title: Prevalence of blood doping in samples collected from elite track and field athletes.
abstract: BACKGROUND
  No reliable estimate of the prevalence of doping in elite sports has been published. Since 2001, the international governing body for athletics has implemented a blood-testing program to detect altered hematological profiles in the world's top-level athletes.
  
  
  METHODS
  A total of 7289 blood samples were collected from 2737 athletes out of and during international athletic competitions. Data were collected in parallel on each sample, including the age, sex, nationality, and birth date of the athlete; testing date; sport; venue; and instrument technology. Period prevalence of blood-doping in samples was estimated by comparing empirical cumulative distribution functions of the abnormal blood profile score computed for subpopulations with stratified reference cumulative distribution functions.
  
  
  RESULTS
  In addition to an expected difference between endurance and nonendurance athletes, we found nationality to be the major factor of heterogeneity. Estimates of the prevalence of blood doping ranged from 1% to 48% for subpopulations of samples and a mean of 14% for the entire study population. Extreme cases of secondary polycythemia highlighted the health risks associated with blood manipulations.
  
  
  CONCLUSIONS
  When applied at a population level, in this case the population of samples, hematological data can be used to estimate period prevalence of blood doping in elite sports. We found that the world's top-level athletes are not only heterogeneous in physiological and anthropometric factors but also in their doping behavior, with contrasting attitudes toward doping between countries. When applied at the individual level, the same biomarkers, as formalized in the Athlete Biological Passport paradigm, can be used in analysis of the observed different physiological characteristics and behavioral heterogeneities.
authors.affiliation: Swiss Laboratory for Doping Analyses, Epalinges, Switzerland. Pierre-Edouard.Sottas@chuv.ch
authors.forename: Pierre-Edouard
authors.initials: PE
authors.lastname: Sottas
authors.forename: Neil
authors.initials: N
authors.lastname: Robinson
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Fischetto
authors.forename: Gabriel
authors.initials: G
authors.lastname: Dollé
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Alonso
authors.forename: Martial
authors.initials: M
authors.lastname: Saugy
mesh_terms: D015415:Biomarkers / Q000097:blood; D001800:Blood Specimen Collection; D004300:Doping in Sports / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D012016:Reference Values; D015813:Substance Abuse Detection; D014142:Track and Field; D055815:Young Adult
chemical_list: D015415:Biomarkers