Rolf Ulrich1, Harrison G Pope2,3, Léa Cléret4, Andrea Petróczi5,6, Tamás Nepusz5,7, Jay Schaffer8, Gen Kanayama9,10, R Dawn Comstock11, Perikles Simon12. 1. Department of Psychology, University of Tübingen, 72076, Tübingen, Germany. 2. Biological Psychiatry Laboratory, McLean Hospital, Belmont, MA, 02478, USA. hpope@mclean.harvard.edu. 3. Department of Psychiatry, Harvard Medical School, Boston, MA, USA. hpope@mclean.harvard.edu. 4. Sport and Exercise Science, Swansea University, Swansea, UK. 5. School of Life Sciences, Pharmacy and Chemistry, Kingston University, Kingston-upon-Thames, Surrey, KT1 2EE, UK. 6. Department of Psychology, The University of Sheffield, Sheffield, S10 2TP, UK. 7. Faculty of Logistics, Molde University College, Molde, Norway. 8. Department of Applied Statistics and Research Methods, University of Northern Colorado, Greeley, CO, USA. 9. Biological Psychiatry Laboratory, McLean Hospital, Belmont, MA, 02478, USA. 10. Department of Psychiatry, Harvard Medical School, Boston, MA, USA. 11. Pediatric Injury Prevention, Education, and Research Program, Colorado School of Public Health, Aurora, CO, USA. 12. Department of Sports Medicine, Rehabilitation and Disease Prevention, Johannes Gutenberg University Mainz, 55131, Mainz, Germany.
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.
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.
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