A controversial study suggesting that doping in sport is far more prevalent than was found to be by conventional testing has finally been published after years of wrangling.
The research, based on anonymous surveys carried out at two elite athletics competitions in 2011, found that up to 57% of competitors admitted doping in the previous 12 months, a figure far surpassing the 1-2% identified by blood and urine tests carried out by the World Anti-Doping Agency (Wada), and higher even than the 14% prevalence estimated from the athlete biological passport.
But the research, commissioned and funded by Wada, has taken almost six years to be officially published, despite the results being leaked to the New York Times in 2013 and later released in the UK under parliamentary privilege by the culture, media and sport committee on blood doping in athletics.
Giving evidence at the inquiry into blood doping in athletics in 2015, Sebastian Coe, president of the IAAF, said that the delay was down to issues surrounding the researchers’ methodologies.
However Rolf Ulrich, first author of the study from the University of Tübingen, pushed back, accusing the IAAF of blocking the release of the study and co-authoring a response to the committee arguing that the delay and comments from Coe and his colleague Thomas Capdevielle were damaging to the authors’ reputations, efforts to combat doping, and scientific freedom.
Indeed the authors, who could not publish without consent from Wada, told the Guardian that they were left in the dark as to the reason for the delay.
“I really can’t answer [why it took so long],” said Ulrich. “I have no idea.”
Paul Dimeo, an expert in drug use in sport from the University of Stirling, who was not involved in the research, said the delay was bordering on scandalous.
“This information should have been transparent and made available much, much sooner,” he said. “It is a well-established methodology, it has been used in numerous other studies which have also shown prevalence to be quite high – some of them have shown it to be 20-40% in other places,” he added.
Wada did not immediately respond to a request for comment.
Now published in the journal Sports Medicine, the research reveals how athletes were quizzed at the 13th International Association of Athletics Federations World Championships in Athletics (WCA) in South Korea and the 12th Quadrennial Pan-Arab Games in Qatar (PAG) – both of which took place in 2011.
The survey used a method known as the “randomised response technique”. At the start of the survey, the participant was asked to think of the date of birth of someone they knew. The participant was then given two further questions simultaneously on the same screen. If the birthday fell in the first 10 days of a month, they were asked to answer a trivial question, but if it fell in the latter part of the month they were asked to answer whether they had used a prohibited substance or method in the last 12 months.
The upshot is that participants were able to answer honestly without fear of identification, with the overall proportion of athletes who answered each question judged based on statistical probabilities of when birthdays fall.
That, say the researchers, offers a way to estimate the proportion of athletes who said they had broken anti-doping regulations in the previous year.
The results from 1,203 athletes at the WCA and 965 athletes at the PAG suggests that levels of doping could be far higher than traditional tests suggest. The researchers found that more than 43% of athletes quizzed at WCA had doped in the past year, with the figure reaching just over 57% for those at PAG. By contrast biological tests at the events found a prevalence of just 0.5% at WCA and under 4% at PAG.
“The big question is, how sure can we be that athletes were actually compliant and they understood and they followed the instructions and answered as they were told?” said Andrea Petróczi, co-author of the research from Kingston University.
Taking into account the possibility that some responders might have answered in error, possibly from not reading the question properly due to their high speed of response, the team estimate that at least 30% of athletes at WCA and 45% of those at PAG doped in the last year.
The authors also explored a host of scenarios under which the athletes might not have answered the doping question truthfully, or otherwise not complied. “In the great majority of those different scenarios it turns out we would have undershot the actual value,” said Harrison Pope Jr, a co-author of the study from Harvard University, adding that that suggests doping was likely more prevalent than the results suggest.
Pope said he was not surprised by the figures, adding that: “It is critical for people to know the sheer magnitude of this problem.”
“Even though the paper refers to events that happened in 2011, there is no particular reason to think the rates of doping in 2017 would be any different,” he added. “The urgent thing at this point is for subsequent studies using this [method] to be conducted now in elite sports to track this problem.”
John Hoberman, an expert in performance-enhancing drug use from the University of Texas at Austin, said that he wasn’t surprised by the findings. “The entire elite global sports system has built incentives to dope into itself in such a way that these are irresistible incentives,” he said.
While Dimeo welcomed the research he said that one limitation of the study did not differentiate between athletes who might have smoked cannabis once in the past 12 months, and those on intensive doping programmes.
Nicole Sapstead, chief executive of UK Anti-Doping, described the findings as “disappointing and concerning statistics”, but she said many things had changed since 2011, including stiffer sanctions. “Testing methods continue to advance but testing is only one part of the anti-doping process,” she said. “There is now greater investment in educating elite and up and coming athletes about the dangers and consequences of taking banned substances, as well as a greater emphasis on intelligence and investigations as an alternative way of catching those who seek to break the rules.”
A spokesperson for the Athletics Integrity Unit, an independent board set up by the IAAF this year with Thomas Capdevielle its the interim head, said that the body would not comment on the specific findings or accuracy of the study, but that the research was welcome.
“The AIU is in no doubt that the percentage of athletes doping in the sport of athletics is significantly above the number of adverse analytical findings currently reported in annual global anti-doping figures,” it said in a statement.
South African sports scientist Ross Tucker said the research showed the authorities needed to do more.
“The study seems to be as robust and accurate as you’ll get,” he added. “It’s certainly a lot more reliable than doing anti-doping testing to identify dopers. It also puts the ball into anti-doping’s court. They have to now respond. Not sure how they do that, but the more this stuff is in the open, the better.”
Jim McVeigh, director of the Public Health Institute at Liverpool John Moores University, said that the implications of the research go far beyond elite sport. “While there are a range of health risks that these athletes are being exposed to, this also sends a concerning message to the general population – that using drugs is an effective or even necessary route to sporting success,” he said.
