Projets de recherche

Code: 13A04JW 

Traditional Chinese Medicine (TCM) has been used in China for thousands of years. Some drugs of TCM contain endogenous steroids such as musk, penis and testes of ox, and oviductus ranae, which make it possible to abuse TCM as doping. In the 2011 FIFA Women's World Cup, adverse analytical findings about the exogenous source of etiocholanolone and other steroids were reported , and musk was regarded as the source of the steroidal preparation. Isotope ratio mass spectrum is applied in doping test to confirm the endogenous steroids abuse by determining the isotopic ratio of 13C/12C, whereas the carbon isotope ratios of steroids in animal materials used in TCM were seldom reported in literature. In view of the fact that TCM materials would be abused as doping, their influences on doping test should be further studied. 
In this project, musk, penis and testes of ox, and oviductus ranae will be collected for the detection of concentrations and carbon isotope ratios of endogenous steroids by GC-MSD and GC/C/IRMS. Excretion study will also be executed to demonstrate the influences of musk intake on the doping test. 
Based on those studies, the possibility of those TCMs abuse as doping will be estimated.

Main Findings: 

Traditional Chinese Medicine (TCM) has been used for a long time. Some TCMs contain prohibited steroids, which make it possible to abuse TCMs as doping. In this study, steroid contents and δ13C-values were analyzed in musk, penis-testes of ox, and forest frog’s oviduct. Excretion study was executed to demonstrate the influences of musk ingestion on doping control.  
  The analysis on 20 batches of musk illustrated that the contents of androgen were greater than that of estrogen and progestin in musk. Etio, 5α-3β17α-diol, 5β-diol, and An were main androgen in musk. IRMS analysis demonstrated that the androgen in wild deer musk possessed δ13C-values in the range of exogenous steroid values, while the steroid δ13C-values in domestic deer musk samples were within the normal range of human body.  
  In penis-testes of ox, An, Etio, DHEA, DHT, 4-AD, T, EpiA, and Preg were detected; Chol had average δ13C-value of -22.6 ‰. In forest frog’s oviduct, Preg and 5β-diol could be identified; Chol bore the average δ13C-value of -27.8 ‰.  
  In musk excretion study, 200 and 100 mg of wild and domestic deer musk samples were administrated by 29 subjects. The urinary profile showed changes, but the changes were inconsistent among subjects. The fluctuations might be proportional to the musk quality. In the IRMS test, the δ13C-values of Etio and 5β-diol were more sensitive than other markers, and AAFs were obtained. It is the first report about the AAFs in the musk administration study. 

Code: 12D14MP

In accordance with the 2012 Prohibited List all 2-agonists are prohibited in sport, in- and out of-competition, except salbutamol, formoterol and salmeterol when administered by inhalation in accordance with the manufacturers recommended therapeutic regime. Whereas for salbutamol and formoterol thresholds differentiating the therapeutic use from misuse are indicated in the List, such threshold for salmeterol has not yet been established and existing data seem inconclusive.

Cytochrome P450 3A4 (CYP3A4) is an enzyme that plays a central role in the metabolism of a wide variety of drugs. P-glycoprotein 1 (P-gp), a protein encoded by the ABCB1 gene, is responsible for the regulation of the distribution of drugs. The activity of CYP3A4 and the expression of P-gp may be responsible for the inter-individual variability of pharmacokinetics (PK) of drugs using these substrates for their metabolic pathway and distribution, respectively. This can be explained due to the genetic polymorphisms of both CYP3A4 and P-gp among individuals and/or drug-drug interactions in the case of co-administration of drugs using CYP3A4. Salmeterol and fluticasone are using the same enzyme isoform CYP3A4 and corticosteroids appear to induce the activity of this enzyme.

This study aims to establish the PK profiles of inhaled salmeterol administered alone or in combination with fluticasone proprionate to healthy volunteers and type the genetic variations of the genes encoding for CYP3A4 enzyme and P-gp transporter protein in the participants of the study. This will allow determining the threshold level of the maximum therapeutic dose of inhaled salmeterol administered alone or in combination with fluticasone and to investigate the role of inhaled corticosteroids as potential masking agents when co-administered with salmeterol. Finally, the study will provide preliminary data on the possible association between genetic polymorphisms of the CYP3A4 and the ABCB1 genes with the PK and excretion profiles of inhaled salmeterol in healthy volunteers.

Main Findings

Results:

As part of the study, liquid chromatography – mass spectrometry (LC-MS) methods for the determination of salmeterol, its metabolite α-hydroxysalmeterol and fluticasone in human urine and plasma were developed and validated. In urine, the Limit of Detection (LOD) was 0.05 ng/mL for salmeterol and fluticasone, and 0.50 ng/ml for α-hydroxysalmeterol, while the Limit of Quantification (LOQ) was 0.10 ng/mL for salmeterol and fluticasone and 1.00 ng/mL for α-hydroxysalmeterol.

At Phase A, the highest observed individual urine concentration of salmeterol when not normalised for specific gravity was 0.56 ng/mL. When all urine concentrations were normalised, the highest concentration observed was 0.61 ng/mL and when only those samples with a specific gravity higher than 1.020 g/mL were normalised the highest concentration observed was 0.53 ng/mL. At Phase B, the highest observed individual urine concentration of salmeterol was 0.91 ng/mL when not normalised for specific gravity, 1.06 ng/mL when all urine concentrations were normalised for specific gravity and 0.79 ng/mL when only those samples with a specific gravity higher than 1.020 g/mL were normalised. No statistically significant differences were found between the concentration of salmeterol at Phase A and Phase B. The reported urinary concentrations of salmeterol represent the free parent compound, only.

At Phase A, the highest observed individual urine concentration of α-hydroxysalmeterol when not normalised for specific gravity was 5.55 ng/mL. When all urine concentrations were normalised, the highest concentration of α-hydroxysalmeterol observed was 6.94 ng/mL and when only those samples with a specific gravity higher than 1.020 g/mL were normalised to a urine specific gravity of 1.020 g/mL, the highest concentration of α-hydroxysalmeterol observed was 5.55 ng/mL. At phase B, the highest observed individual urine concentration of α-hydroxysalmeterol when not normalised for specific gravity was 3.42 ng/mL. When all urine concentrations were normalised, the highest concentration of α-hydroxysalmeterol observed was 11.4 ng/mL and when only those samples with a specific gravity higher than 1.020 g/mL were normalised the highest observed individual urine concentration of α-hydroxysalmeterol was 3.42 ng/mL. No statistically significant differences were found between the concentration of α-hydroxysalmeterol at Phase A and Phase B.

Conclusions:

We propose establishing a threshold for salmeterol and α-hydroxysalmeterol high enough to prevent any adverse analytical findings from the administration of salmeterol up to the maximum therapeutic dose yet able to detect those athletes who use salmeterol in excess doses. Based on the findings of the present study, the data that are available in the literature from other excretion studies and the analysis of routine doping control samples and a possible accumulation rate of 1.3, a urinary threshold concentration of 2.0 ng/mL for salmeterol can be supported.

Code: 12D20ZC

In CHINADA, 25% of the OOC tests is given to target testing each year. Thus, intelligent target test plan (TTP) becomes a crucial research that lays on the daily TDP work. During recent years, we exert our efforts on improving the TTP. Moreover, another way that attracts our attention is to follow up with the lab data, which could be very useful in discovering those potential drug-users. However, the kind and way of put those data into practice shall be pondered deeply over.

In 2010 Laboratory Statistics Report from WADA, the adverse analytical findings of AAS is 60.8% in the whole number of the AAF. Be different from exogenous AAS, endogenous anabolic androgenic steroids are difficult to detect.

It is recommended that a urine sample in which the parameter is met during the screening procedure, be routinely submitted to the IRMS analysis. Even though, some parameters abovementioned are still under the detection line after taken the endogenous AAS by athletes. It is obvious that finding out the athlete’s markers variant longitudinally means much to the antidoping job.

In the project, we will develop the AAF study, the cross-sectional study, and model construction study as well as the longitudinal study. For the results of this project, we hope we can set up the endogenous AAS model of the athletes and find out the accurate time to carry out testing according to the individual AAS model.

Main Findings

In order to fix the development of Athlete Steroidal Passport (ASP) module, the project has been adjusted. Doping risk of sports was assessed firstly. Besides the data of steroid profile from high-risk sports from 2009 to 2014 were collected, the data of non-athletes were also collected for baseline analysis. Based on these results, statistics of intra-individual CV of T/E ratio with sport factor and period factor was conducted to find the high risk period of different sport.

Three levels of doping risk of different sports were classified for in competition and out of competition separately. The results can be helpful the focus on different sports for IC and OOC tests.

The steroid profiles of non-athlete population have been analyzed. The cut-off value of different genotype was defined using cluster analysis. Also, the range of intra-individual CV of T/E ratio was calculated, which was much higher than it was reported before.

The steroid profiles of athlete population were analyzed based on the data of non-athletes. Through the analysis of the suspicious samples from suspicious athletes selected with intra-individual CV of T/E ratio with sport and competition period, the high risk months of each sport have been found. This regularity of each sport can be the guidance of establishing the test distribution plan, not only for target athletes, but also for all the athletes of the same sport.

Code: 12B8FD 

Blood doping is banned by the World Anti-Doping Agency in all sports due to its effects on sport performance, especially in endurance disciplines. WADA accredited laboratories have developed testing methods for the detection of blood doping by eryhtropoietins, synthetic hemoglobins, RSR13, and homologous blood transfusions, while no direct, internationally recognized method is yet available for the detection of autologous blood transfusions. We propose a flow cytofluorimetric approach based on the recognitions of markers of storage in red blood cells. More specifically, markers of apoptosis (namely, phosphatidylserine) and markers to detect reduction of antigen expression on red blood cells membrane (primarily among them CD55 and CD59 proteins) have already been evaluated by our laboratory as potential diagnostic parameters to detect the infusion of previously stored blood, with very promising results. Preliminary data obtained on several different blood samples, tested at different times after collection and in different storage conditions, showed that the selected parameters are significantly modified by red blood cells storage. We are planning to implement the number of markers considered for this study, possibly broadening the panel of diagnostic markers to be monitored to effectively detect the recourse to autologous blood transfusions. Once the most suitable diagnostic markers will be identified and selected, the effectiveness of the approach will be verified on subjects undergoing preoperative autologous donation in the framework of pre and post- surgery practices. 
We strongly believe that the proposed approach could effectively complement the analysis presently under evaluation for the detection of autologous blood transfusions, representing a significant advancement towards the development of a robust and reliable direct method to detect autologous blood transfusion.

Main Findings:

One  of  the  current  challenges  for  the  Antidoping  Laboratories  worldwide  is  the  detection  of  Autologous Blood Transfusion (ABT). At present, ABT can be detected only by indirect methods, which require the longitudinal evaluation of the stability of selected hematological parameters, as in the hematological module of the athlete biological passport.  
This  project  aimed  to  study  and  to  explore  a  multi---parametric  strategy,  based  on  flow  cytofluorimetry, targeting specific morphological/biochemical changes of red blood cells, as well as  the  alteration  of  other  hematological  parameters  (e.g.  the  increase  of circulating  microparticles), consequent to the storage period of the withdrawn blood prior to the reinfusion in  the  receiver  person.  This  approach  is  in  fact  a  “direct”  detection  strategy,  since  it  recognizes  specific changes on the “exogenous” (this meaning the transfused) red blood cells (RBCs).  
We have conducted a series of experiments on human whole blood samples that were focused on the  identification  of  diagnostic  signs  of  red  blood  cells  aging  also  matching  all  the  following  conditions: (i) to be easily detected by flow cytofluorimetry; (ii) to be stable after addition of the stored sample to fresh blood; and (iii) to show a sufficiently pronounced variation, allowing their identification also in mixed blood samples generated after a transfusion practice.   
From the data we obtained two main conclusions can be drawn: i) Flow  cytofluorimetry  is  able  to  identify  multiple  indicators  of erythrocytes  aging  that  are generated after a storage time in the fridge and blood banks condition.
ii) The  signals  of  RBC  aging  that  have  been  detected  in  our experimental  conditions  (I.e.,  by considering a period of storage up to 40 days) are the following:a. reduction of the expression of surface proteins on RBC;
b. moderate increase in the concentration of glycated HB (HbA1c);
c. reduction of RBC main size, that generates a population of smaller and more dense erythrocytes;
d. the  consequent  formation  of  a  population  of  microparticles,  that is  a  direct consequence of red blood cells microvesiculation process. Unluckily,  it  was  not  possible  to  verify  in  vivo  the  observation  recorded  ex  vivo,  as  well  as  to  evaluate  the  potential  effectiveness  of “markers  of  reinfusion”,  due  to  the  lack  of  samples collected from auto---transfused subjects. Experiments in this direction are still in progress, thanks to newly activated, ongoing cooperation with other research groups and clinical laboratories.  
In  spite  of  the  above  limitation,  the  data  we  collected  at  this  stage  are  very  promising  in  the  development of a universal, direct method for detecting both autologous and homologous blood transfusions: based on our results, a detection strategy based on the counting of the number of microvesicles and the counting of red blood cells of the more dense fraction (smaller in size) seem to present a higher diagnostic value than that based on the variation over time of the expression of specific proteins on the red blood cell membrane.  
Finally, it has to be stressed out that our proposed approach needs a solid standardization: indeed, the  same  counting,  when  performed  on  different  flow  cytofluorimetry  instruments,  that  use  different  detectors settings,  can  lead  to  different  measurements,  inevitably  resulting  in  an increase of the inter---laboratory variability of the results. 

Code: 12A18GG

Testosterone is still regarded as the major contributor to steroid doping world-wide. Among the most common forms of application are injections of different sorts of esters. State-of-the-Art detection of Testosterone doping includes the quantification of the Testosterone /Epitestosterone – Ratio (T/E – ratio) as well as subsequent Isotope ratio mass spectrometry (IRMS). Previous published studies of our research group have demonstrated that a comparably high percentage of testosterone preparations do not significantly differ from endogenous values of testosterone and markers of testosterone doping. Consequently when such preparations with endogenous – like 13CVPDB values are applied, IRMS - technology fails to detect testosterone
doping. Direct detection of the testosterone ester leads to an unequivocal proof of doping with testosterone preparations, because such esters are not built endogenously.  Previous studies indicate that a direct detection of testosterone esters in both hair and plasma is possible.
Aim of the proposed project is the investigation and optimisation of the direct detection of testosterone esters in body fluids like serum, whole blood and stabilized blood with an already developed detection method using modern and sensitive technology. The project will gain information on diagnostic windows for detection of doping using testosterone esters and proper sampling conditions. Additional aim of the proposed project is to evaluate the suitability of already collected blood samples in doping control (e.g. samples collected for blood parameter measurement or growth hormone detection) for a possible reanalysis for testosterone esters.

Main Findings:

Injections of synthetic esters of testosterone are among the most common forms of testosterone application. In doping control, the detection of an intact ester of testosterone in blood gives an unequivocal proof of the administration of exogenous testosterone. The aim of the current project was to investigate the detection window for a number of testosterone esters in blood. Furthermore, the suitability of different types of blood collection devices was evaluated.
A clinical study with six participants was carried out, comprising a single injection of a testosterone ester preparation. The enrolled subjects were randomly assigned to receive either a single intramuscular injection of testosterone undecanoante 1000 mg (Nebido®) or a single intramuscular injection of a mixture of four testosterone esters: testosterone propionate 30 mg, testosterone phenylpropionate 60 mg, testosterone isocaproate 60 mg and testosterone decanoate 100 mg (Sustanon®). Three subjects were assigned to each study group and blood was collected throughout a testing period of 60 days. At each sampling, the blood was collected into three different blood collection tubes: Tube A: Vacuette 9 ml serum tube with clot activator and gel separator (Greiner bio-one Vacuette®, Kremsmünster, Austria). Tube B: Vacuette 6 ml plasma tube with sodium fluoride, potassium oxalate, and no gel separator (Greiner bio-one Vacuette®, Kremsmünster, Austria). Tube C: Vacutest 3.5 ml plasma tube with sodium fluoride, disodium ethylenediaminetetraacetic acid (Na2EDTA), and gel separator (Vacutest Kima, Arzergrande, Italy). Additionally, a study on the in vitro degradation of testosterone esters in blood was performed, using the same collection tubes as described above. The applied analytical method included liquid-liquid extraction and preparation of oxime derivatives, prior to TLX-sample clean-up and LC-MS/MS detection.
In the clinical study, the elimination half-lives and detection times depended on the type of testosterone ester administrated. The depot effect of an intramuscular testosterone ester preparation increases in proportion to the length of the ester side chain. This is because the half-life of the absorption increases with longer chains.
As expected, the shortest chained ester, testosterone propionate, showed the most rapid elimination and shortest half-life. Nevertheless, the ester could still be detected for 4-5 days in serum and plasma of all study participants receiving the drug. Testosterone phenylpropionate and testosterone isocaproate were detected for at least 8 days in serum and plasma, whereas testosterone decanoate showed a detection time of 18 days. Testosterone undecanoate was detectable in all post-administration blood samples collected during the whole study period (60 days), thereby giving the longest detection time of the esters investigated.
The stability studies showed that the shorter chained testosterone esters were hydrolysed more rapidly in blood collection tubes not stabilized with NaF (tube A) compared to stabilized tubes (tube B and C). The rate of hydrolysis seems to be dependent on storage temperature. In the clinical study, though, the testosterone ester detection window was not affected by the applied blood collection tube.

Code: 12B11GK

Recombinant human growth hormone (rhGH) has been on the list of forbidden substances since availability of its recombinant form in the early 1990s; however adequate routine doping tests are lacking. The project aims to develop a fast and highly sensitive drug test for detecting two or more hGH-dependent markers in the serum of elite adolescent athletes. In our approach proteomic markers for hGH action such as insulin-like growth factor 1 (IGF-1) and pro-collagen type III N-terminal peptide (P-III-P) will be identified in just a single immunoassay. Considering the desirable reduction of time, costs and workload using FCS instead of other currently available IGF-1 and P-III-NP assays the presented methodology will be an important contribution for a functional doping test for proper use of rhGH. 

Main Findings: 

Two approaches have been developed to detect recombinant hGH in blood in order to control its misuse with the intention of improving athletic performance. Adequate non-invasive tests for human growth hormone (hGH)-dependent markers such as insulin-like growth factor 1 (IGF-1) and pro-collagen type Ill N-terminal peptide (PIIINP) are still lacking. In this one-year project a fast and sensitive bead-based immunoassay for IGF-1 and PIIINP detection in serum was developed based on Fluorescence Correlation Spectroscopy (FCS). FCS was used as a reliable technology for measuring absolute concentrations in the nano-molar range. Three FCS immunoassays - a sandwich and a competitive immunoassay for IGF-1 as well as a competitive PIIINP assay - were established and validated against commercially available ELISA. We were able to detect molarities between 0.5 and lOnM of IGF-1 and between 0.5 and 2.5nM of PIIINP with high accuracy in serum samples.  
Considering the desirable reduction of time, costs and workload using FCS instead of other currently available IGF-1 and PIIINP assays the presented methodology might be an important contribution for proper use of rhGH in sports. 

Code: 12A23RC 

This proposal describes a detailed plan to improve the ability to analyze prohibited doping substances by the development of brand new, original methodologies in Analytical Chemistry.  The proposal teams up an advanced mass spectrometry laboratory at the University of Paris (VI) with France’s leading organization in the battle to ensure the absence of illegal performance enhancing substances in athletes, the “Agence Française de Lutte contre le Dopage” (AFLD). 
Using the original approach of regioselective anion attachment mass spectrometry that has been recently developed by the Cole research group, we seek to improve the limits of detection of prohibited steroids, especially those of limited polarity that exhibit poor responses by conventional mass spectrometric ionization approaches. In addition, we seek to expand the ability to unequivocally identify novel doping substances (those not on the current Prohibited list), while also enabling the direct analysis of conjugated steroids. The expected outcomes of this work are a substantial improvement in the ability to detect prohibited steroids at ultra-trace levels, and an enhancement of the specificity in structural analysis that is obtainable by tandem mass spectrometry.

Main Findings: 

Neutral anabolic steroids are doping agents that do not provide strong signals by electrospray ionization-mass spectrometry (ESI-MS), thus making their detection challenging when using this technique. While some steroids may be analyzed adequately with older more labor-intensive anti-doping analysis methods (such as GC-MS employing electron ionization (EI), often preceded by derivatization), there remains a need for the development of a new method that is capable of efficiently analyzing more difficult compounds, especially those that are less susceptible to ionization. We have investigated the addition of anions, in ammonium salt form, to anabolic steroid samples as ionization enhancers and confirmed that better signals and lower limits of detection are obtained using Anion Attachment Mass Spectrometry as compared to both positive and negative ESI in the absence of additives. Overall, the developed method allows for substantially improved detection of neutral steroids. For the neutral steroids targeted in this study, results show that the instrumental limit of detection (LOD) obtained using Anion Attachment Mass Spectrometry is always equal to, or better than, that obtained in either positive or negative ion ESI-MS in the absence of any additive. In the case of the most difficult compounds (calusterone-M, norbolethone-M), no signal was obtained in negative ion ESI-MS, but upon addition of NH4F, it becomes possible to detect these compounds at concentrations as low as 25 ng/mL, which represents a 100-fold improvement compared to the LODs obtained in positive ion ESI-MS. 
Atmospheric Pressure Photo-Ionization (APPI) Mass Spectrometry was also tested for its ability to produce mass spectrometric signals from trace level samples, and obtained results were compared to results acquired using Anion Attachment Mass Spectrometry. As a test case, the fluoxymesterone metabolite produces the cation radical ion M+. when analyzed using APPI, but a 50-fold loss in signal is observed from APPI when compared to the Anion Attachment approach. In summary, none of the tested "difficult to ionize" steroids exhibited better signal responses by APPI as compared to those obtained by Anion Attachment Mass Spectrometry. On the other hand, the formation of anion adducts does not appear to improve the sensitivity of conjugated steroids containing a carboxylic acid that is already susceptible to deprotonation and [M-H]- formation in conventional ESI-MS. 
Looking ahead to the implementation of this new approach to "real-world" antidoping samples, we have obtained preliminary Liquid Chromatography-Multiple Reaction Monitoring (LC-MRM) results that show trace level detection of the problematic fluoxymesterone metabolite down to the 5 ng/mL level. This improved sensitivity, relative to existing methods, will serve to reduce the number of false negatives in real sports doping analyses.

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Résumé

La présente étude vise à mettre en place une stratégie de prévention du dopage à partir d’une enquête sur les connaissances, attitudes et pratiques des élèves en rapport avec le dopage. Les résultats attendus permettront de faire progresser l’état des connaissances générales de la discipline, en ce qui concerne la situation du dopage en milieu scolaire ivoirien. En effet, en Côte d’Ivoire, les travaux réalisés sur le dopage concernent généralement les sportifs issus des clubs professionnels (football notamment), et ne prennent pas en compte le milieu scolaire.

Méthodologie

Il s’agit d’une recherche action fondée sur une enquête CAP diagnostique des connaissances, attitudes et pratiques des élèves en matière de produits dopants, dont les résultats serviront à concevoir des messages de communication. Ces messages seront utilisés d’une part pour une série de conférences publiques dans les écoles, et d’autre part pour une sensibilisation de proximité menée par des comités locaux (composés d’élèves des établissements scolaires concernés) mis en place par le projet, en vue d’un changement de comportement. En outre, une prise en charge psychosociale des cas de dépendance vis-à-vis des produits dopants, identifiés lors de l’enquête, sera réalisée par les assistants sociaux membres de l’équipe, en vue d’aider les élèves concernés à abandonner ces pratiques.

Résultats

• 20,6% des élèves enquêtés affirment connaître des élèves sportifs utilisant des produits pour améliorer leur performance dans le sport. Par ailleurs, 5,3% des élèves sportifs enquêtés affirment avoir eux‐mêmes déjà utilisé des produits pour améliorer leur performance. Recommandation: réduire la prévalence du dopage en milieu sportif scolaire.
• Le désir de vaincre la peur et le stress, ainsi que le besoin d’endurance/de vigueur constituent les principales raisons d’utilisation des produits dopants par les élèves sportifs enquêtés. Recommandation: Sensibiliser les élèves sportifs sur les méthodes recommandées pour vaincre la peur et le stress lors des compétitions et pour obtenir de l’endurance sur le plan physique.
• 10% des élèves sportifs affirment utiliser les multivitamines avant les compétitions ou pendant les entraînements, et 24,3% les utilise après. Recommandation: Sensibiliser les élèves sportifs en vue du non usage de produits multivitaminés avant et pendant les compétitions et les entrainements
• Les boissons alcoolisées constituent l’une des substances les plus utilisées par les élèves sportifs comme produit pour augmenter les performances dans la pratique du sport. Il est aussi fait cas de l’usage de drogue. Recommandation: sensibiliser les élèves sportifs à la non prise de boissons alcoolisées avant et pendant les compétitions et entrainements.
• 66,1% des élèves enquêtés ont déjà entendu parler de dopage. Soit 33,9% qui n’en ont pas entendu parler en dehors de l’enquête. Recommandation: informer les élèves sur le dopage, sa définition selon l’AMA et l’’OM.
• La télé (70,6%) est de loin le canal par lequel les élèves ont entendu parler du dopage. L’accès à cette information par le biais de l’école représente 15,1%. Recommandation: renforcer les capacités des écoles à diffuser des informations sur le dopage, notamment par la formation des membres de clubs de santé scolaire sur le dopage.
• 23,9% des élèves qui ont entendu parler de dopage ne sont pas en mesure de citer les produits interdits dans le sport, et certains parmi ceux‐qui disent connaître ces produits font parfois un amalgame avec des produits non nocifs. Recommandation : Informer les élèves sportifs sur la liste des produits interdits dans la pratique du sport.
• 92,2% des élèves admettent qu’il y a des conséquences négatives liées au dopage. Recommandation: informer plus largement les élèves sur les conséquences concrètes du dopage.

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