Association Between Implementation of the Athlete Biological Passport and Female Elite Runners’ Performance

This is a sel -a chi ed e sion o an o iginal a icle. This e sion may di e om he o iginal in pagina ion and ypog aphic de ails. Au ho (s): Ti le: Yea : Ve sion: Copy igh : Righ s: Righ s u l: Please ci e he o iginal e sion: CC BY-NC-ND 4.0 h ps://c ea i ecommons.o g/licenses/by-nc-nd/4.0/ Associa ion Be ween Implemen a ion o he A hle e Biological Passpo and Female Eli e Runne s’ Pe o mance © 2020 The Au ho s. Published by Human Kine ics, Inc. Published e sion Iljuko , Se gei; Kauppi, Jukka-Pekka; Uusi alo, A ja L. T.; Pel onen, Juha E.; Schumache , Yo ck O. Iljuko , S., Kauppi, J.-P., Uusi alo, A. L. T., Pel onen, J. E., & Schumache , Y. O. (2020). Associa ion Be ween Implemen a ion o he A hle e Biological Passpo and Female Eli e Runne s’ Pe o mance. In e na ional Jou nal o Spo s Physiology and Pe o mance, 15(9), 1231-1236. h ps://doi.o g/10.1123/ijspp.2019-0643 2020 Associa ion Be ween Implemen a ion o he A hle e Biological Passpo and Female Eli e Runne s’Pe o mance Se gei Iljuko , Jukka-Pekka Kauppi, A ja L.T. Uusi alo, Juha E. Pel onen, and Yo ck O. Schumache The pu pose o his esea ch was o e alua e he pe o mances o emale middle- and long-dis ance unne s be o e and a e he implemen a ion o a new an idoping s a egy ( he A hle e Biological Passpo [ABP]) in a coun y accused o sys ema ic doping. A e ospec i e analysis o he esul s o Russian Na ional Championships om 2008 o 2017 was pe o med. The 8 bes emale pe o mances o he 800-m, 1500-m, 3000-m s eeplechase, 5000-m, and 10,000-m e en s om he semifinals and finals we e analyzed. The yea ly numbe o a hle es ulfilling s anda d qualifica ions o in e na ional compe i ions was also e alua ed. O e all, numbe s o a hle es banned o doping in 2008–2017 we e calcula ed. As a esul , 4 e en s (800, 1500, 5000 [all P<.001], and 10,000 m [P<.01]) ou o 5 showed s a is ically significan de e io a ion in he pe o mances when compa ing be o e and a e he in oduc ion o he ABP. The 3000-m s eeplechase was he only e en ha did no show s a is ically significan change. The highes ela i e dec ease in he numbe o unne s who me s anda d qualifica ion o in e na ional compe i ion was o he 5000-m e en (46%), ollowed by 1500-m (42%), 800-m (38%), 10,000-m (17%), and 3000-m s eeplechase (1%). In conclusion, implemen a ion o he ABP was ollowed by a significan educ ion in he pe o mance o emale unne s in a coun y accused o sys ema ic doping. I can be easonably specula ed ha mo e s ingen an idoping es ing, mo e specifically he in oduc ion o he ABP, is a key eason o his educ ion. Keywo ds:an idoping, Wo ld An i-Doping Agency, doping in spo s, blood doping The use o pe o mance-enhancing d ugs in spo s da es back cen u ies and has con inued h oughou he his o y o a hle ic compe i ion. 1 In he middle o he 20 h cen u y wi h he ins u- men aliza ion o spo s o poli ical pu poses du ing he Cold Wa , he scale o doping changed and, in a numbe o coun ies, was suppo ed by s a e- un o ganiza ions. 2,3 The e ha e been indica- ions ha in some coun ies such s uc u es ha e con inued o pe sis , which has ansla ed o a much highe p e alence o doping compa ed wi h o he na ions. 4 Du ing he his o y o mode n spo s, di e en s a egies and ules o he figh agains doping we e ini ia ed by spo s go e ning bodies. Fo ack-and-field compe i ions, he fi s d a o a lis o banned subs ances in spo s was in oduced by he In e na ional Associa ion o A hle ic Fede a ions as ea ly as 1928. Anabolic s e oid es ing was in oduced in 1974 and egula ou -o -compe i ion es s in 1989. 1 A numbe o s udies ela ed he in oduc ion o ou -o - compe i ion doping es ing o a dec ease o pe o mance in a ange o spo s disciplines. 5–7 I is easonable o associa e s agna ion o eg ession in peak compe i ion esul s wi h new an i-doping s a egies, as he p ima y aim o doping is an imp o emen in a hle ic pe o mance, which seems o be pla eauing in many disciplines. 8,9 One o he ecen an i-doping s a egies is he implemen a ion o he A hle e Biological Passpo (ABP). 10 The ABP is based on a collec ion o blood ma ke s om an a hle e in a longi udinal and indi idual way. De ia ions om indi idually calcula ed e e ence anges can indica e he use o o bidden subs ances o me hods. Success ul expe iences wi h he ABP ha e been epo ed by se e al in e na ional spo ing bodies. 11 As pe o mance imp o emen is he p ima y goal o doping, i was p oposed ha changes in pe o mance le els could be used o assessmen o new an i-doping s a egies e ficiency. 12,13 Conside - ing his amewo k, he goal o he p esen in es iga ion was o assess he a hle ic pe o mances be o e and a e he implemen a- ion o an ABP p og am in a coun y wi h a known high p e alence o doping. 4 We chose spo ing disciplines ha ha e been his o i- cally a ec ed by doping and whe e he coun y was in e na ionally dominan o decades. 14 Ma e ials and Me hods We ex ac ed he 8 bes pe o mances om semifinals and finals (measu ed as unning imes) om di e en emale ack unne s a Russian Na ional Championships om 2008 o 2017. A publicly a ailable da abase www. ilas opaja.com was used as he sou ce o he da a. As ou da a a e based on publicly a ailable esou ces, no in o med consen was ob ained. This s udy was conduc ed in acco dance wi h he Decla a ion o Helsinki. Dis ances o 800-m, 1500-m, 3000-m s eeplechase, 5000-m, and 10,000-m e en s we e © 2020 The Au ho s. Published by Human Kine ics, Inc. This is an Open Access a icle dis ibu ed unde he e ms o he C ea i e Commons A ibu ion-NonCom- me cial-NoDe i a i es 4.0 In e na ional License, CC BY-NC-ND 4.0, which pe mi s he copy and edis ibu ion in any medium o o ma , p o ided i is no used o comme cial pu poses, no modifica ions a e made, app op ia e c edi is gi en, and a link o he license is p o ided. See h p://c ea i ecommons.o g/licenses/ by-nc-nd/4.0. This license does no co e any hi d-pa y ma e ial ha may appea wi h pe mission in he a icle. Fo comme cial use, pe mission should be eques ed om Human Kine ics, Inc., h ough he Copy igh Clea ance Cen e (h p://www. copy igh .com). Iljuko is wi h he Dep o Spo s and Exe cise Medicine, Clinicum, Uni e si y o Helsinki, Helsinki, Finland, and KIHU—Resea ch Ins o Olympic Spo s, Jy äs- kylä, Finland. Kauppi is wi h he Facul y o In o ma ion Technology, Uni e si y o Jy äskylä, Jy äskylä, Finland. Uusi alo and Pel onen a e wi h he Clinic o Spo s and Exe cise Medicine, Founda ion o Spo s and Exe cise Medicine, Helsinki, Finland. Schumache is wi h Aspe a O hopedic and Spo s Medicine Hospi al, Doha, Qa a . Iljuko (se gei.iljuko @gmail.com) is co esponding au ho . 1 In e na ional Jou nal o Spo s Physiology and Pe o mance, (Ahead o P in ) h ps://doi.o g/10.1123/ijspp.2019-0643 ORIGINAL INVESTIGATION B ough o you by JYVASKYLAN YLIOPISTO | Downloaded 02/26/20 12:55 PM UTC chosen o analysis. T ack disciplines a e less p one o ex e nal con ounding ac o s a ec ing pe o mance esul s. Unlike in ma a hon o c oss-coun y unning whe e he same dis ance is un on di e en ou es and may a y o a significan ex en due o en i onmen al ac o s and ace cou se design, ack disciplines a e mo e s anda dized, hus making he esul s compa able o e yea s. The pe iod om 2008 o 2017 was selec ed as i comp ises a ime pe iod p io o he implemen a ion o he ABP (in 2009) and a ime pe iod a e . ABP p ofiles we e buil om 2009 onwa ds, and hey ha e p o ided su ficien in o ma ion since 2011. The fi s sanc ions based on he da a we e handed ou a ound his ime. Thus, i was assumed ha he ABP impac ed pe o mance om 2012 onwa ds. The e o e, 2012 was chosen as he yea o di e - en ia e pe iods “be o e”and “a e ” he in oduc ion o he ABP. Female middle- and long-dis ance unne s we e chosen o his analysis due o hei in e na ional success and long-s anding Eu opean dominance. 14 Due o hei le el o success, i is s ongly assumed ha mos o he a hle es we e pa o he In e na ional Associa ion o A hle ic Fede a ions and Russian An i-Doping Agency es ing pool and hus he ABP p og am. S a is ical Analysis Pe o mance Da a Fo he pu pose o s a is ical analysis, we fi s spli he pe o - mance da a in o 2 g oups: he bes 8 unning imes o each yea ’s championship (1 ime pe unne pe yea ) be ween he yea s 2008 and 2012 (g oup G1, ep esen ing unning imes be o e he in oduc ion o he ABP) and he bes 8 unning imes o each yea be ween he yea s 2013 and 2017 (g oup G2, ep esen ing unning imes a e he ABP is assumed o ha e had an e ec on pe o mance). Ou null hypo hesis was ha he e is no di e ence in he unning esul s be o e and a e he in oduc ion o he ABP. Ou al e na i e hypo hesis was ha he esul s a e signifi- can ly slowe a e he in oduc ion o he ABP. To assess whe he he e is a significan di e ence in unning imes be ween he g oups, we used a pe mu a ion es designed o pa ially pai ed con inuous da a ( o mo e de ails o he analysis p oce- du e, see “Pe o mance da a analysis”in he Supplemen a y Ma e ial [a ailable online]). 15 Numbe o A hle es Quali ying o Majo In e na ional Compe i ions To allow an in e na ional pe spec i e, we also de e mined he numbe o a hle es in each discipline who me he highes in e na- ional quali ying s anda ds o he pa icipa ion in majo a hle ic compe i ions wi h hei pe o mance esul a he Na ional champion- ships. The A qualifica ion s anda ds o he 2008 Olympic Games in Beijing (China), 2009 Wo ld Championship in Be lin (Ge many), 2010 Eu opean Championship in Ba celona (Spain), 2011 Wo ld Championship in Daegu (Sou h Ko ea), 2012 Olympic Games in London (G ea B i ain), 2013 Wo ld Championship in Moscow (Russia), 2014 Eu opean Championship in Zu ich (Swi ze land), 2015 Wo ld Championship in Beijing (China), 2016 Olympic Games in Rio de Janei o (B azil), and 2017 Wo ld Championship in London (G ea B i ain) we e used o his pu pose. We assessed whe he he e was a s a is ically significan dec ease in he numbe o a hle es mee ing he highes s anda d qualifica ion o in e na ional compe i ions a e he in oduc ion o he ABP. Fo his pu pose, we used a weigh ed chi-squa e es o homogenei y, 16 which is applicable o pa ially pai ed ca ego ical da a ( o mo e de ails, see “A-s anda d pe o mance analysis”in he Supplemen a y Ma e ial [a ailable online]). Fu he mo e, o eflec he ela ionship o ABP implemen a ion on pe o mance, we calcula ed he o al numbe o a hle es who qualified o in e na- ional compe i ions and hose who we e e en ually sanc ioned o doping. Fo addi ional cla i y, we coun ed he numbe o a hle es sanc ioned on ABP g ounds and o o he an i-doping ules iola- ions. These calcula ions we e di ided in o 2 pe iods: 2008–2012 and 2013–2017. All s a is ical analyses p ocedu es used in his s udy we e implemen ed using he MATLAB (The Ma hWo ks Inc, Na ick, MA). Mo eo e , because we analyzed 5 dis ances, he ob ained P alues o each dis ance we e co ec ed o mul iple compa isons using Bon e oni co ec ions. Resul s While excellen pe o mance pe se is no an indica ion o any w ongdoing, pe o mance moni o ing may p o ide an addi ional alue in he assessmen o an i-doping s a egies. As was demon- s a ed in p e ious s udies, some majo changes in pe o mance le els ha e his o ically ollowed implemen a ion o new an i- doping s a egies. 5–9,13 In ou in es iga ion, we analyzed changes in he compe i ion pe o mance o Russian emale middle- and long-dis ance unne s be o e and a e implemen a ion o he ABP. To ou knowledge, his esea ch is he fi s o in es iga e he ela ionship o ABP implemen a ion on a hle ic pe o mance. Figu e 1shows he a e age unning pe o mances ( imes) be o e and a e he implemen a ion o he ABP. Fou e en s (800, 1500, 5000, and 10,000 m) ou o 5 showed a s a is ically significan inc ease in unning imes (ie, de e io a ion in he pe o mances) wi h implemen a ion o he ABP (see Table 1). The highes ela i e dec ease in unning pe o mance was obse ed o he 5000-m (3.4%, P<.001), ollowed by 10,000-m (2.6%, P= .007), 1500-m (2.2%, P<.001), 800-m (2.0%, P<.001), and 3000-m s eeplechase (0.4%, P= .322). The 3000-m s eeplechase was he only e en ha did no show s a is ically significan de e io a ion in he unning pe o mance a e he in oduc ion o he ABP. The e ec o he ABP implemen a ion on he numbe o A qualifica ion s anda d unne s o di e en e en s is shown in Figu e 2. Fo 800-, 1500-, and 5000-m e en s, he e was a dec ease in he numbe o A s anda d unne s a e he in oduc ion o he ABP (see Table 2). The highes ela i e dec ease in he numbe o A s anda d unne s was obse ed o he 5000-m e en (46.2%, P= .001), ollowed by 1500-m (42.1%, P<.001), 800-m (38.1%, P<.001), 10,000-m (16.7%, P= .050), and 3000-m s eeplechase (10.0%, P= .346) e en s. O e all, 53% o a hle es who ulfilled qualifica ion s anda ds in 2008–2012 we e sanc ioned o doping; 29 o hem we e sanc ioned on g ounds o he ABP and 11 o o he doping agen s and an i-doping ules iola ions. In 2013–2017, 9 a hle es we e sanc ioned based on he ABP and 6 on g ounds o con en ional doping es esul s. Thus, al oge he , 30% o a hle es who qualified o in e na ional compe i ions in 2013–2017 we e e en ually banned o doping. Discussion The e is a lack o s udies in es iga ing he e ficiency o cu en an i-doping s a egies. Pe o mance moni o ing and p ofiling we e p oposed as a po en ial ool o he measu emen o an i-doping e ec i eness. 12,13 (Ahead o P in ) 2Iljuko e al B ough o you by JYVASKYLAN YLIOPISTO | Downloaded 02/26/20 12:55 PM UTC Changes in Pe o mance The esul s o ou analysis e eal a significan d op in emale a hle es’pe o mance o 800-, 1500-, 5000-, and 10,000-m dis- ciplines a e implemen a ion o he ABP. Fo 800-, 1500-, and 5000-m e en s, his de e io a ion was mos no able: 2.33 seconds (1.9%), 5.26 seconds (2.1%), 31.60 seconds (3.4%) acco dingly (P<.001), and 49.83 seconds (2.6%) o he 10,000 m (P<.01) (Figu e 1and Table 1). Con a y o hese findings, he 3000-m s eeplechase pe o mance dec ease be ween 2008–2012 and 2013– 2017 pe iods was only 2.31 seconds (0.4%) and was no s a is ically significan . The excep ion o he s eeplechase esul s could be explained by he ac ha his discipline was only accep ed in o he Wo ld Championship p og am in 2005. T adi ionally, s eeplechase is also a discipline ha was no nu u ed in Russia. Fu he mo e, s eeple- chase has a mo e mul i ac o ial pe o mance p ofile, whe e a hle es ha e o jump ba ie s, which adds a ce ain skill le el on op o he pu e unning pe o mance. The magni ude o pe o mance changes ound in ou s udy is compa able wi h hose caused by means o blood doping. The e a e a numbe o ea lie s udies in es iga ing he e ec s o blood boos ing on unning pe o mance. 17–19 The au ologous blood ans usion e ec s o olumes >760 mL ha e been in es iga ed mos o en. As desc ibed by Pandol e al, 20 an expec ed imp o e- men in unning pe o mance o 2, 4, 6, 8, and 10 km based on hese ea lie s udies was abou 7, 15, 30, 45, and 68 seconds, espec i ely. I is wo h men ioning ha subjec s in ol ed in hese in es iga ions we e expe ienced, bu no eli e-le el a hle es. S udies done wi h eli e-le el a hle es ound mo e mode a e imp o emen s in unning pe o mance. 21–23 As was shown wi h eli e-le el middle- and long-dis ance unne s, blood boos ing could imp o e pe o mance om 1% o 4% depending on he Figu e 1 —Box plo s o he unning imes (in minu es:seconds) in he 2 g oups be o e and a e he implemen a ion o he A hle e Biological Passpo o di e en e en s: (A) 800-m, (B) 1500-m, (C) 3000-m sc, (D) 5000-m, and (E) 10,000-m e en . The cen al ho izon al line inside each box shows he median, and he ho izon al edges o he box deno e he 25 h and 75 h pe cen iles o he unning ime dis ibu ion. The whiske s co espond o he da a co e age o ±2.7σ, and indi idual da a poin s ou side his co e age a e ma ked wi h he “+”symbol. E en s showing a s a is ically significan de e io a ion in pe o mance a e implemen a ion o he ABP a e deno ed by as e isks (weigh ed mean di e ence s a is ics, see Supplemen a y Ma e ial [a ailable online] o mo e de ails): **P<.01; ***P<.001. Abb e ia ion: sc indica es s eeplechase. Table 1 Change in Running Pe o mance Wi h he Implemen a ion o he A hle e Biological Passpo E en ΔsΔ%T w P 800 m 2.33 2.0 −6.25 <.001 1500 m 5.26 2.2 −5.61 <.001 3000 m sc 2.31 0.4 −0.50 .322 5000 m 31.60 3.4 −5.63 <.001 10,000 m 49.83 2.6 −2.72 .007 Abb e ia ions: Δs, absolu e change in he a e age unning ime (in seconds) be ween 2008–2012 and 2013–2017 pe iods; Δ%, ela i e change in he a e age unning ime be ween 2008–2012 and 2013–2017 pe iods; sc, s eeplechase; T w , weigh ed mean di e ence s a is ics be ween 2008–2012 and 2013–2017 pe iods; P, Bon e oni-co ec ed P alues o T w . No e: The nume ic da a om Figu e 1 wi h mo e de ailed in o ma ion a e p esen ed in his able. A nega i e alue o T w means dec ease in unning pe o mance (ie, inc ease in unning ime) wi h he A hle e Biological Passpo implemen a ion. (Ahead o P in ) Changes in Runne s Pe o mance A e ABP 3 B ough o you by JYVASKYLAN YLIOPISTO | Downloaded 02/26/20 12:55 PM UTC Figu e 2 —Numbe o unne s mee ing he A-s anda d c i e ia in he 2 g oups be o e and a e he implemen a ion o he ABP o di e en e en s: (A) 800-m, (B) 1500-m, (C) 3000-m sc, (D) 5000-m, and (E) 10,000-m. E en s showing s a is ically significan dec ease in he numbe o A-s anda d unne s a e he implemen a ion o he ABP a e deno ed by as e isks (weigh ed chi-squa e s a is ics, see Supplemen a y Ma e ial [a ailable online]): **P<.01; ***P<.001. Among he A-s anda d unne s, g ay and black colo s deno e he po ions o he sanc ioned and nonsanc ioned unne s, espec i ely. ABP indica es A hle e Biological Passpo ; sc, s eeplechase. Table 2 Changes in he Numbe o A-S anda d Runne s Wi h Implemen a ion o he ABP Numbe o a hle es who compe ed in 2008–2012 and we e sanc ioned wi h ABP implemen a ion Numbe o a hle es who compe ed in 2013–2017 and we e sanc ioned wi h ABP implemen a ion E en Numbe o a hle es who ul illed A- s anda d quali ica ion in 2008–2012 ABP O he s P opo ion o sanc ioned, % Numbe o a hle es who ul illed A- s anda d quali ica ion in 2013–2017 ABP O he s P opo ion o sanc ioned, %Δq y Δ%P 800 m 21 9 2 52 13 2 2 31 8 38.1 <.001 1500 m 19 9 4 68 11 3 2 45 8 42.1 <.001 3000-m sc 10 3 0 30 9 1 0 11 1 10.0 .346 5000 m 13 4 3 54 7 1 2 43 6 46.2 .001 10,000 m 12 4 2 50 10 2 0 20 2 16.7 .050 To al 75 29 11 53 50 9 6 30 Abb e ia ion: ABP, A hle e Biological Passpo ; Δq y, absolu e dec ease in he numbe o A-s anda d qualifica ion a hle es om 2008–2012 o 2013–2017 pe iod; Δ%, ela i e dec ease in he numbe o A-s anda d qualifica ion a hle es om 2008–2012 o 2013–2017 pe iod; P, Bon e oni-co ec ed P alues o weigh ed chi-squa e s a is ics deno ing change in he numbe s o A-s anda d qualifica ion a hle es om 2008–2012 o 2013–2017. 4(Ahead o P in ) B ough o you by JYVASKYLAN YLIOPISTO | Downloaded 02/26/20 12:55 PM UTC discipline. 21 By means o au ologous blood ans usion, pe o - mance inc eases o he 800 and 1500 m can each 3% o 4% (2.9 and 4.9 s) and 1% o 2% o he 5000 and 10,000 m (29 and 50 s). The ela i e inc ease in pe o mance appea s o be highe o sho e dis ances, likely due o inc eased oxygen ca ying and bu e ing capaci y h ough he inc ease o o al hemoglobin mass. In he ea ly s udies, he au ologous blood ans usion was indi id- ually adjus ed o bodyweigh and ini ial hemoglobin le el. The olume o ans usions a ied om 750 o 1200 mL o whole blood. 23 Less p ominen e ec s o blood ans usion on highe calibe a hle es ha e also been epo ed by o he s. 24 The di e ences in esea ch p o ocols and he a ie y in pe o mance le el o subjec s in ol ed make he discussion on he e ec s and olumes o blood ans usion challenging. Also, e y ew s udies ha e in es iga ed he e ec s o low- olume blood ans usions on a hle ic pe o - mance, and hese esul s a e con o e sial. 24,25 The conside able amoun o doping cases (Table 2) coinciding wi h implemen a ion o he ABP p o ides g ounds o specula e ha he magni ude o he pe o mance dec ease eflec s he gains ha we e a ailable by means o blood doping be o e. Such pe o mance inc eases would equi e ans usion o >800 mL o whole blood o he use o e y h opoiesis-s imula ing subs ances in significan dosages, bo h o which a e eliably de ec able by he ABP nowadays. 26,27 Changes in he Numbe o A hle es Able o Quali y o In e na ional Compe i ions The numbe o a hle es mee ing he highes en y s anda ds o in e na ional compe i ions (Eu opean Championship, Wo ld Championships, and Olympic Games) also d opped d ama ically in mos disciplines (Figu e 2and Table 2). The e we e al oge he 75 a hle es who ulfilled in e na ional qualifica ion s anda ds in 2008–2012, bu du ing 2013–2017, hei numbe dec eased o 50. This dec ease happened despi e he ac ha since 2015, he In e na ional Associa ion o A hle ic Fede a ions qualifica ion s anda ds we e lowe ed conside ably, hus allowing en ance o in e na ional compe i ions o a hle es wi h weake esul s. I he pe o mances o he 2013–2017 pe iod had been e alua ed by 2008–2012 “A”le el s anda ds, i would become appa en ha less han 50 a hle es had been able o pe o m a an in e na- ional le el. The dec ease in pe o mance and numbe o a hle es able o quali y o in e na ional compe i ion is p ima ily explained by he conside able numbe o doping cases (Table 2). Doping cases abo e we e di ided in o ABP cases and o he cases o an i-doping ule iola ions acco ding o o ficial e dic s. The majo i y o he doping cases we e es ablished by means o he ABP. I is also wo h o men ioning ha ABP has been shown o imp o e he a ge ing o con en ional doping es ing and hus also imp o e es ing e ficiency. 28 This e ec may no be elucida ed by he p o ided s a is ics bu dese es conside a ion. These da a a e in ag eemen wi h p e ious esea ch ha indica ed a high p e alence o blood doping in a gi en subpop- ula ion be o e implemen a ion o he ABP. 4,29 Howe e , con- side ing he iming o p e ious esea ch, hese es ima es o doping p e alence may no necessa ily eflec he cu en si ua ion. Changes in pe o mance o e gi en pe iods could also be a ec ed by a numbe o addi ional ac o s. The lowe le el o pe o mance du ing 2013–2017 could be in e p e ed as a lack o alen in he upcoming gene a ion o a hle es. Howe e , i is no ewo hy ha a po ion o a hle es banned du ing 2008–2012 la e e u ned o compe i ion in 2013–2017. Ne e heless, his did no inc ease he o e all le el o pe o mance, and none o hem we e able o each hei p e ious bes pe o mances. The dec ease in pe o mance le els in 2013–2017 could also be in e p e ed as a de e en e ec o he ABP and e ec i e changes in p ac ices o using illici d ugs and/o means. This no ion is suppo ed by ex e nal in es iga ions. Acco ding o he Independen Commission Repo , i was only du ing sp ing 2012 when he en ou age o a hle es in ol ed in doping unde s ood he p inciples o he ABP and we e o ced o adjus hei beha io . 30 Thus, awa eness o he ABP implemen a ion could indeed be an expla- na ion o changes in p ac ices and he ela ed dec ease in pe o - mance le el. Conclusion Ou esul s a e in line wi h he p e ious esea ch ha showed a significan de imen al e ec on pe o mance wi h he in oduc ion o new an i-doping measu es. 5–9,13 The e ec s o he ABP on p ac ices o a hle es ha e been desc ibed be o e, 11 bu ou s udy is he fi s o in es iga e he ela ionship o ABP implemen a ion on a hle e pe o mance. We demons a e ha pe o mance esul s o eli e-le el emale unne s o he 800, 1500, 5000, and 10,000 m dec eased significan ly wi h he implemen a ion o he ABP and hese changes we e 2.33, 5.26, 31.60, and 49.83 seconds, espec- i ely. The numbe o a hle es able o quali y o in e na ional compe i ion subs an ially dec eased a e he implemen a ion o he ABP. Pe o mance p ofiling can be a po en ial ool o e alua ing an i-doping e ficiency. I should be conside ed o be implemen ed on a b oade scale by an i-doping o ganiza ions. 12,13 Acknowledgmen s Resea ch was unded by he Wo ld An i-Doping Agency (g an numbe ISF17D04SE) and U heiluopis osää iö Founda ion. Re e ences 1. Ljungq is A. B ie his o y o an i-doping. In: Rabin O, Pi siladis Y, eds. Acu e Topics in An i-Doping: Medicine and Spo Science. Basel, Swi ze land: Ka ge ; 2017:1–10. 2. F anke WW, Be endonk B. Ho monal doping and and ogeniza ion o a hle es a sec e p og am o he Ge man Democ a ic Republic go e nmen . Clin Chem. 1997;43(7):1262–1279. PubMed ID: 9216474 3. Kalinski MI. S a e-sponso ed esea ch on c ea ine supplemen s and blood doping in eli e so ie spo . Pe sp Biol Med. 2003;46(3): 445–451. doi:10.1353/pbm.2003.0035 4. So as P-E, Robinson N, Fische o G, Dolle G, Alonso JM, Saugy M. P e alence o blood doping in samples collec ed om eli e ack and field a hle es. Clin Chem. 2011; 57:762–769. PubMed ID: 21427381 doi:10.1373/clinchem.2010.156067 5. Seile S, De Koning JJ, Fos e C. The all and ise o he gende di e ence in eli e anae obic pe o mance 1952–2006. Med Sci Spo s Exe c. 2007;39(3):534–540. PubMed ID: 17473780 doi:10.1249/01. mss.0000247005.17342.2b 6. K use TN, Ca e RE, Rosedahl JK, Joyne MJ. Speed ends in male dis ance unning. PLoS One. 2014;19(9):1–6. (Ahead o P in ) Changes in Runne s Pe o mance A e ABP 5 B ough o you by JYVASKYLAN YLIOPISTO | Downloaded 02/26/20 12:55 PM UTC 7. Pe nege TV. Speed ends o majo cycling aces: does slowe mean cleane ? In J Spo s Med. 2010;31(4):261–264. PubMed ID: 20148370 doi:10.1055/s-0030-1247593 8. Be helo G, Ta fle M, Helou NE, e al. A hle e a ypici y on he edge o human achie emen : pe o mances s agna e a e he las peak in 1988. PLoS One. 2010;5(1):e8800. PubMed ID: 20098706 doi:10. 1371/jou nal.pone.0008800 9. Fos e L, Haake S, James DM, Ne ill AM. Modelling e ec s o d ug es ing p ocedu es on pe o mance ends in he sho pu . J Spo s Med Doping S ud. 2014;4(5):1–5. 10. So as P-E, Robinson N, Rabin O, Saugy M. The a hle e biological passpo . Clin Chem. 2011;57:969–976. PubMed ID: 21596947 doi:10.1373/clinchem.2011.162271 11. Zo zoli M, Pipe A, Ga nie PY, Vouillamoz M, D o ak J. P ac ical expe iences wi h he implemen a ion o an a hle e’s biological p ofile in a hle ics, cycling, oo ball and swimming. B J Spo s Med. 2014; 48:862–866. PubMed ID: 24648438 doi:10.1136/bjspo s-2014- 093567 12. Iljuko S, Schumache YO. Pe o mance p ofiling-pe spec i es o an i-doping and beyond. F on Physiol. 2017;8:1102. PubMed ID: 29312004 doi:10.3389/ phys.2017.01102 13. Schumache YO, Po giesse T. Pe o mance p ofiling: a ole o spo science in he figh agains doping. In J Spo s Physiol Pe o m. 2009;4(1):129–133. PubMed ID: 19417234 doi:10.1123/ijspp. 4.1.129 14. Ma c A, Sedeaud A, Shipman J, e al. Geog aphic en olmen o he op 100 in a hle ics unning e en s om 1996 o 2012. J Spo s Med Phys Fi ness. 2017;4:418–425. 15. Am o L, Pauly M. Pe mu ing incomple e pai ed da a: a no el exac and asymp o ic co ec andomiza ion es . J S a Compu Simul. 2017;87(6):1148–1159. doi:10.1080/00949655.2016.1249871 16. Samawi HM, Vogel R. Tes s o homogenei y o pa ially ma ched- pai s da a. S a Me hodol. 2011;8(3):304–313. doi:10.1016/j.s ame . 2011.01.002 17. B ien A, Simon T. The e ec s o ed blood cell in usion on 10-km ace ime. JAMA. 1987;257:2761–2765. doi:10.1001/jama.1987. 03390200101022 18. Go o h HW, Campbell NL, Hodgdon JA, Susec AA. Hema ologic pa ame e s o ained dis ance unne s ollowing induced e y h o- cy hemia. Med Sci Spo s Exe c. 1982;14:174. doi:10.1249/ 00005768-198202000-00346 19. Williams MH, Wesseldine S, Somma T, Schus e R. The e ec s o induced e y h ocy hemia upon 5-mile eadmill un ime. Med Sci Spo s Exe c. 1981;13(3):169–175. PubMed ID: 7253868 doi:10. 1249/00005768-198103000-00004 20. Pandol KB, Young AJ, Sawka MN, e al. Does e y h ocy e in usion imp o e wo-mile un pe o mance a high al i ude? Eu J Appl Physiol Occup Physiol. 1998;79(1):1–6. PubMed ID: 10052653 doi:10.1007/s004210050465 21. Volko NI. The use o he me hod o au ohemo ans usion aimed a inc ease o a hle e’s exe cise pe o mance. In Bioene ge ics o Spo s Ac i i ies. Theo y and P ac ice o Physical Cul u e and Spo s. Moscow, Russia; 2010:73–81. 22. Maka o a GA. S udy o he Influence o Au ohemo ans usion on Some Pa ame e s o Func ional S a e in Man [disse a ion]. Moscow: Resea ch Cen e o Blood T ans usion and Hema ology; 1975:25. 23. Aulik JV. Au ohemo ans usion o Enhancing Wo k Capaci y o A hle es. [disse a ion]. Moscow: Resea ch Cen e o Blood T ans usion and Hema ology; 1980:44. 24. Sawka MN, Young AJ, Muza SR, e al. E y h ocy e ein usion and maximal ae obic powe : an examina ion o modi ying ac o s. JAMA. 1987;257(11):1496–1499. doi:10.1001/jama.1987.03390110072029 25. Bejde J, B een eld Ande sen A, e al. Time ial pe o mance is sensi i e o low- olume au ologous blood ans usion. Med Sci Spo s Exe c. 2019;51(4):692–700. PubMed ID: 30407276 doi:10.1249/ MSS.0000000000001837 26. Mo kebe g J, Sha pe K, Belhage B, e al. De ec ing au ologous blood ans usions: a compa ison o h ee passpo app oaches and ou blood ma ke s. Scand J Med Sci Spo s. 2011;21(2):235–243. PubMed ID: 19903320 doi:10.1111/j.1600-0838.2009.01033.x 27. Po giesse T, So as PE, Ech ele T, Robinson N, Umhau M, Schumache YO. De ec ion o au ologous blood doping wi h adap- i ely e alua ed bioma ke s o doping: a longi udinal blinded s udy. T ans usion. 2011;51(8):1707–1715. PubMed ID: 21382045 doi:10. 1111/j.1537-2995.2011.03076.x 28. Zo zoli M, Rossi F. Case s udies on ESA-doping as e ealed by he biological passpo . D ug Tes Anal. 2012;4(11):854–858. PubMed ID: 22514122 doi:10.1002/d a.1340 29. Ul ich R, Pope Hg, Cle e L, e al. Doping in wo eli e a hle ics compe i ions assessed by andomized- esponse su eys. Spo s Med. 2018;48(1):211–219. PubMed ID: 28849386 doi:10.1007/s40279- 017-0765-4 30. Wo ld An i-Doping Agency. The Independen Commission Repo 1. Final Repo . No embe 9, 2015. h ps://www.wada-ama.o g/ en/ esou ces/wo ld-an i-doping-p og am/independen -commission- epo -1. Accessed July 2019. (Ahead o P in ) 6Iljuko e al B ough o you by JYVASKYLAN YLIOPISTO | Downloaded 02/26/20 12:55 PM UTC