Prevalence estimate of blood doping in elite track and field at the introduction of the Athlete Biological Passport

In elite sport, the Athlete Biological Passport (ABP) was invented to tackle cheaters by monitoring closely changes in biological parameters, flagging atypical variations. The haematological module of the ABP was indeed adopted in 2011 by the International Association of Athletics Federations (IAAF). This study estimates the prevalence of blood doping based on haematological parameters in a large cohort of track & field athletes measured at two international major events (2011 & 2013 IAAF World Championships) with a hypothesized decrease in prevalence due to the ABP introduction.\n\nA total of 3683 blood samples were collected and analysed from all participating athletes originating from 209 countries. The estimate of doping prevalence was obtained by using a Bayesian network with seven variables, as well as \"doping\" as a variable mimicking doping with low-doses of recombinant human erythropoietin (rhEPO), to generate reference cumulative distribution functions (CDFs) for the Abnormal Blood Profile Score (ABPS) from the ABP.\n\nOur results from robust haematological parameters indicate an estimation of an overall blood doping prevalence of 18% in average in endurance athletes (95% Confidence Interval (C.I.) 14-22%). A higher prevalence was observed in female athletes (22%, C.I. 16-28%) than in male athletes (15%, C.I. 9-20%). In conclusion, this study presents the first comparison of blood doping prevalence in elite athletes based on biological measurements from major international events that may help scientists and experts to use the ABP in a more efficient and deterrent way.\n\nWhat are the new findings ?O_LIThis study presents the first comparison of blood doping prevalence in elite track & field athletes based on biological measurements from major international events\nC_LIO_LIOur results from robust haematological parameters indicate an estimation of an overall blood doping prevalence of 18% in average in endurance athletes.\nC_LIO_LIThe confidence intervals for blood doping prevalence range from 9-28% with wide discrepancies between certain countries.\nC_LI\n\nHow might it impact on clinical practice in the near futureO_LIThe further development of the Athlete Biological Passport with a careful monitoring of biological parameters still represents the most consistent approach to thwart athletes using undetectable prohibited substances or methods.\nC_LIO_LIThis study describes a method to define blood doping prevalence with the analysis of robust haematological parameters\nC_LIO_LIEstimates of doping prevalence in subpopulations of athletes may represent a valuable tool for the antidoping authorities to perform a risk assessment in their sport.\nC_LI