Drugs in Sport 8th Edition

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Contents

List offigures XlV

List of tables XVl

List of boxes XlX

About the contributors XXl
Acronyms and glossary of terms XXlll

PART I
The context and regulation of drug use in sport

I Drugs and their use in sport 3

DAV I D MOTTRAM

1.1 Introduction 3
1.2 What is a drug? 3
1.3 Why might athletes take drugs? 9
1. 4 The use qf drugs for performance enhancement 12
1.5 Key points 15
Riferences 16

2 The evolution of doping and anti-doping in sport 17

DAVID MOTTRAM

2.1 Introduction 17
2.2 The Ancient O{ympic and Roman Games 18
2.3 Nineteenth century 19
2.4 Ear{y twentieth century 19
2.5 The 1940s and 1950s 19
2.6 The 1960s 19
2.7 The 1970s 21
2.8 The1980s 21
2.9 The 1990s 22
2.10 2000 to 2010 23
2.11 2011 to 2020 27
2.12 2021 and onwards 33
2.13 Key points 34
Riferences 3 4
v1 Contents
3 Prevalence of doping in sport 37
ANDREA PETR6CZI , .J OHN CLEAVES , OLIVIER DE HON , DOMINIC SAGOE AND
MARTIAL SAUGY

3.1 Introduction 3 7
3.2 Drfinition qf "doping"fir determining prevalence 38
3.3 Evidence sources 39
3. 4 Reviews on doping prevalence 40
3.5 Prevalence from doping control tests 45
3. 6 Prevalence from ADRVs with direct link to Athlete Biological Passport 47
3. 7 Population-level estimation from ABP data 48
3.8 Prevalence from ADRVs 49
3. 9 Scientific literature 58
3. 10 Evidence synthesis 60
3.11 A note on perceived prevalence 62
3.12 Key points 63
Riferences 65

4 Regulation of anti-doping in sport - international and national

operational frameworks 72
NE IL CHESTER AND N I CK WO.JEK

4.1 Introduction 72
4.2 JiVhy regulate drug use in sport? 72
4.3 Tfte history qf the anti-doping rnovernent 73
4. 4 Anti-doping structure 75
4.5 Tfte f;ftOrld Anti-Doping Agenry 77
4. 6 The UNESCO International Convmtion Against Doping in Sport 77
4.7 The f;ftOddAnti-Doping Code 78
4.8 Court qf Arbitration fir Sport 85
4.9 Kf!Y points 85
Riferences 85

5 Doping control in sport 87

NEIL C HES TER , NICK WO.JEK AND YORCK OLAI' SCHUMACHER

5.1 Introduction 8 7
5.2 Anarytical investigations 88
5.3 Athlete Biological Passport 96
5.4 Non-anarytical investigations 101
5.5 Sanctions 102
5. 6 Education 105
5. 7 Key points 105
Refirences 106

6 The role of Athlete Support Personnel in drug use in sport 108

NE IL CHESTER , MARK STUART AND DAVID MOTTRAM

6.1 Introduction 108

6.2 Influences on an athlete's sporting career 109
 Contents vu
6.3 rt'lw are Athlete Support Personnel? 10.9
6. 4 The mle rif Athlete Support Personnel with regard to drug use in sport 11 0
6.5 Anti-doping regulations relating to Athlete Support Personnel 114
6. 6 Education for Athlete Support Personnel 11.9
6. 7 Key points 1 20
Riferences 120

7 Medical and pharmacy services for international games 124

MARK STUART

7.1 Introduction 12 4
7. 2 A1edical services at sporting venues 125
7.3 The games polyclinic 125
7. 4 Polyclinic services 126
7. 5 Role rif healthcare prqfessionals in anti-doping 12 8
7. 6 Medical worlifiJrce and training 12 8
7. 7 Medicines governance 129
7.8 Prescribing prohibited substances to athletes 129
7. 9 Selection rif medicines for athlete treatment at games 13 0
7.10 Patterns rif drug use 132
7.11 Importation rif drugs for team use 13 4
7.12 Anti-doping supportfor local health care services 13 5
7.13 Key points 136
Bibliography 13 6

PARTII
Substances and methods used and misused in sport 139

8 Anabolic agents 14 1
NEn C HESTER

8.1 Introduction 141

8.2 Anabolic androgenic steroids 142
8.3 Pharmacology rif anabolic androgenic steroids 145
8. 4 Clinical uses rif anabolic androgenic steroids 146
8.5 Anabolic androgenic steroids as performance- and image-enhancing agents 147
8. 6 Adverse iffects following anabolic androgenic steroid use 148
8. 7 Use rif anabolic androgenic stemids in sport 15 0
8.8 Prevalence rif anabolic androgenic steroid use in sport 152
8.9 Designer steroids 15 4
8.1 0 Pro hormones 15 4
8.11 Detection rif anabolic androgenic steroids 155
8.12 Selective androgen receptor modulators 15 6
8. 13 Beta- 2 agonists 15 6
8. 14 Tibolone 15 7
8.15 Ecdysterone 15 7
8.16 Key points 158
Riferences 158
VIn Contents
9 Peptide hormones, growth factors, related substances
and mimetics 164
DAV I D MOTTRAM AND NE I L C H ESTER

9.1 Introduction 164

9.2 What are peptide hormones and growthfactors? 164
9.3 Clinical uses of peptide hormones and growth foe tors 168
9. 4 The use and misuse of erythropoietins and agents affecting erythropoiesis
in sport 170
9.5 The use and misuse of peptide hormones and their releasingfactors in sport 172
9. 6 The use and misuse of growth foe tors and growth foetor modulators in sport 17 6
9. 7 The prevalence of peptide hormones and growth foe tors in sport 17 7
9.8 Key points 180
Riferences 18 0

10 Beta-2 agonists 186

NE IL C HESTER AND DAV!D MOTTRAM

1 0.1 Introduction 186

10.2 Jil!hat are beta-2 agonists? 186
I 0.3 Clinical uses of beta-2 agonists 187
10. 4 The use and misuse of beta-2 agonists in sport 191
10.5 Key points 197
References 198

11 Hormone and metabolic modulators 202

NE I L CHESTER

11.1 Introduction 202

11.2 Hormone and metabolic modulators and the WADA Prohibited List 202
11.3 Aromatase inhibitors 205
11.4 Anti-oestrogenic substances: anti-oestrogens and selective oestrogen receptor
modulators 206
11.5 Agents preventing activin receptor JIB activation 207
11.6 Metabolic modulators 209
11.7 Key points 212
Riferences 213

12 Diuretics and masking agents , 216

DAVID MOTTRAM

12. 1 Introduction 216

12.2 JiVhat are diuretics? 216
12.3 The use and misuse of diuretics and masking agents in sport 216
12. 4 Key points 223
Riferences 22 4
 Contents ix
13 Manipulation of blood and blood components 226
YORC K OLAF SCHUMACHER

I3. I Introduction 226

I3.2 Blood tranifusions 227
I3.3 Erythropoiesis-stimulating agents 229
I3.4 New developments in erythropoietic drugs 230
I3.5 Blood substitutes 23I
I3.6 Key points 233
References 233

14 Chemical and physical manipulation 235

DAVID MOTTRAM

14.I Introduction 235

I4.2 WADA regulations with respect to chemical and physical manipulation 235
I4.3 Prevalence qf chemical and physical manipulation in sport 236
I4. 4 Techniques for identifying chemical and physical manipulation 23 8
I4.5 Institutionalised manipulation qf the doping control process 239
14. 6 Key points 2 42
Riferences 242

15 The potential for gene and cell doping in sport 245

DOM I N I C J. WELLS

I5.I Introduction 2 45
I5.2 JiVhat are gene and cell therapies? 246
I 5.3 Clinical uses qf gene and cell therapy 246
I 5. 4 The action, uses and adverse dfects qf gene and cell doping in sport 2 49
I 5.5 Key points 253
Riferences 253

16 Stimulants 258
DAVID MOTTRAM

I6.I Introduction 258

I 6.2 What are stimulants? 258
I6.3 Clinical uses qf stimulants 26I
I 6. 4 The use, misuse and adverse dfects qf stimulants in sport 262
I 6. 5 WADA regulations for stimulant use in sport 2 7I
I 6.6 Key points 275
Riferences 2 75

17 Caffeine 279
N EIL C HESTER

I7.I Introduction 279

I 7.2 Pharmacology 280
17.3 Mechanisms qf action 2BI
x Contents
17. 4 Performance-enhancing properties 283
17.5 Cciffeine combinations 287
17.6 Therapeutic actions 288
17. 7 Adverse side-dfects 289
17.8 Caffeine use and anti-doping regulations 2.90
17..9 Key points 2.92
Riferences 2.92

18 Cannabinoids 298
DAVID MOTTRAM

18.1 Introduction 298

18.2 vVhat are cannabinoids? 2.98
18.3 Cannabis use in society 3 00
18.4 The use and misuse of cannabinoids in sport 3 01
18.5 Key paints 306
R'!forences 306

19 G1ucocorticoids 309
N ICK WO.J EK

1.9. 1 Introduction 3 0.9

1.9. 2 Clinical uses, side-dfects and made of action 310
19.3 Physiological and pharmacological dfects relevant to sport performance 312
19. 4 Anti-doping regulations 316
1.9.5 Key paints 319
Riferences 320

20 Narcotics 326
DAVID MOTTRAM

20.1 Introduction 326

20.2 J!Vlzat are narcotics? 326
20.3 Clinical uses of narcotics 327
20.4 The use and misuse of narcotics in sport 328
20.5 Key paints 332
References 332

21 Non-narcotic analges ics and non-steroidal

anti-inHanunatory drugs 333
NICK WOJEK

21.1 Introduction 333

21.2 Properties and made of action 333
21.3 Clinical uses and dficacy 335
21.4 Adverse dfects 337
21.5 Prevalence of use and ethical issues of NSAID use within sport 338
21.6 Key paints 340
R'!forences 3 41
 Contents x1

22 Beta blockers 346

DAVID MOTTRAivl

22.1 Introduction 3 46
22.2 What are beta blockers? 346
22.3 Clinical uses if beta blockers 347
22.4 The use and misuse if beta blockers in sport 349
22.5 Kf)' points 352
Riferences 352

23 Alcohol 354
DAVID MOT'rRAM

23.1 Introduction 354

23.2 What is alcohol? 354
23.3 Adverse iffects if alcohol 356
23.4 The use and misuse if alcohol in sport 357
23.5 Kf)' points 360
Riferences 360

24 Sports nutrition, supplements and herbal preparations 362

NE f L C HESTER

24.1 Introduction 362

24.2 Sports nutrition 363
24.3 What are sports supplements? 363
24.4 Wiry do athletes use supplements? 364
24.5 The prevalence if supplement use 364
2 4. 6 The risks associated with supplement use 3 65
2 4. 7 Herbal supplementation 3 69
2 4. 8 Scifeguarding athletes against inadvertent doping through supplement use 3 74
24.9 Kf)' points 376
References 3 76

PART Ill
Evolving issues concerning drug use in sport 381

25 Drug use in society and the potential impact on the anti-doping

movement 383
NE! L CHESTER AND JIM MCVE JC B

25.1 Introduction 383

25.2 Recreational psychoactive drug use 384
25.3 Performance- and image-enhancing drug use 385
25.4 Performance-enhancing drug use in recreational/non-elite athletes 388
25.5 Human enhancement technology 388
25.6 The normalisation if drug use in society and impact on the anti-doping movement 390
25.7 Kf)' points 392
References 393
xn Contents
26 Inadvertent use of prohibited substances in sport 397
DAVID MOTTRAM AND NE I L CHESTER

26. 1 Introduction 397

2 6. 2 VV!ry athletes mtry take prohibited substances inadvertently 3 9 7
26.3 Risk levels for the inadvertent use if prohibited substance in sport 398
26.4 WADA rules and regulations regarding inadvertent use if prohibited substances 406
26.5 The Role if Athlete Support Personnel (ASP) in preventing inadvertent use
if prohibited substances 408
26.6 Athlete responsibilities in preventing inadvertent use if prohibited substances 410
26.7 Key points 410
Riferences 410

27 Hormonal treatments for transgender athletes and

athletes with a difference of sex development 4 13
STEPHANE BERMON AND ALMA KAJ ENIENE

2 7.1 Introduction 413

2 7.2 Hormonal treatments in transgender athletes 414
2 7. 3 Transgender athletes: eligibility regulations and anti-doping rules 419
2 7. 4 Athletes with a difference if sex development 422
27.5 Key points 425
Riferences 42 6

28 Medical and anti-doping consider ations for athletes

with disability 428
CHER I BLAUWET AND ALEXANDRA GUNDERSEN

28.1 Introduction 428

28.2 Musculoskeletal injury 430
28.3 Medical illness 431
28.4 Concussion 433
28.5 Relative energy diftciency in sport (RED-S) 434
28.6 Cardiac considerations 435
28.7 Doping and other concerning practices in para sport 436
28.8 Conclusion 438
Riferences 439

29 Governance and corruption in sport with respect to doping 442

NEIL KING

29. 1 Introduction 442

29.2 The evolution if anti-doping policy: an overview 443
29.3 The anti-doping governance infrastructure 444
29.4 Case stuqy: Doping in Russia and the McLaren Reports 446
 Contents xm
29.5 Building an iffective governance infrastructure and anti-doping polir;y 447
29.6 Discussion: At a crossroads - doping as a test case for sport governance 453
29.7 Key points 454
Riferences 454

Index 458
Figures

l.l Some physiological effects of adrenaline mediated through the five

principal classes of adrenergic receptors 8
1.2 The number of AAFs reported by WADA Laboratories (20 17- 20 19) for
substances designated by WADA as "substances of abuse" 12
2.1 Timeline for landmark events related to doping and anti-doping in sport 18
3.1 Main groups of evidence sources for establishing doping prevalence 39
3.2 Trends in the number of doping control samples and ABP samples taken 48
3.3 Outcomes from the Adverse Analytical Findings reported in the
Anti-Doping Administration and Management System (ADAMS)
between 2016 and 2018 50
4.1 A schematic representation of the structure of anti-doping within the
context of the World Anti-Doping Code 76
5.1 Normal haematological profile depicting the haematological markers
haemoglobin concentration (top left box), reticulocytes (bottom right)
and OFF score (top right) 97
5.2 Example of a blood passport indicating the abuse of an erythropoietic
stimulant such as EPO 99
5.3 Flow chart of the evaluation process for the assessment of blood profiles in
the Athlete Biological Passport lOO
5.4 A flow diagram illustrating the chain of events with respect to sample
provision, analysis and potential sanctioning following the confirmation of
an Adverse Analytical Finding 104
6.1 Influences on the career pathway of athletes 109
6.2 Athlete Support Personnel with a key role in doping control 110
8.1 The formation of testosterone and its derivatives 144
8.2 The molecular structure of testosterone illustrating the major sites of
modification in the formation of synthetic anabolic androgenic steroids 145
8.3 The sports within which Adverse Analytical Findings for anabolic agents
were identified through WADA-accredited laboratory statistics for 2019 153
9.1 Sports in which AAFs for peptide hormones were most frequently recorded
from WADA anti-doping testing statistics for 2019 178
10.1 Sports in which AAFs for Beta-2 agonists were most frequently recorded
from WADA anti-doping testing statistics for 2019 195
11.1 Sports in which AAFs for Hormone and Metabolic Modulators were most
frequently recorded from WADA anti-doping testing statistics for 2019 205
 List of figures xv
12.1 Sports in which AAFs for diuretics and other masking agents were most
frequently recorded from WADA anti-doping testing statistics for 20 19 222
16.1 The interrelationships between the various nervous systems of the body 259
16.2 Sports in which AAFs for stimulants were most frequently recorded from
WADA anti-doping testing statistics for 2019 274
17.1 C hemical structure of naturally occurring methylxanthines 281
18. 1 Sports in which AAFs for cannabinoids were most frequently recorded
from WADA anti-doping testing statistics for 20 19 303
19.1 Simplified scheme of the synthesis, secretion, and actions of g1ucocorticoids. 310
2 1.1 Biosynthesis of prostag1andins and the mode of action of NSAIDs 334
22. 1 Sports in which AAFs for beta blockers were most frequently recorded
from WADA anti-doping testing statistics for 2019 352
Tables

l.l Examples of the classification and description of drugs by their names 4

1.2 Examples of the classification of drugs by their mechanism of action
and use 4
1.3 Examples of dosage forms for drugs prohibited in sport 5
1.4 Side-effects associated with some drugs that are commonly misused in sport 8
1.5 Examples of medical conditions for which athletes may require drug
treatment involving drugs that appear on the WADA Prohibited List 10
1.6 Physiological attributes for sport performance 13
1.7 WADA Prohibited List - January 2021 14
2.1 Major revisions to the IOC Prohibited List 1967- 2003 20
2.2 Major revisions to the WADA Prohibited List 2004-2012 25
2.3 Major revisions to the WADA Prohibited List 2013- 2022 26
2.4 Significant changes introduced in the 2015 World Anti-Doping Code 29
2.5 Key findings of the McLaren Independent Person First Report 30
2.6 Some key findings of the McLaren Independent Person Second Report 30
2.7 Key findings of CAS Arbitration on WADA v RUSADA, December 2020 31
2.8 Significant changes introduced in the 2021 World Anti-Doping Code 34
3.1 Summary of literature reviews on doping prevalence 42
3.2 Adverse Analytical Findings and Atypical Analytical Findings in doping
control samples between 20 16 and 20 19 45
3.3 Breakdown of the Adverse Analytical Findings and Atypical Analytical
Findings in doping control samples by substance categories between 2016
and 2019 46
3.4 Athlete Biological Passport blood doping 47
3.5 Athlete Biological Passport hormonal module 4·7
3.6 Estimated prevalence of blood doping from ABP samples in track and field 49
3.7 Conversion rates from doping-control testing to Adverse Analytical
Findings, and to Anti-Doping Rule Violations between 2016 and 2018 by
sample 50
3.8 Overview of Anti-Doping Rule Violation from 20 14 to 2018 (athletes only) 51
3.9 Doping control tests, Adverse Analytical Findings and Anti-Doping Rule
Violations by sports (Olympic sports only) 53
3.10 Doping control tests, Adverse Analytical Findings, Atypical Analytical
Findings and Adverse Anti-Doping Rule Violations by gender 56
 List cif tables XVll

3.11 Detailed view of analytical Anti-Doping Rule Violations by nationality of

the athlete 57
3.12 Anti-Doping Rule Violations at the 2016 Summer and 2018 Winter
Olympic Games 59
3.13 Strength of evidence support for prevalence ranges 60
3.14 Gender differences 61
3.15 Summary of doping prevalence by evidence sources and level of evidence
(in 5% increments) 62
6.1 ADRVs listed in Article 2 of the World Anti-Doping Code 115
6.2 Profile of non-analytical Anti-Doping Rule Violations (ADRVs) committed
by athletes and Athlete Support Personnel 115
6.3 Profile of non-analytical Anti-Doping Rule Violations (ADRVs) by type of
violation 116
6.4 Country of origin for the 169 Athlete Support Personnel listed as
suspended by WADA on I 0 April 2021 117
6.5 Education modules on the Anti-Doping e-Learning (ADeL) platform 120
7.1 Most commonly prescribed medicines during the London 2012 Olympic
Games period 133
7.2 Some results of sports injuries and illnesses at London 2012 Olympic
Games and Rio 2016 Olympic Games 135
8.1 Class SI of the 2021 WADA List of Prohibited Substances and Methods 142
8.2 Categorisation of AAS according to their route of administration and their
structural modification from testosterone 146
8.3 Prohibited anabolic agents identified by WADA-accredited laboratories in
2019 153
9.1 The list of peptide hormones, growth factors, related substances and
mime tics on the WADA Prohibited List (January 2021) 166
9.2 WADA statistics for the number of positive results for substances classed as
peptide hormones, growth factors and related substances (20 13- 20 19) 177
10.1 Selective beta-2 agonists 187
10.2 WADA Prohibited List (2021) regulations relating to Beta-2 agonists 192
10.3 WADA statistics for the number of Adverse Analytical Findings for
substances classed as Beta-2 agonists (2010- 2019) 195
11.1 WADA Prohibited List (2021 ) regulations relating to hormone and
metabolic modulators 203
11.2 Prohibited hormone and metabolic modulators identified by
WADA-accredited laboratories from 2012 to 2019 204
12.1 Classification of diuretics and their major clinical uses 217
12.2 List of substances included as diuretics and masking agents in the
WADA Prohibited List 2021 221
12.3 WADA statistics for the number of positive results for substances classed as
diuretics and masking agents (20 12- 20 19) 222
14.1 WADA 2021 regulations relating to chemical and physical manipulation 236
14.2 Adverse Analytical Findings relating to chemical and physical
manipulation from WADA laboratory statistics (20 12- 20 19) 237
15.1 WADA Prohibited List (2021) regulations relating to gene and cell doping 251
16.1 Examples of stimulants used in sport 262
16.2 Stimulants subject to urinary threshold limits for anti-doping regulations 265
XVlll List of tables
16.3 Stimulants that appear on the WADA Prohibited List and which are
commonly found in supplements 267
16.4 WADA (2021) Prohibited List regulations regarding stimulants 272
16.5 Statistics from WADA-Accredited Laboratories for Adverse Analytical
Findings for substances classed as stimulants (20 12- 20 19) 274
17.1 Caffeine content of selected beverages and OTC products 280
18.1 Regulations for cannabinoids in the 2021 WADA Prohibited List 302
18.2 WADA statistics for the number of AAFs for substances classed as
cannabinoids (20 12- 20 19) 303
19.1 Incidence of glucocorticoids reported as Adverse Analytical Findings by
WADA-accredited laboratories from 2009 to 2019 (taken from WADA
anti-doping testing figures) 318
20.1 WADA (2021) Prohibited List regulations with respect to in-competition
use of narcotics 329
20.2 WADA statistics for the number of AAFs for substances classed as narcotics
(20 12- 20 19) 331
21.1 Examples of NSAIDs, selective COX-2 inhibitors, and other non-narcotic
analgesics available in the UK 336
22.1 Tissues and organs of the body that contain 13-adrenoceptors and the
pharmacological effects produced by beta blockers 347
22.2 Beta blockers and their receptor selectivity 347
22.3 Clinical conditions for which beta blockers are prescribed 348
22.4 2021 WADA regulations for beta blockers 350
22.5 WADA statistics for the number of Adverse Analytical Findings for beta
blockers (20 12- 20 19) 351
23.1 Demonstrable effects of alcohol at different blood alcohol concentrations 356
23.2 WADA annual statistics for the number of Adverse Analytical Findings for
alcohol 360
25.1 Examples of pharmacological agents used to enhance performance and
Image 390
26.1 Examples of prohibited substances that may be taken inadvertently 398
26.2 Definition of "No fault or negligence" and "No significant fault or
negligence" 407
26.3 Summary of WADA's ineligibility sanctions 408
27.1 Main changes and side-effects observed in transgender women during
hormonal treatment 416
27.2. Main changes and side-effects observed in transgender men during
hormonal treatment 418
28.1 Sports currently included on the Paralympic Summer and Winter Games
programme 429
28.2 Medications commonly used by Paralympic athletes with their associated
diagnoses, potential side-effects and necessity for a Therapeutic Use
Exception 438
Boxes

2.1 German Democratic Republic Doping Programme (late 1960s to early 1980s) 21
2.2 Ben Johnson (1988) 22
2.3 The Festina Affair (1998) 23
2.4- Alain Baxter (2002) 24
2.5 The BALCO Affair (2003) 24
2.6 Operaci6n Puerto (2006) 27
2.7 Lance Armstrong (20 12) 28
2.8 Alberta Salazar (20 19) 32
2.9 Operation Viribus (20 19) 33
6.1 The United States Postal Service Pro-Cycling Team Doping
Conspiracy (20 12) 117
6.2 WADA investigation of Sochi allegations (20 16) 118
6.3 Alberta Salazar (20 19) 118
6.4 Dr Mark Schmidt (202 1) 119
7.1 Prescription procedure for prohibited substances at international games 130
9.1 Lance Armstrong (20 12) 178
9.2 Johannes Durr (20 14) 178
9.3 Terry Newton (2010) 179
9.4· Nikolay Marfin and Vadim R akitin (20 12) 179
9.5 Stephen Dank and Essen don Football Club (20 12) 179
9.6 Maria Luisa Calle (20 15) 180
9.7 Michael Nackoul (2016) 180
10.1 Chris Froome (20 17) 193
10.2 J essica Hardy (2008) 196
10.3 Alberta Contador (20 l 0) 197
11.1 Madisyn Cox (20 18) 2 11
11.2 Maria Sharapova (20 16) 212
12.1 Veronica Campbell-Brown (20 13) 223
14.1 Galabin Boevski, Zlatan Vanev and Georgi Markov (2003) 237
14.2 Rebeca Gusmao (2007) 237
16.1 Kelli White (2003) 263
16.2 Andreea Raducan (2000) 264
16.3 Alain Baxter (2002) 264
16.4 Richard Gasquet (2009) 266
16.5 Frankie Dettori (20 12) 266
16.6 Vitalijs Pavlovs, William Frullani and Evi Sachenbacher-Stehle (20 14-) 268
XX List if boxes
16.7 Nesta Carter (20 16) 268
16.8 Asafa Powell (20 13) 269
16.9 Tom Simpson (1967) 270
18.1 Ross Rebagliati (I998) 304
18.2 Tomas Enge (2002) 305
18.3 Michael Phelps (2009) 305
I8.4 Nicholas Delpopolo (20 12) 305
I8.5 Jake Humphries (20 I6) 305
20.I Cahors Affair (2004) 331
20.2 Ambesse Tolosa (2007) 331
22.I KimJong-Su (2008) 352
26.1 Alberto Contador (20 I 0) 399
26.2 Nick Delpopo1o (20 12) 399
26.3 Andreea Raducan (2000) 400
26.4 Filip Radojevic (20 I 7) 400
26.5 Timo Hoffmann (20 13) 401
26.6 Nicklas Backstrom (20 I4) 402
26.7 Abdur Rehman (20 I2) 403
26.8 Richard Gasquet (2009) 403
26.9 Gil Roberts (20 I6) 404
26.IO Oisin Murphy (2020) 404
26.1I Jessica Hardy (2008) 405
26.12 Rhys Williams and Gareth Warburton (20I4) 405
26.13 Evi Sachenbacher-Stehle (20I4) 405
26.I4 Dieter Baumann (I999) 406