School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, 807, Taiwan; College of Pharmacy, Kaohsiung Medical University, Kaohsiung, 807, Taiwan.
Department of Sports Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan.
Environ Pollut. 2023 Sep 15;333:122087. doi: 10.1016/j.envpol.2023.122087. Epub 2023 Jun 20.
Biological testing is a key component of the current anti-doping programme implemented by the authorities to detect doping in sports. Strategies such as longitudinal individualised data analysis and sport-specific analysis have been developed to increase the comprehensiveness of the testing. However, the trends of drug misuse in sports might not be effectively captured through today's testing plan. Wastewater testing, assembling individual-level data of a designated group to produce population-level results in one single aggregated sample, can be employed to as a complementary strategy offering added value for doping control. This paper presents an updated summary of the status of anti-doping testing and analytical methodologies for wastewater. The available literature on wastewater-based analyses of drugs prohibited in sports is reviewed. Publications surrounding sporting activities or competitions and others relevant to sports doping are selected. We debate between potential strategies and major limitations of using wastewater monitoring in anti-doping. Knowledge gaps and research directions, specifically on metabolites, stability, sensitivity, and ethical and legal considerations, are discussed. Choosing different wastewater sampling sites allows target sub-population that involved competing athletes and potentially reveal sport-specific or athlete-level-specific behaviour. Sampling from on-board toilets or athlete villages could target international-level athletes, sampling from the dormitories of national training centres allows monitoring of national-level athletes on a daily basis, and sampling from sports stadiums provides a full picture of drug use in the general population during an event. Confounding occurs as (i) the presence of non-athlete composition and the difficulty of analyses to be completely selective to the athlete population; and (ii) the identification of compounds prescribed legitimately with Therapeutic Use Exemptions, only banned in-competition, and naturally occurring. The practicalities of the approach are contextualised in monitoring the non-threshold substances such as anabolic agents, selective androgen receptor modulators, metabolic modulators, and hypoxia-inducible factor activators.
生物检测是当前反兴奋剂机构实施的反兴奋剂计划的一个关键组成部分，旨在检测体育比赛中的兴奋剂。为了提高检测的全面性，已经开发了纵向个体化数据分析和特定运动分析等策略。然而，通过今天的检测计划，可能无法有效捕捉到运动中药物滥用的趋势。污水检测是一种将指定群体的个体数据汇总到一个单一的综合样本中，以产生群体水平结果的方法，可以作为一种补充策略，为兴奋剂控制提供附加价值。本文介绍了反兴奋剂检测和污水分析方法的最新进展。综述了关于污水中禁用药物分析的可用文献。选择了与运动活动或比赛相关的出版物和其他与运动兴奋剂相关的出版物。我们讨论了在反兴奋剂中使用污水监测的潜在策略和主要限制。讨论了知识空白和研究方向，特别是代谢物、稳定性、灵敏度以及伦理和法律方面的考虑。选择不同的污水采样点可以针对参与比赛的目标亚人群，并可能揭示特定运动或运动员特定的行为。从船上厕所或运动员村采样可以针对国际水平的运动员，从国家训练中心的宿舍采样可以每天监测国家水平的运动员，从体育场馆采样可以全面了解事件期间一般人群的药物使用情况。干扰会发生，因为 (i) 存在非运动员成分，并且分析难以完全针对运动员人群具有选择性；和 (ii) 以治疗用途豁免合法规定的化合物的识别，仅在比赛中禁用，以及天然存在。这种方法的实用性在监测非阈值物质（如合成代谢剂、选择性雄激素受体调节剂、代谢调节剂和缺氧诱导因子激活剂）方面得到了说明。
