MALE SOCCER PLAYERS IN BRAZIL: 10 YEARS OF FOLLOW-UP

Objective

To understand the Adverse Analytical Finding (AAF) that have occurred in Brazilian soccer in a recent 10-year period, comparing them to international data, to know the Brazilian profile.

Methods

A review of the AAR in the Doping Control Commission database of the Brazilian Football Association from 2008 to 2017. The AAR in professional male soccer players between 2008 and 2017 were considered.

Results

The sample selected in this research was composed of 40,092 doping tests, with 113 AAR, identified in 18 different competitions (0.28%) in the professional category, in Brazilian national and state competitions between 2008 and 2017, flagged in doping control exams through urine samples. Stimulants were detected most frequently (31.0%), followed by glucocorticoids (21.2%), diuretics, and masking agents (19.5%). The Brazilian Championship series did not show a relationship with any of the World Anti-Doping Agency (WADA) groups of substances. Series A showed 0.07% of AAR, Series B 0.21%, Series C 0.75% and Series D 1.49.

Conclusion

The rate of AAR in Brazilian soccer was 0.28%, lower than the average for all soccer worldwide, and shows similar percentages among field positions. Stimulants were the most prevalent drugs. The national elite soccer competitions showed significantly fewer cases than the lower divisions. Level of Evidence II; Retrospective Study.

From Anti-doping-I to Anti-doping-II: Toward a paradigm shift for doping prevention in sport

Doping remains an intractable issue in sport and occurs in a complex and dynamic environment comprising interactions between individual, situational, and environmental factors. Anti-doping efforts have previously predominantly focused on athlete behaviours and sophisticated detection methods, however, doping issues remain. As such, there is merit in exploring an alternative approach. The aim of this study was to apply a systems thinking approach to model the current anti-doping system for four football codes in Australia, using the Systems Theoretic Accident Model and Processes (STAMP). The STAMP control structure was developed and validated by eighteen subject matter experts across a five-phase validation process. Within the developed model, education was identified as a prominent approach anti-doping authorities use to combat doping. Further, the model suggests that a majority of existing controls are reactive, and hence that there is potential to employ leading indicators to proactively prevent doping and that new incident reporting systems could be developed to capture such information. It is our contention that anti-doping research and practice should consider a shift away from the current reactive and reductionist approach of detection and enforcement to a proactive and systemic approach focused on leading indicators. This will provide anti-doping agencies a new lens to look at doping in sport.

Anti-Doping Knowledge of Students Undertaking Bachelor's Degrees in Sports Sciences in Spain

In Spain, students pursuing a career in athletic training, physical education, or scientific evaluation of sports enroll in a bachelor’s degree in sports sciences. This degree provides knowledge and skills in a broad array of sports settings and promotes research-based interdisciplinary knowledge. However, the student’s syllabus rarely includes specific academic training on anti-doping regulations or doping prevention. The purpose of this study was to assess the anti-doping knowledge of the students undertaking a bachelor’s degree in sports sciences in Spanish universities. One thousand two hundred and thirty-three bachelor students in sport science (907 males, 322 females, and 4 participants with non-binary sex) from 26 Spanish universities completed a validated questionnaire about general anti-doping knowledge. The questionnaire is an adapted version of the Play True Quiz of the World Anti-Doping Agency and contains 37 multiple-choice questions. The score obtained in the questionnaire was transformed into a 0−100-point scale. The questionnaire was distributed among students within each university by a faculty member and it was filled out online. Students obtained a score of 65.8 ± 10.10 points (range = 32−92 points). There was an effect of the course in the score obtained (p < 0.001). Students of the first course (63.6 ± 9.5 points) had lower scores than the remaining courses (p < 0.037) while the students of the fourth course obtained the highest scores (68.7 ± 9.5 points; p < 0.019). The students with an itinerary on sports performance were the respondents with the highest anti-doping knowledge (67.2 ± 10.2) points, followed by the students with an itinerary on health (66.7 ± 9.5 points). The knowledge of basic anti-doping rules and doping prevention strategies of the bachelor students in sports sciences in Spain was suboptimal. Increasing doping prevention information in the syllabus of the bachelor’s degree in sports sciences is essential as these future professionals will directly work with populations at risk of doping.

Moral Identity and Attitudes towards Doping in Sport: Whether Perception of Fair Play Matters

Research evidence suggests that athletes' attitudes towards banned substances are among the strongest predictors of intention to use or actual practice of doping. Previous research has found that personal morality was negatively related to doping attitudes. However, less is known about the role of athletes' perceptions of fair play on their attitudes towards doping. First, we examined whether moral identity was associated with athletes' attitudes towards doping and whether their perceptions of fair play mediated this relationship. The second purpose was to determine whether these associations differed among non-athletes. Overall, 365 university students (49.9% males, 55.3% athletes) participated in this study (mean age 22.02, SD = 6.58). They completed questionnaires measuring the aforementioned variables. The results showed that athletes' moral identity and endorsement of fair play were negatively associated with their attitudes towards doping. The mediation analyses showed that the effect of moral identity on attitudes towards doping was partially mediated by perceptions of fair play (indirect effect, β = -0.10, p < 0.05). Unlike student athletes, non-athletes' moral identity negatively predicted attitudes towards doping only indirectly, via fair play perception (indirect effect, β = -0.08, p < 0.05). The study provides insights into how a person's morality and perception of moral values in sport may act as factors related to doping in sport. The practical implications for the promotion of anti-doping attitudes for athletes and separately for student non-athletes were provided together with future research perspectives.

Study of frequency and type of adverse analytical findings in the different disciplines of aquatics

We aimed to analyze the number and distribution of doping control tests in which a banned substance was reported (i.e., adverse analytical finding) in aquatics. The analysis was performed by using the data provided by the WADA Testing Figure Reports from 2015 to 2019. A total of 79,956 doping control tests were analyzed. Sprint swimming, middle-distance swimming and water polo were the disciplines with the highest number of doping control tests. However, there were no differences in the frequency of adverse findings among disciplines (overall, ∼0.56%, from 0.13 in artistic swimming to 0.76% in sprint swimming). Sprinters and long-distance swimmers presented a higher frequency of beta-2-agonists than the remaining aquatic disciplines (p < 0.05). These results indicate that the type of prohibited substances employed is strongly influenced by the intrinsic characteristics of each aquatic discipline.

Attitudes Toward and Susceptibility to Doping in Spanish Elite and National-Standard Track and Field Athletes: An Examination of the Sport Drug Control Model

The Sport Drug Control Model (SDCM) is likely to be the model which most explicitly represents the theoretical paradigm of the psychological study of the use of doping in sport. This model can be further developed through its analysis in different populations and cultures. The main aim of this study was to empirically test the SDCM while analyzing for the first time the intentions and attitudes toward doping in Spanish track and field athletes. A secondary aim was to assess the extent to which the variables in the model together predict attitude, susceptibility, and behavior toward the use of performance-enhancing substances. Participants were 281 Spanish elite and national-standard track and field athletes from whom 80.1% were 18-28 years old and 49.5% were females. Participants completed the SDCM questionnaire measuring morality, legitimacy, benefits appraisal, threat appraisal, self-efficacy to refrain from doping, reference groups' endorsement of doping methods/substances, use of legal supplements, availability and affordability of doping, attitudes toward doping, susceptibility to doping and, self-reported use of banned performance-enhancing substances or methods. Structural equation modeling supported a good fitness of the SDCM and confirmed that positive attitudes toward doping predicted high susceptibility to doping (β = 0.55, p < 0.001), which is in turn associated with the use of prohibited substances and methods (β = 0.12, p < 0.05). The factors that have most influence on attitudes toward doping are morality (β = 0.46, p < 0.001) and reference group opinion (β =0.62, p <0.001). Self-reported doping use was 9.6%. These findings confirm SDCM reproducibility and variability (as it accounts for several variables) in Spanish track and field competitive athletes. It is recommended to implement preventive programs which allow athletes to acquire a strong moral stance against doping and coaches to employ the tools required to instill and educate their athletes in rejecting these illegal practices that corrupt the integrity of competitive sport.

Frequency and type of adverse analytical findings in athletics: Differences among disciplines

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.

Doping Prevalence in Competitive Sport: Evidence Synthesis with "Best Practice" Recommendations and Reporting Guidelines from the WADA Working Group on Doping Prevalence

BACKGROUND

The prevalence of doping in competitive sport, and the methods for assessing prevalence, remain poorly understood. This reduces the ability of researchers, governments, and sporting organizations to determine the extent of doping behavior and the impacts of anti-doping strategies.

OBJECTIVES

The primary aim of this subject-wide systematic review was to collate and synthesize evidence on doping prevalence from published scientific papers. Secondary aims involved reviewing the reporting accuracy and data quality as evidence for doping behavior to (1) develop quality and bias assessment criteria to facilitate future systematic reviews; and (2) establish recommendations for reporting future research on doping behavior in competitive sports to facilitate better meta-analyses of doping behavior.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to identify relevant studies. Articles were included if they contained information on doping prevalence of any kind in competitive sport, regardless of the methodology and without time limit. Through an iterative process, we simultaneously developed a set of assessment criteria; and used these to assess the studies for data quality on doping prevalence, potential bias and reporting.

RESULTS

One-hundred and five studies, published between 1975 and 2019,were included. Doping prevalence rates in competitive sport ranged from 0 to 73% for doping behavior with most falling under 5%. To determine prevalence, 89 studies used self-reported survey data (SRP) and 17 used sample analysis data (SAP) to produce evidence for doping prevalence (one study used both SRP and SAP). In total, studies reporting athletes totaled 102,515 participants, (72.8% men and 27.2% women). Studies surveyed athletes in 35 countries with 26 involving athletes in the United States, while 12 studies examined an international population. Studies also surveyed athletes from most international sport federations and major professional sports and examined international, national, and sub-elite level athletes, including youth, masters, amateur, club, and university level athletes. However, inconsistencies in data reporting prevented meta-analysis for sport, gender, region, or competition level. Qualitative syntheses were possible and provided for study type, gender, and geographical region. The quality assessment of prevalence evidence in the studies identified 20 as "High", 60 as "Moderate", and 25 as "Low." Of the 89 studies using SRP, 17 rated as "High", 52 rated as "Moderate", and 20 rated as "Low." Of the 17 studies using SAP, 3 rated as "High", 9 rated as "Moderate", and 5 rated as "Low." Examining ratings by year suggests that both the quality and quantity of the evidence for doping prevalence in published studies are increasing.

CONCLUSIONS

Current knowledge about doping prevalence in competitive sport relies upon weak and disparate evidence. To address this, we offer a comprehensive set of assessment criteria for studies examining doping behavior data as evidence for doping prevalence. To facilitate future evidence syntheses and meta-analyses, we also put forward "best practice" recommendations and reporting guidelines that will improve evidence quality.

Doping Attitudes, Beliefs, and Practices among Young, Amateur Croatian Athletes

Recent studies revealed that amateur athletes, especially young ones, have an increasing tendency of performance-enhancing drugs (PEDs) usage. The aim of this study was to explore PEDs attitudes, beliefs, and practices among young, amateur Croatian athletes. This cross-sectional study using a specially designed questionnaire as a research tool was done during the August 2019 to January 2020 period among a convenient sample of 400 amateur athletes of median age 18 (interquartile range 15 to 21) years. The prevalence of current PEDs usage was 1.3%, while past PEDs usage prevalence was 3.3%. Current PEDs usage was more frequent among young adults (p = 0.048) and athletes playing individual sports (p = 0.001). Athletes who were engaged in sports from one to five years had more permissive attitudes toward PEDs (p < 0.001) as measured by the Performance Enhancement Attitude Scale. Female athletes had more positive beliefs about PEDs usage (p = 0.008). The study did not establish any correlation between current or past PEDs usage and attitudes toward PEDs as well as beliefs about PEDs usage. However, there was a weak positive correlation between attitudes toward PEDs and athletes’ beliefs about PEDs usage (r_s = 0.465, p < 0.001). PEDs usage is present among young Croatian amateur athletes. There is a need for interventions directed toward the prevention of PEDs usage in an observed subgroup of athletes.

Doping in the Ultimate Fighting Championship (UFC): A 4-year epidemiological analysis

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.

Outcomes of adverse analytical findings in individual and team sports

The aim of this investigation was to describe the outcomes of the adverse analytical findings in different Olympic sports. The data included were gathered from the World Anti-Doping Agency Anti-doping Rule Violations Reports (2013-2017). Weightlifting (78.1 ± 9.4%) wrestling (73.2 ± 18.5%) and volleyball (68.3 ± 18.7%) were the sports with the highest proportion of cases that ended in an antidoping sanction. Gymnastics (45.1 ± 10.1%), triathlon (32.6 ± 11.9%) and shooting (29.9 ± 14.1%) were the sports with a higher frequency of cases that were not sanctioned due to medical reasons. Gymnastics (22.4 ± 18.4%), boxing (23.2 ± 16.0%) and taekwondo (17.3.1 ± 16.4%) presented the highest proportion of cases that are still pending resolution. The proportion of cases that ended in no sanction was higher in fencing (26.2 ± 22.7%), skating (23.6 ± 35.1%) and tennis (18.6 ± 26.5%). These results indicate that the sanctions derived from antidoping rule violations were not uniform in all sports disciplines.

Annual banned-substance review: Analytical approaches in human sports drug testing 2019/2020

Analytical chemistry-based research in sports drug testing has been a dynamic endeavor for several decades, with technology-driven innovations continuously contributing to significant improvements in various regards including analytical sensitivity, comprehensiveness of target analytes, differentiation of natural/endogenous substances from structurally identical but synthetically derived compounds, assessment of alternative matrices for doping control purposes, and so forth. The resulting breadth of tools being investigated and developed by anti-doping researchers has allowed to substantially improve anti-doping programs and data interpretation in general. Additionally, these outcomes have been an extremely valuable pledge for routine doping controls during the unprecedented global health crisis that severely affected established sports drug testing strategies. In this edition of the annual banned-substance review, literature on recent developments in anti-doping published between October 2019 and September 2020 is summarized and discussed, particularly focusing on human doping controls and potential applications of new testing strategies to substances and methods of doping specified the World Anti-Doping Agency's 2020 Prohibited List.

Sport-Specific Use of Doping Substances: Analysis of World Anti-Doping Agency Doping Control Tests between 2014 and 2017

Background: In recent years, there has been a solid effort across all sports organizations to reduce the prevalence and incidence of doping in sport. However, the efficacy of current strategies to fight against doping might be improved by using anti-doping polices tailored to the features of doping in each sport. Objectives: The aim of this investigation was to analyze the substances more commonly found in doping control tests in individual and team sports. Material and Methods: The publicly accessible Testing Figures Reports made available by the World Anti-Doping Agency, were analyzed from 2014 to 2017. Results: The most commonly detected groups of banned substances were anabolic agents and stimulants but the distribution of adverse findings per drug class was very different depending on the sports discipline. Weightlifting, athletics, rugby, hockey and volleyball presented abnormally high proportions of anabolic agents (p = 2.8 × 10^-11). Cycling, athletics and rugby presented atypically elevated proportions of peptide hormones and growth factors (p = 1.4 × 10^-1). Diuretics and masking agents were more commonly found in boxing, wrestling, taekwondo, judo, shooting, and gymnastics than in other sports (p = 4.0 × 10^-68). Cycling, rowing, aquatics, tennis, gymnastics and ice hockey presented abnormally high proportions of stimulants (p = 1.8 × 10^-5). Conclusions: These results indicate that the groups of banned substances more commonly detected in anti-doping control tests were different depending on the sports discipline. These data suggest the prohibited substances used as doping agents might be substantially different depending on the type of sport and thus, sports-specific anti-doping policies should be implemented to enhance the efficacy of anti-doping testing.