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Living at high altitude is popular, since lower oxygen levels there boost red-bloodcell counts in a natural way—which, in contradistinction to chemical means, is permitted. It also makes it harder to interpret ABP results, leaving room for chemical enhancement as well. Remote places, moreover, are harder for out-of-competition testers to reach.
生活在高海拔地区是很受欢迎的，因为那里的低氧水平能够以一种自然的方式增加红细胞的数量，这和化学方法不同，这是被允许的。同时它还使得对运动员生物护照(ABP)结果的解释更加困难，为化学增强留下了空间。此外，赛外测试人员很难到达偏远地区。
Another option is to get advanced warning of out-of-competition testing from corrupt or sympathetic officials. Asbel Kiprop is a Kenyan runner banned in 2019 for failing an EPO test. He told the AIU he had often been warned of supposedly unannounced tests. Tip-offs give athletes time to dilute their blood, or to wait for microdosed drugs to clear their bodies. If all else fails, they can simply hide in a cupboard when the testers come knocking. If elite athletes go AWOL too often, they can be sanctioned. But as a fail-safe, it can be a useful tactic. "The principle", says Dr Tucker, "is never take a test you won't pass."
另一种选择是提前从腐败或容易策反的官员那里收到赛外检测的警告。阿斯贝尔·基普罗斯是一名肯尼亚跑步运动员，因未能通过EPO测试而于2019年被禁赛。他告诉田径诚信委员会(AIU)他能够收到有关秘密测试的情报信息。这让运动员有时间稀释血液，或者等待微剂量药物清理身体。如果这些办法都没有奏效，那么他们可以在测试者上门时躲在橱柜里。如果精英运动员经常擅自离开，他们会受到处罚。但作为一种保险措施，这可能是一种有用的策略。塔克博士说：“原则是永远不要参加你通过不了的测试。”
WADA's task, meanwhile, is made harder by the fact that, unlike dopers, it must operate in the open, leaving its methods vulnerable to attack. One way to interpret official limits for some substances, says an observer, is as a sanctioned value up to which athletes can push. Natural variation between people means the allowable limits for some substances must be reasonably generous, leaving room for athletes to boost them artificially.
与此同时，由于测试必须公开进行，测试在明，兴奋剂使用者在暗，这使得测试方式很容易被钻空子，世界反兴奋剂机构(WADA)的测试任务也变得更加艰巨。一名观察人士表示，解读某些药物官方限制的一种方式是，将其视为运动员所能达到的认可值。人与人之间的自然差异意味着某些药物的许可限度必须够大，从而为运动员人为地提高自己留下空间。
Such variations, says Dr Tucker, are one reason why the ABP, which tracks changes in an athlete's physiology over time, is difficult to apply to steroid doping. Natural levels of steroid hormones vary widely between people. Even within an individual they can fluctuate sharply, depending on stress, sleep deprivation and the like. And because a doping ban can be fatal to an athlete's career, anti-dopers must err on the side of caution. WADA's processes are tuned to minimise the number of false positives, in which innocent athletes are wrongly accused. That means they will generate plenty of false negatives, in which the guilty are incorrectly cleared.
塔克博士说，由于ABP追踪的是运动员的生理随时间的变化，所以这种自然差异是ABP难以应用于类固醇兴奋剂的原因之一。类固醇激素的自然水平因人而异，且差别很大。甚至在个体内部，它们也会因压力、睡眠不足等因素而急剧波动。由于禁药对运动员的职业生涯可能是致命的，反兴奋剂者必须慎之又慎。为避免在假阳性中无辜的运动员被错误指控，世界反兴奋剂机构调整其程序以尽量减少假阳性的数量。这意味着它们将产生大量的假阴性结果，其中有罪的人就成了漏网之鱼。
Money and national pride complicate things further. Though WADA oversees the anti-doping system for many sports, it relies on national authorities to do most of the legwork. "Many countries have really improved their approach to anti-doping over the past few years," says Dr Catlin. "But not everyone has the resources to do that." In 2013 Renee Anne Shirley, a former boss of the Jamaica Anti-Doping Commission, said a lack of resources meant her organisation had conducted only a single out-of-competition test in the months before the 2012 London Olympics, at which Jamaican athletes won a dozen medals. WADA itself is not exactly flush with cash. Its budget for 2021 is $40m—less than some individual athletes earn in a year.
金钱和民族自豪感使事情变得更加复杂。虽然世界反兴奋剂机构监督许多体育项目的反兴奋剂系统，但它需要依靠国家当局来做大部分的跑腿工作。卡特林博士说：“在过去几年里，许多国家确实改进了反兴奋剂方法，但并不是每个国家都有资源这么做。”2013年，牙买加反兴奋剂委员会前主席蕾妮·安妮·雪莉表示，由于资源缺乏，她的组织在2012年伦敦奥运会之前的几个月里只进行了一次赛外测试，而牙买加运动员在伦敦奥运会上赢得了12枚奖牌。世界反兴奋剂机构本身的现金也并不充裕。2021年它的预算是4000万美元——比一些运动员一年的收入还要少。
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