3.1 The most frequently detected substances
Five hundred and sixty-five Sanctioned Athletes/Athlete Support Personnel, across 83 different MF, were recorded between 2008 and 2019 (Figure 1). Five hundred and sixty-two of these sanctions had a named prohibited substance/prohibited method noted. Five hundred and fifty-nine of these sanctions occurred due to the detection of prohibited substances, with only three sanctions occurring due to the use of prohibited methods (n = 2 urine substitution, n = 1 blood substitution). Of these 559 sanctions, 51 different substances were detected, from 10 different categories within the WADA Prohibited List, with exogenous AAS metabolites and markers indicating EAAS usage accounting for 82% of detected substances (Figure 2).
Three hundred and ninety-six sanctions occurred from an in-competition (IC) test and 167 from an OOC test with two sanctions testing location undefined. From the ten most detected substances, six substances, Dehydrochloromethyltestosterone (89%), markers indicating EAAS usage (76%), Metenolone (100%), Methylhexanamine (100%), Methyltestosterone (71%) and Nandrolone (86%) showed a higher instance of detection IC (Figure 2).
3.2 Prohibited substance usage and Continental Federation
Of the 565 Sanctioned Athletes/Athlete Support Personnel counted 199 were from Asia, 267 from Europe, 34 from Africa, and 65 from Pan America. There were no sanctions from Oceania. From the 562 sanctions that had the available data, the proportion of detected substances that were classified as exogenous AAS, markers of EAAS usage (i.e. the most detected substances) and all other substance category types varied by IWF Continental Federation (p < 0.001). The proportions of these detected substance types was significantly different between Asia (70%, 15%, 15%) and Pan America (37%, 30%, 33%) (p < 0.001), Asia and Africa (50%, 17%, 33%) (p = 0.039), Europe (74%, 11%, 15%) and Pan America (p < 0.001) and Europe and Africa (p = 0.015) with no differences between Asia and Europe or Pan America and Africa, highlighting regional differences in detected prohibited substances.
3.3 Prohibited substance usage and nation
For the 10 nations with the highest number of sanctions, when looking at the 10 most detected substances, each nation had at least one substance that accounted for more than one third of all detected substances as follows: Azerbaijan (n = 35 sanctions) (Metandienone 38%), Kazakhstan (n = 35) (Stanozolol 51%), Russia (n = 32) (Dehydrochloromethyltestosterone 52%), Bulgaria (n = 30) (Metandienone 42% and Stanozolol 45%), Belarus (n = 23) (Stanozolol 44%), Armenia (n = 22) (Stanozolol 38%), Ukraine (n = 19) (Dehydrochloromethyltestosterone 40% and Stanozolol 40%), Romania (n = 18) (Stanozolol 60%), Thailand (n = 18) (Metandienone 50% and EAAS 50%) and Moldova (n = 17) (Dehydrochloromethyltestosterone 37%) (Figure 3).
3.4 Most Affected Nations of 2008 and 2012 Retesting
Sixty-one weightlifters, from 13 different countries, were retrospectively announced to have committed an ADRV for prohibited substances from the Beijing 2008 (n = 25) and London 2012 (n = 36) Olympic Games. Sixteen of these weightlifters (64%) from Beijing 2008 were medallists (4 Gold, 5 Silver and 7 Bronze). For Beijing 2008 Kazakhstan and Azerbaijan had more athletes generate a retrospective ADRV than those who did not and for Belarus, Ukraine, Russia, and Kazakhstan more medals were won by athletes who generated a retrospective ADRV than those who have not (Figure 4). Eighteen of these weightlifters (50%) from London 2012 were medallists (5 Gold, 5 Silver and 8 Bronze). For London 2012 Russia, Kazakhstan, Belarus, Azerbaijan, and Armenia had more athletes generate a retrospective ADRV than those who have not and for both Romania and Moldova all athletes that competed generated a retrospective ADRV. All medallists from Ukraine, Kazakhstan, Belarus, Romania, Azerbaijan, Armenia, and Moldova generated retrospective ADRVs and for Russia twice as many medals were won by athletes who generated a retrospective ADRV (Figure 4).
3.5 Most Affected Categories of 2008 and 2012 Retesting
From Beijing 2008 five weight categories, (Men’s u94kg, Women’s u48kg, Women’s u69kg, Women’s u75kg, and Women’s 75kg+) and from London 2012 three weight categories, (Women’s u53kg, Women’s u63kg and Women’s u69kg) had two medallists produce retrospective ADRVs from AAFs. In two instances from London 2012 (Men’s u94kg and Women’s u75kg) all medal winners produced retrospective ADRVs from AAFs, with the Men’s u94kg category being the worst affected with eight athletes generating retrospective ADRVs from AAFs, six of whom originally placed in the top 10.
3.6 Detected Substances from 2008 and 2012 Retesting
In total, across both the Beijing 2008 and London 2012 Olympic Games, 94 prohibited substances were detected in the re-tested samples with Dehydrochloromethyltestosterone and Stanozolol accounting for 83% of all detected substances. The majority of retrospective ADRVs (58 of 61) were caused by the detection of one of these two substances with exogenous AAS accounting for 94% of all detected substances. Across both Olympic Games, for the 10 nations with the highest number of announced retrospective ADRVs the proportions of detected substances are shown in Figure 5. For each nation there is at least one substance that makes up ≥40% of all detected substances as follows: Kazakhstan (n = 10 ADRVs) (Stanozolol 67%), Russia (n = 10) (Dehydrochloromethyltestosterone 71%), Belarus (n = 8) (Dehydrochloromethyltestosterone 44%, Stanozolol 44%), Azerbaijan (n = 6) (Dehydrochloromethyltestosterone 67%), Armenia (n = 5) (Dehydrochloromethyltestosterone 50%, Stanozolol 50%), Turkey (n = 5) (Stanozolol 71%), Romania (n = 4) (Metenolone 40%, Stanozolol 40%), Ukraine (n = 4) (Dehydrochloromethyltestosterone 100%), China (n = 3) (Growth Hormone-Releasing Peptide-2 75%) and Moldova (n = 3) (Dehydrochloromethyltestosterone 67%).