Meta-analysis of the Level of Outbreak and Knowledge on Performance- Enhancing Substances (PES) Consumption Effects in Different Societies of Athletes

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1 AENSI Journals Advances in Environmental Biology ISSN EISSN Journal home page: Meta-analysis of the Level of Outbreak and Knowledge on Performance- Enhancing Substances (PES) Consumption Effects in Different Societies of Athletes 1 Ali Hejabi, 2 Farshad Tojari, 3 Mohammadreza Esmaeili 1 M.A. Student in Sport Management, College of Physical Education and Sport Sciences, Islamic Azad University, Central Tehran Branch, Iran 2 Associate Professor in Sport Management, College of Physical Education and Sport Sciences, Islamic Azad University, Central Tehran Branch, Iran 3 Assistant Professor in Sport Management, College of Physical Education and Sport Sciences, Islamic Azad University, Central Tehran Branch, Iran A R T I C L E I N F O Article history: Received 25 September 2014 Received in revised form 26 October 2014 Accepted 25 November 2014 Available online 31 December 2014 Keywords: Doping, knowledge, prohibited substances, performance-enhancing substances (PES) A B S T R A C T According to the Medical Commission of International Olympic Committee (IOC), doping is defined as prescription or consumption of an exterior or endogenous substance with abnormal doses and/or abnormal usage method by a healthy person with the purpose of increasing sports efficiency. These days, doping has become as a complex problem among the athletes. The purpose of conducting this study, made in the meta-analysis method, includes studying, comparing and analyzing two variables of level of outbreak of ergogenic substances and level of knowledge on the effects of consumption of these substances. In this study, sevens articles related to the subjectmatter hereof and with different statistical societies (in terms of field of sport and age group) were chosen. Total number of studied samples in such seven articles included 8915 people. The average outbreak of PES consumption and average knowledge on PES consumption effects have been 43.99% and 25.5%, respectively AENSI Publisher All rights reserved. To Cite This Article: Ali Hejabi, Farshad Tojari, Mohammadreza Esmaeili., Meta-analysis of the Level of Outbreak and Knowledge on Performance-Enhancing Substances (PES) Consumption Effects in Different Societies of Athletes. Adv. Environ. Biol., 8(22), , 2014 INTRODUCTION Doping means using substances belonged to prohibited, limited medicines and/or using different unauthorized methods. According to ex-ioc Chief, Juan Antonio Samaransh, doping is a kind of cheating. Using different medicines and complementary substances to increase physical performance and develop muscle volume has been seen since thousands of years ago [13]. It appears that using PES is the main reason on several abnormal behaviors, and involving with consuming these substances depends on personal choice [3]. Data indicates that the population exposed to the risk of PES drug abuse includes certain number of athletes from different ages, who are quite more extensive than what was previously thought to be [1]. In recent years, unfortunately along with the medical and pharmaceutical knowledge progress as well as correct taking benefit from increasing discoveries of such sciences, some people promote unsuitable using these drugs in the society for the mere sake of gaining profit. One of the fields of such profit-seeking has been applying unauthorized using the drugs in sports and promotion of the same, while there are economic, social and even political purposes beyond drug abuse. Several issues of medal discharging, extensive reported harmful physical and mental effects from the athletes as well as significant number of mortality caused by committing doping show the serious extension of this anti-value in the sports scene. In 1981, a survey made among American athlete students indicated that 80% of surveyed students had at least drunk alcohol once, while 20% had records on consuming marijuana and 2% had records on using anabolic steroids. Today, it is estimated that one out of three million American athletes use androgenic anabolic steroids [18; 2]. Estimation to use these drugs among the bodybuilders is between and 80% [16]. In one of the studies conducted on female athletes (1998) it has been reported that 8.3% of the gymnasts and 11.8% of ice hockey players used PES [15]. Corresponding Author: Ali Hejabi, M.A. Student in Sport Management, College of Physical Education and Sport Sciences, Islamic Azad University, Central Tehran Branch, Iran

2 148 Ali Hejabi et al, 2014 In a study titled using unauthorized drugs in clubs and the problem of unidentifiable drug abuse Kanayama et al [6] reported that 511 people out of the study samples from 5 different sports clubs during the past three years, 18%, 25% and 5% of men used Androstenedione, Ephedrine and anabolic steroid, respectively, while these figures have been 3%, 13% and 0%, respectively, among women [6]. In studying doping and using PES in 351 men and 82 women (both athletes and non-athletes) in Sivas, Turkey, Ozdemir, et al. [10] reported outbreak of doping and PES as 8% (71 cased out of 833 athletes). Using PES in athletes was meaningfully (145%) in comparison with athletes (18%). Consumption of ergogenic substances which were more common included: 60.5% anabolic steroids, 12.7% carnitin, 5.4% eritropoitin, 11.3% sodium bicarbonate, and 14.1% keratin. Outbreak of ergogenic substances was reported as 1.6% and 2.2%, respectively [13]. In another study conducted by Kashi and Sarlak [8], titled studying the factors affecting prohibited substances and endogenic complementary drugs in high school students by taking benefit from a self-reporting and researcher-made on 1,180 male and female students in 8 cities and Tarhan district, Kouhdasht township. The results showed that 9.3% of the participated students in this study admitted consumption of at least on PES, of whom 3.7% and 7.1% used prohibited drugs and sports complementary substances. However, some of the people have used both. Information analysis in this study indicated that knowledge on doping and knowing the ergogenic substances names is from amongst the factors effective in outbreak of the same substances. Meanwhile, knowing the names of ergogenic substance together with four other factors were the most important ergogenic substances predicting variables (R= ). In a study conducted by Goulet, et al. [3], titled predictors of using PES among 3573 young athletes (avg. age 1.5 yrs.), in Quebec Province, Canada, it was indicated that knowledge on prohibited substances has a little effect on the purpose and behavior of PES consumption among young athletes. In the study conducted by Halabchi, et al. [4], titled studying the level of knowledge of wrestlers of Tehran city clubs on doping and estimation of the same from the current outbreak in the country which was made as interval-based study and among 426 people through taking benefit from questionnaire during years 2006 and 2007, it was shown that: the knowledge of wrestlers on the three scopes of doping, knowledge on prohibited drugs and recognizing side effects, are weak or average in 70.8%, 95.8% and 99.5% cases, respectively. Thus, the importance of problem of drugs in sport and the recent scandals of using banned drugs and doping in sport have encouraged researchers to study mental psychological variables as predictors for drug usage in sport in Iran. All have been claimed that the programs for managing doping prevention in sport cannot be effective if the predictor factors (psychological, social, political, and ) are neglected [9;10;11;19]. Knowledge on the PES and their effects have always been considered as one of the factors preventing the consumption of such types of substances, and informing and various trainings regarding introduction to the effects of these substances is of special position in planning of those involved in confronting the consumption of the same. The important issue which may play the role of facilitator in this process is knowledge on the potential differences between such affecting among the different societies and age groups of athletes. It seems knowledge on this link and identifying the more vulnerable societies may highly help in correct directing the policymakers activities and planning of educational programs. Therefore, the main purpose of this study may be considered as studying the relation between two variables of effects of PES and the level and level of outbreak of consumption of these substances and comparison of such relationship and/or potential difference among different societies of athletes and in various age groups. MATERIALS AND METHODS Meta-analysis method has been used in this study. In order to do so, while studying the relevant articles, which had focused in a way on the doping behavior and its factors affecting the different athletes' societies, the variables of: (1) level of outbreak and (2) level of knowledge on effects of consumption of PES which are commonly studied, were extracted and studied? Results: Studies societies: In this study, seven articles were analyzed and studied, while their studied societies include bodybuilders of Kermanshah city, bodybuilders of Sabzevar, Tehran city wrestlers, some female athletes of national and club levels in Tehran province, some female and male athletes in 5 cities of Lorestan province (Khoramabad, Boroujerd, Azna, Alashtar and Kouhdasht), high school and pre-college students of Hamedan province and bodybuilders of 5 provinces (Tehran, Esfahan, Lorestan, Khouzestan, and Ghom). The total number of studied samples in these seven articles included 8915 people (Table No. 1).

3 149 Ali Hejabi et al, 2014 Table 1: Introduction of studied statistical societies together with the statistics of each society. No. Studied society Society s statistics (ppl.) 1 bodybuilders of Kermanshah city bodybuilders of Sabzevar Tehran city wrestlers female athletes of national and club levels in Tehran province female and male athletes in 5 cities of Lorestan province students of Hamedan province bodybuilders of 5 provinces 259 SUM 8915 Level of ergogenic substances consumption outbreak: In terms of ergogenic substances outbreak and among studied societies, female athletes of national and club levels in Tehran city, are heading with 77.5% [9] and bodybuilders of five provinces with 63.3% [8], wrestlers of clubs of Tehran city with % [4], Kermanshah Bodybuilders with 28.3% [14], Sabzevar bodybuilders with 34% [5], female and male athletes of five cities of Lorestan with 32.5% [7], and Hamedan students with 12.3% [17] are ranked in the next levels (Chart No. 1 and Table No. 2). Table 2: Level of outbreak of ergogenic substances in studied societies. No. Studied society Level of outbreak (%) 1 female athletes of national and club levels in Tehran province bodybuilders of 5 provinces Tehran city wrestlers 4 bodybuilders of Kermanshah city bodybuilders of Sabzevar 34 6 female and male athletes in 5 cities of Lorestan province students of Hamedan province 12.3 Average (%) Information on substances side effects: In terms of knowledge on ergogenic substance consumption side effects, bodybuilders of five provinces with 55.98% were the most knowledgeable group, followed by female athletes of national and club levels in Tehran city, with 42%, Kermanshah bodybuilders with 39.4%, Sabzevar bodybuilders with 26.7%, female and male athletes of five cities of Lorestan with 13.3% and Hamedan students with 1% and wrestlers of Tehran city with merely 0.5% (chart 2 and table 3). Table 3: Level of outbreak of ergogenic substances in studied societies. No. Studied society Knowledge on substances side effects 1 bodybuilders of 5 provinces female athletes of national and club levels in Tehran province 42 3 bodybuilders of Kermanshah city bodybuilders of Sabzevar female and male athletes in 5 cities of Lorestan province students of Hamedan province 1 7 Tehran city wrestlers 0.5 Average (%) female athletes of national and club levels in Tehran province bodybuilders of 5 provinces Tehran city wrestlers bodybuilders of Kermanshah city bodybuilders of Sabzevar female and male athletes in 5 cities of Lorestan province students of Hamedan province

4 1 Ali Hejabi et al, 2014 Chart 1: Ergogenic substances outbreak level in studied societies. Discussion and Conclusion: Several studies all around the world focused on studying the level of knowledge of consumers of ergogenic substances on side effects of these substances and indicated that those people who use these substances fail to have sufficient knowledge in this regard and pay less attention choosing the same. The results of several studies conducted by Sarlak and Kashi in the field of outbreak or ergogenic substances in Iran since 2004 indicates quite low knowledge of ergogenic substances consumers on their side effects. By observing the outbreak level of PES consumption in different societies, a relatively big interval is seen from around 12% thru 77.5%, which indicates that meaningful difference level of outbreak among different societies of athletes in terms of type of sport and age group. Meanwhile, it is also true regarding information from side effects, in a way that knowledge on side effects varies from 0.5% among Tehran city clubs wrestlers up to 55.98% among bodybuilders (5 provinces), which is a meaningful difference. The important and unpredictable point observed in this study may be reported as per the following: 0.5 Tehran city wrestlers 1 students of Hamedan province 13.3 female and male athletes in 5 cities of Lorestan province 26.7 bodybuilders of Sabzevar 39.4 bodybuilders of Kermanshah city 42 female athletes of national and club levels in Tehran province bodybuilders of 5 provinces Chart 2: Level of knowledge on ergogenic substances side effects in studied societies level of outbreak(%) 40 knowledge on effectsof consumption of PES(%) Chart 3: Comparison of level of outbreak and level of knowledge in seven groups.

5 151 Ali Hejabi et al, 2014 By studying the results found in the conducted studies, it may be said that there is a meaningful and however, indirect relationship between level of knowledge from ergogenic substances consumption effects and level of outbreak of consumptions of the same, i.e. most of the groups, notwithstanding more knowledge on effects of ergogenic substances effects, are pioneering in consumption of the same, while the groups with less knowledge also have less consumption. This issue is true for 6 out of 7 studied societies. For instance, bodybuilders (5 provinces) are in the best conditions in terms of knowledge on side effects and also are ranked second in terms of level of consumption outbreak. Merely Tehran province wrestlers, who have less knowledge on PES consumption side effects (0.5%), have more outbreak of such type of substances (%). It seems that knowledge available on such substances and their effects in the level of different media has either not be sufficient and/or has been in a way that it has been effective. It may well be seen in chart 3, that except for one case, level of outbreak and knowledge on side effects in seven groups are almost on straight line and close to each other, which proves the said issues. Higher level of outbreak in physical-intense athletes, such as bodybuilders approves the results of other studies conducted in this regard. However, the reverse relationship between level of outbreak and knowledge on side effects is contradiction with most of the different studies findings which have reported knowledge on side effects as a preventive factor from level of consumption. Low level of knowledge on ergogenic substances consumption among the students reminds the fact that the education administration shall consider correct information in this regard to be included in its educational program. Meanwhile, it is suggested that a single study is conducted on the level of outbreak of PES consumption outbreak and knowledge on side effects in different sports societies, so that first of all the relationship of level of knowledge and level of outbreak and effects is more clear by taking benefit of the relevant results and secondly through comparison of these results in different athletes societies, the priorities of training and preventive programs are directed towards such societies while identifying those athletes who are more exposed to the relevant risks. REFERENCES [1] Buckley, W.E., C.E. Yesalis, K.E. Friedl, W.A. Anderson, A.L. Streit, J.E. Wright, Estimated prevalence of anabolic steroid use among male high school seniors. JAMA, 260(23): [2] Cogeni, J., S. Miller, Supplements and drugs used to enhance athletic performance. Pediatr Clin North Am., 49: [3] Goulet, C., P. Valois, A. Buist, Me lanie Cote, Predictors of the Use of Performance-Enhancing. Clin J Sport Med., 20: [4] Halabchi, F., A. Esteghamati, M. Mansournia, Studying the level of knowledge of Tehran city club wrestlers on doping and estimation of the same on current outbreak in the country. Bio-sports sciences, 1: [5] Hamedinia, M., Studying the outbreak of using complementary substances, attitude towards the same and their side effects in Sabzevar township bodybuilding clubs, Olympic quarterly magazine, 13 th year, 3(3): [6] Kanayama, G., G.H. Cohane, R.D. Weiss, H.G. Pope, Past anabolic-androgenic steroid use among men admitted for substance abuse treatment: an under recognized problem? J. Clin. Psychiatry, 64: [7] Kargarfard, M., A. Kashi, Z. Sarlak, Outbreak of consumption of ergogenic substances and level of knowledge on effects and side effects of the same among Lorestan athletes. Principles of mental health scientific and research magazine, 11(2): [8] Kashi, A., M. Kargarfard, H. Molavi, Z. Sarlak, Consumption of ergogenic substances among bodybuilding athletes: outbreak, recognition and knowledge on its side effects. Olympic quarterly magazine, 2(34): [9] Manouchehri, J., Tojari, F., & Ganjouei, F.A., Variance analysis: Doping attitude, doping behavior and sport orientation in elite martial artists. European Journal of Experimental Biology, 3(1): [10] Manouchehri, J., Tojari, F., Examining the conceptual model: Relationships between sport orientation, doping attitude and doping behavior in Iranian elite martial artists. European Journal of Experimental Biology, 3(2): [11] Manouchehri, J., Tojari, F., Development and validation of instruments to measure doping attitudes and doping beliefs. European Journal of Experimental Biology, 3(2): [12] Minasian, V., M. Srlak, Outbreak, attitude and knowledge on ergogenic substances side effects among elite athletes in the national and club levels in Tehran province. Research in sports sciences, 25: [13] Ozdemir, L., N. Nur, I. Bagcivan, O. Bulut, H. Sumer, G. Tezeren, Doping and performance enhancing drug use in athletes living in Sivas, Mid Anatolia: a brief report. Journal of Sports Science and Medicine, 4:

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