The first most notable use of drugs in sport was during the 1904 Olympics where a marathon runner took strychnine, a type of poison that when taken in small doses can provide performance enhancements (World Anti-Doping agency 2015). The World Anti-Doping agency (WADA), founded in 1999, arose following a series of deaths of athletes due to drug abuse and a police raid on the tour de France in 1998 (World Anti-Doping Agency 2015). One example of a drug that is on the WADA banned list is Erythropoietin (EPO). This is a peptide hormone that is produced naturally, mainly in the kidneys (Reichel 2011; Robinson et al. 2006). Tissue hypoxia (lack of oxygen) stimulates the kidneys to release this hormone (Jelkman 2012; Robinson et al. 2006) that then moves to the bone marrow where it acts upon undifferentiated stem cells converting them to Erythrocytes (red blood cells) in a process called Erythropoiesis (Reichel 2011; Robinson et al. 2006). This increase in red blood cells enables greater transport of oxygen to the muscles thus reducing tissue hypoxia and allowing athletes to exercise harder for longer (Robinson et al. 2006). With major side effects associated with the drug, concerns over the athletes’ health are as common as about them doping. An increased red blood cell count in the body means the blood is thicker, causing higher blood pressure and ultimately a greater demand being placed on the heart. This may lead to problems arising such as heart failure or a stroke (World Anti-Doping Agency 2015). When people are putting themselves in physical danger to achieve their goals, it has to be realised by everyone that a change is needed.


Early testing for EPO was very inaccurate with as much as 50% of EPO samples not being tested positive in the lab trials (Robinson et al. 2006). Developments in technology allowed the testing of an athletes’ haematocrit (their red blood cell level) and reticulocyte haematocrit (their level of ‘premature’ red blood cells). This however did rely on the fact that samples needed to be collected within 24 hours of the athlete injecting the EPO due to the half-life of the hormone (Robinson et al. 2006). This and other problems such as micro dosing (taking small doses of EPO often enough to get the same benefit but not be over the level of detection) were methods used by athletes to get away with doping.

The introduction of a blood passport is a good step in the right direction. This protocol is on the premise that each athlete must provide a regular sample [and are eligible for random tests], all of which goes on their file. If any of their new samples differ significantly from previous ones then it is up to the athlete [not WADA] to explain this inconsistency (World Anti-Doping Agency 2015).  One step in the right direction is however, not enough but now with the rise of a new organisation called Clean Protocol doping may be harder to get away with than before.

Clean Protocol

Clean Protocol is an organisation set up to aid in the fight against doping in sports. They use a nine step programme but unlike almost every other test created to determine if someone has been doping this protocol does not test for specific drugs in the athletes’ system it is simply a test of deception (Clean Protocol 2015). Deception is an underlying theme amongst athletes who take illegal drugs in sport. They do not want to be caught, so they lie when questioned on the subject and this is where Clean Protocol triumphs. The nine steps of the test involve:

  1. Volunteering – An unusual aspect of this protocol is that the athletes volunteer themselves to take the test. This in itself may show a certain level of innocence. That is not to say that athletes who do not sign up are doping but the question must be asked (Clean Protocol 2015).
  1. Disclosure – A disclosure of all the people that the athlete is exposed to that may affect their performance, including everyone from their parents to their coach (Clean Protocol 2015).
  1. Encouragement – Encouraging the athletes’ support crew to volunteer to commit to the same principles of Clean Protocol (Clean Protocol 2015).
  1. Biological data – The athlete must then publish their biological data (results of blood and urine tests) (Clean Protocol 2015).
  2. Information gathering – Clean Protocol will then gather as much information about the athlete as they can including but not limited to; injuries, planned events, training schedule and supplements (Clean Protocol 2015).
  1. Psychometric testing – This looks at the athletes attitudes towards performance enhancing substances. With more tests to be introduced in the future to increase validity (Clean Protocol 2015).
  1. Deception testing – Using new software designed to monitor specific movements in the eyes, Clean Protocol will test to see if the athlete is being deceitful when answering questions. While this may seem like a glorified lie detector test, eye movements such as dilation and contraction of the pupils are hard to control and thus deception can be picked up on (Clean Protocol 2015).
  1. Legally binding statement (Optional) – Depending on the result of the deception test (if it shows they may be lying) the athlete may be asked to sign a legally binding statement. This essentially is a legal contract saying they will abide by the anti-doping rules set out by the governing body / WADA. If they were to break this contract [were found to be doping] then they would be prosecuted under the laws of their country (Clean Protocol 2015).
  1. Functional Magnetic Resonance Imaging (Optional) – An FMRI is a test that measures brain activity and can detect changes based on if the athlete is telling the truth or lying. This is an expensive procedure so is only proposed in extreme circumstances.

If an athlete goes through this process and the deception test in step 7 shows they are telling the truth then they can officially state they are clean. Clean Protocol are attempting to shift the emphasis away from detection and onto prevention. It is not about finding the cheats, it’s about showing which athletes are clean. They hope that through this they can change the mind-set associated with performance enhancing drugs (Clean Protocol 2015). If you were to ask someone what they thought of Lance Armstrong they might reply along the lines of ‘I don’t agree with what he did but everyone else was doing it’. This is the attitude that Clean Protocol are looking to change. If they can show that ‘x’ amount of athletes are clean then it is impossible for someone else to justify themselves taking performance enhancing drugs on the basis that ‘everyone else is doing it’. This protocol is akin to finding a solution to the cause of a disease in medicine as opposed to just treating the symptoms.

While there are positives and negatives to this protocol it is a giant leap forward in the fight against doping in sport. The system can only get better as more athletes sign up; with more clean athletes on file there can be even less justification based on others. With that comes the change in sociological behaviour [more athletes not turning to doping as a way to improve themselves], the ultimate goal still remaining eradication of drugs in sport. While it is a shame to admit that this may never happen due to athletes who dope on the principal of winning by any means [even at the cost of clean athletes] it is without a doubt a great step in the right direction.

ReferencesShow all

lean Protocol. 2015. [Online]. Available from: [Accessed 6 February 2015].

Jelkman, W. 2012. Erythropoietin gene doping: facts and fictions. Sportwissenschaft. 42(4): pp.280-285.

Reichel, C. 2011. Recent developments in doping testing for erythropoietin. Analytical and Bioanalytical Chemistry. 401(2): pp.463-481.

Robinson, N., et al. 2006. Erythropoietin and blood doping. Journal of Sports Medicine. 40(1): pp.30-34.

World Anti-Doping Agency. 2015. [Online]. Available from: [Accessed 6 February 2015]

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