Ensuring Clean Competition at the Highest Levels of Sports

Ensuring Clean Competition at the Highest Levels of Sports

By Christine Yu

Sports are predicated on a simple premise: May the best athlete win. There’s an assumption of fair play, but when the stakes are high, athletes sometimes resort to using performance-enhancing substances to gain a competitive advantage. 

Some substances, such as anabolic steroids, growth hormone and erythropoietin (EPO), are banned by the World Anti-Doping Agency because they can boost performance. Others, such as diuretics, are prohibited because they can help mask the presence of a banned drug during testing. Athletes also violate doping policy if they manipulate their blood, genes or cells to improve performance. 

But athletes must worry about more than just steering clear of banned substances. Sometimes traces of drugs can be found in over-the-counter medication, vitamins and supplements. Athletes with a medical condition who need to take an otherwise banned substance must request a therapeutic use exemption first. 

With the rise of designer drugs and more sophisticated doping methods, anti-doping efforts have become paramount for keeping sport clean. “These people that cheat, they follow the literature, too,” says Michael Sawka, PhD, adjunct professor of biological sciences at Georgia Institute of Technology. “It’s a constant game of cat and mouse. You’re not going to catch them all, but if you can catch a certain percentage of those cheating, people are less likely to take the risk.”

Sawka, who is an expert in blood volume control and environmental physiology and performance, among other areas, is a scientific advisory board member of the Partnership for Clean Competition (PCC). PCC is an anti-doping research collaborative founded in 2008 by the U.S. Olympic and Paralympic Committee, National Football League, Major League Baseball and U.S. Anti-Doping Agency. It provides grants and supports working groups around the world to improve the detection of performance-enhancing substances. PCC also funds postdoctoral scholars and fellowships to introduce people to the field of anti-doping research. 

Sawka is working with others to improve the athlete biological passport (ABP), which tracks an athlete’s biological and physiological profile longitudinally. Suspicious fluctuations may suggest doping. For example, Sawka says they’re trying to identify biomarkers that are indicative of blood doping that could be added to the ABP.

They’re also examining ways to look at the age distribution of red blood cells. “If you take blood out, put blood in or start on erythropoietin, you’re going to see a difference in the age distribution of the red blood cells,” Sawka says. “The trick is how do you get good markers of age distribution so we can look at how it changes?

“Athletes want fair sport. They don’t want to compete against cheaters,” he continues. And doping doesn’t just affect elite athletes, those competing at the highest national and international levels. “When people cheat at one level, it goes downstream and to younger kids.” 

This article was originally published in the July 2024 issue of The Physiologist Magazine. Copyright © 2024 by the American Physiological Society. Send questions or comments to tphysmag@physiology.org.