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• articles where the exact composition of analyzed IPEDs is not provided by the author • peer-reviewed original articles with full-text available Disagreements in study eligibility, data extraction, and quality assessment were resolved by consensus between the two reviewers. Quality assessment for bias of analytical studies was conducted using the ToxRtool for in-vitro studies and was assessed by two reviewers (RM and PB) independently. Furthermore, we continued pursuing relevant references to articles and manually tracked electronic citations related to the topic in order to identify sources in obscure locations, also called the snow-ball method .
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Rather, those products are produced in clandestine underground laboratories lacking the necessary knowledge or equipment to produce these compounds in adequate quantity and quality, as also described by other authors 26, 35, 38. Substandard and counterfeit products found in our systematic review were most likely produced by manufacturers not in line with good manufacturing practices (GMP’s) . In Europe, AAS from the black market appear to be more likely to be substituted and less likely to be inert, but also less likely to be over-concentrated compared to Brazil. But in addition, products that contain the labeled substances can still be over-concentrated or under-concentrated.
Analytical methods can vary considerably in terms of instrumentation cost, analysis time, and identification and quantification software. We demonstrate that visual inspection of the package, label, and internal content to identify preliminary signs of counterfeiting of AAS have shown to be mostly ineffective. Interestingly, this systematic review showed significant differences between the two included world regions. AAS were the most dominant group within all analyzed products, and they were almost exclusively analyzed within the WADA class S1. Some authors assessed visual inspection of packaging and detection of counterfeiting rate with contradicting results.
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