Doping in Sport -Exercise Scientists Have to Take Responsibility

The impact of sport in society has tremendously increased over the last decades. Elite sport is strongly intertwined with commerce, and athletic success is not only associated with prestige, but also with considerable financial compensation. Athletics today is not just a hobby anymore. Most elite athletes are nearly engaged full time in sport and the pressure and drive to perform are strong. The pressure on athletes may further increase when sponsors place extra pressure on the athlete when performances are not as expected. Expectations from the public contribute to pushing the athlete to the performance limit, and the use of ergogenic aids for boosting performance, while unethical, is tempting for some. International sport organizations take a strong stand against doping. The scientific community also has a responsibility in the fight against doping and the protection of fair play. To obtain a solid scientific basis for banning substances, more studies have to be conducted on the effects of banned substances on performance and on the health risks. Since the route of administration and dosage may be higher in sport compared to normal medical practice, the dosage and way of administration have to be taken into account. Although doping research may have a negative image, it should be realized that most doping agents are regular drugs, and scientific investigations may have spin offs for regular medical treatment. Another responsibility of the scientific community is to spread scientific data and to take part in education of athletes, coaches and others involved in sport, particularly because in sport there are many misconceptions about doping. In sport circles there is insufficient information on the effects of the banned substances on exercise performance, and many athletes are unaware that some of the banned substances lack any performance enhancing effect. Politicians and rule makers should realize that any substance on the doping list could make athletes believe that they have an ergogenic effect, and therefore may stimulate its abuse.

Another responsibility of scientists is to assist in the control of misuse of ergogenic aids, and to make control fair and reliable. For that purpose not only detection methods have to be refined, but also more scientific data are needed about the physiology and pharmacokinetics of banned substances as well as the kinetics of excretion in the urine. Sport scientists working closely with athletes are often in a good position to conceive and develop new anti-doping methods.

A recent development in the attempt to boost performance is the use of erythropoietin (EPO) and oxygen carriers. Because EPO can only be detected in the urine for approximately one week after the last dosage, additional blood screening has been introduced into sports such as cycling, skiing and skating. With the original blood screening hemoglobin and hematocrit levels were measured and cut off values for no-start have been introduced. Presently one of the most fair and advanced blood testing methods is the SAFE (Safe and Fair Events) paradigm developed by Dr. Stray-Gundersen in cooperation with the International Skating Union. With this method all athletes are screened with one blood sample taken the day before the competition, and post competition samples taken only on those athletes who have been selected for doping control. With this approach the entire field is checked for potentially dangerous polycythemia prior to start. In addition, parameters of red blood cell formation indicate the use of EPO, oxygen carriers, plasma expanders and some other manipulations. In suspected cases the plasma can be spun, frozen and studied. In addition targeted urine sampling for EPO detection can take place. Although the experience with this approach is positive, further studies are needed to refine and validate the methodology. A scientific journal is a proper medium to publish research and to discuss the matter scientifically. Therefore, original investigations and review papers like the ones in the current issue, are welcomed. Since some of the forbidden substances may be used in athletes while scientific studies only include animal research, additional research on humans should have a high priority. Therefore, exercise scientists should take their responsibility in this matter, and contribute to safe and fair sport.