World Anti-Doping Agency

Journal Article Breaking Boundaries: Exploring Performance Enhancement and Anti-Doping Testing in Sports Get access Imir G Metushi, Imir G Metushi Assistant Professor, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States Address correspondence to this author at: Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Ave., CHS A3-231S, Los Angeles, CA 90095-1732, United States. E-mail imetushi@mednet.ucla.edu. Search for other works by this author on: Oxford Academic Google Scholar Allison Wagner, Allison Wagner Director of Athlete and International Relations, OLY, Silver Medalist, Former World Record Holder, World Champion, NCAA Champion, United States Anti-Doping Agency, Colorado Springs, CO, United States Search for other works by this author on: Oxford Academic Google Scholar Brian Ahrens, Brian Ahrens Director of Olympic Analytical Laboratory, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States Search for other works by this author on: Oxford Academic Google Scholar Magnus Ericsson, Magnus Ericsson Director of Laboratoire AntiDopage Francais, Universite Paris-Saclay, Orsay, France Search for other works by this author on: Oxford Academic Google Scholar Olivier Rabin, Olivier Rabin Professor, Senior Director of Science and Medicine, World Anti-Doping Agency, Montreal, QC, Canada Search for other works by this author on: Oxford Academic Google Scholar Tim Sobolevsky, Tim Sobolevsky Senior Scientist at Olympic Analytical Laboratory, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States Search for other works by this author on: Oxford Academic Google Scholar Travis T Tygart Travis T Tygart Chief Executive Officer, United States Anti-Doping Agency, Colorado Springs, CO, United States Search for other works by this author on: Oxford Academic Google Scholar Clinical Chemistry, Volume 70, Issue 7, July 2024, Pages 897–904, https://doi.org/10.1093/clinchem/hvae074 Published: 05 July 2024 Article history Received: 08 April 2024 Accepted: 08 May 2024 Published: 05 July 2024

Ferro-coke, which is produced by mixing coal and iron ore, briquetting and carbonizing, can be used in a blast furnace to greatly decrease the reducing agent ratio. To ensure the strength of ferro-coke, asphalt pitch (ASP) is used as a binder, but the supply of ASP is limited, and the development of alternative binder are required. This study investigated the application of Hyper-coal (HPC), a low-ash caking additive obtained by solvent extraction of coal, as a new binder for ferro-coke. It was found that superior ferro-coke strength could be obtained by using HPC in which insoluble solid concentration was less than 15 wt.%, to that of ASP. This threshold value was specified from the permeation tests. The permeabilities of binders were determined by measuring the permeation distance in the packed layer of coal and/or iron ore under the carbonizing conditions. HPC appeared higher permeability than ASP in the packed layer of iron ore and coal mixtures. It was considered that the excellent thermal plasticity of HPC, lower melting temperature and higher fluidity than ASP, affected higher permeation into the inter particle void especially lower temperature range before starting the reduction of iron ore, which rapidly decreased in the permeabilities of both binders due to the distortion of carbon structures. Those results suggested that HPC was superior to ASP as a binder for ferro-coke.

The book, International Design Organizations: Histories, Legacies and Values, is a well-crafted edition of the papers of the conference of the same name held in Brighton in 2017. To my knowledge, this was probably the first academic meeting specifically organized for bringing international scholars who studied the formation and evolution of international design organizations and networks from the viewpoint of the global history of design. Therefore, the publication is unique in being the very first collection of scholarly essays examining the histories of international and national design organizations and networks from a global perspective. In design circles, international design organizations such as the World Design Organization (WDO—previously ICSID) and the International Council of Design (Ico-D—previously Icograda) have long been discussed just in terms of practical benefits of their membership or the perceived impact of their events such as the World Design Capital of WDO, yet these organizations have been rarely the subject of a systematic scholarly debate with historical and critical perspectives. The design discourse has always been heavily preoccupied with objects, images, products, brands, and, of course, individual designers rather than the nature of professional interactions, the formation of networks, social structures, organizations, and power relations in design. A critical analysis of that deeply rooted tendency is beyond the aim and scope of this short review, yet that resistance to comprehending design as a social practice with several layers of power relations has certainly become part of the professional ideology of design. Nevertheless, both the conference in 2017 and the book are signs of the emerging academic interest at the international level in understanding ‘design as a globally organized social practice’ with both historical and critical perspectives.

ObjectivesThe percentage of athletes with Therapeutic Use Exemptions (TUEs) competing in elite sport and the association with winning medals has been a matter of speculation in the absence of validated competitor numbers. We used International Olympic Committee (IOC) and World Anti-Doping Agency (WADA) data to identify athletes competing with TUEs at five Olympic Games (Games) and a possible association between having a TUE and winning an Olympic medal.MethodsWe used the IOC’s competition results and WADA’s TUE database to identify the number of TUEs for athlete competitions (ACs, defined as one athlete competing in one event) and any associations with medals among athletes competing in individual competitions. We calculated risk ratios (RR) for the probability of winning a medal among athletes with a TUE compared with that of athletes without a TUE. We also reported adjusted RR (RRadj) controlling for country resources, which is a potential confounder.ResultsDuring the Games from 2010 to 2018, there were 20 139 ACs and 2062 medals awarded. Athletes competed with a TUE in 0.9% (181/20 139) of ACs. There were 21/2062 medals won by athletes with a TUE. The RR for winning a medal with a TUE was 1.13 (95% CI: 0.73 to 1.65; p=0.54), and the RRadj was 1.07 (95% CI: 0.69 to 1.56; p=0.73).ConclusionThe number of athletes competing with valid TUEs at Games is <1%. Our results suggested that there is no meaningful association between being granted a TUE and the likelihood of winning a medal.

The use of systemic glucocorticoids (GCs), as well as local injections, continues to be a controversial issue in the sport/anti-doping community. There is widespread and legitimate use of GCs for numerous health conditions, yet there are concerns about side effects and the possibility of enhanced athletic performance in limited settings. This is compounded by the uncertainty regarding the prevalence of GC use, mechanisms underlying physiological effects and complex pharmacokinetics of different formulations. While WADA continues to promote research in this complex area, some international sporting federations, major event organisers and professional sports leagues have introduced innovative rules such as needle policies, mandatory rest periods and precompetition guidelines to promote judicious use of GCs, focusing on athlete health and supervision of medical personnel. These complementary sport-specific rules are helping to ensure the appropriate use of GCs in athletes where overuse is a particular concern. Where systemic GCs are medically necessary, Therapeutic Use Exemptions (TUEs) may be granted after careful evaluation by TUE Committees based on specific and strict criteria. Continued vigilance and cooperation between physicians, scientists and anti-doping organisations is essential to ensure that GC use in sport respects not only principles of fairness and adherence to the rules but also promotes athlete health and well-being. The purpose of this narrative review is to summarise the use and management of GCs in sport illustrating several innovative programmes by sport leagues and federations.

The percentage of circulating reticulocytes (RET%) is a useful marker of blood doping in the context of the Athlete Biological Passport (ABP). The viability of the ABP depends on the comparability of sample data obtained across multiple laboratories for a given athlete. With the recent introduction of a different technology for the measurement of reticulocytes, the goal of this study was to compare currently employed Sysmex XT/XE analyzers to the recently introduced Sysmex XN analyzer. RET% differences were searched in two independent data sets, the first consisting of 95369 RET% values coming from 29 laboratories located in five continents as part of routine testing for the ABP, the second from a targeted study involving 510 samples analyzed on both a Sysmex XT and XN analyzers by two different laboratories. A relatively small but significant bias of 0.27 ([0.22-0.35] 95% CI) for the first data set and 0.19% ([0.16-0.22] 95% CI) for the second data set was observed with Sysmex XN analyzers returning higher values than Sysmex XT/XE analyzers. This bias appears constant over most of the range of RET% measured in elite athletes. When RET% values are obtained for the same athlete with different technologies (XT/XE vs XN), an adjustment of RET% emanating from the XT/XE instruments through a decrease of 0.22% within the ABP calculated ranges appears to be sufficient to integrate the results from the two technologies.

Athletes dope to trigger physiological changes that provide advantages in competition. Doping leaves a biological fingerprint in the athlete's body. The Athlete Biological Passport (ABP)3 is the paradigm in testing that aims to detect this biological fingerprint (1, 2). Biomarkers of doping measured or inferred from blood and urine samples are used for that purpose, in the same way that biomarkers of disease are used in medicine as indicators of the presence or severity of a disease. Although both types of biomarkers aim to distinguish a biological fingerprint induced by a specific cause from the usual biological profile expected for a natural physiological condition, biomarkers of doping are collated and evaluated according to standards specific to forensic sciences. Several aspects of the ABP have been developed and validated in recent years. They include strict protocols for the collection, transport, and analysis of samples; a scrupulous chain of custody; an adaptive Bayesian method to evaluate longitudinal biological profiles; and application of forensic standards for the evaluation of doping evidence—with the anonymity of the athlete guaranteed at all steps of the process. The blood passport aims to detect any modification of erythropoiesis, whether by blood transfusion or the use of erythropoiesis-stimulating agents, such as recombinant erythropoietin (rEPO) (1, 3). The ABP can be used for intelligence, for sanctioning, for health protection, and, in turn, for deterrence. It can be used for intelligence because antidoping organizations (ADOs) can use data from the passport to define suspicious biological profiles and identify athletes who have them. It can be used for sanctioning because the weight of ABP evidence can be sufficiently high in some cases to prove beyond reasonable doubt that an athlete doped. The ABP can be used for health protection because it provides a direct view of the impact …