Injury and Poisoning Profile in Anabolic Steroid Users.

Windfeld-Mathiasen, Josefine; Tulstrup, Morten; Heerfordt, Ida M; Dalhoff, Kim P; Andersen, Jon T; Horwitz, Henrik · Ann Emerg Med · 2025

prospective_cohort · Level II

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Abstract

This study investigated the 1-year risk of injuries and poisonings among anabolic androgenic steroid users compared with controls from the general population. In a cohort study conducted in Denmark, 1,189 anabolic androgenic steroid users were identified through a national antidoping program and matched with 59,450 controls. Participants were followed for 1 year. Data on hospital contacts, educational length, and occupational status were retrieved from nationwide registries. The primary outcomes were the incidence of injuries and poisonings. The secondary outcomes differentiated between fracture and nonfracture injuries, and medicinal versus nonmedicinal causes of poisonings, and described specific causes of injury-related hospital contacts. Anabolic androgenic steroid users had significantly higher incidences of injuries and poisonings compared with controls. The risk difference for any injury was 7.8% (95% confidence interval [CI] 5.5 to 10.2) and the adjusted hazard ratio (aHR) was 1.46 (95% CI 1.29 to 1.66). Specifically, the risk of fractures was more than doubled among anabolic androgenic steroid users (aHR of 2.23, 95% CI 1.72 to 2.89), with head injuries being particularly prevalent. The risk difference for any poisoning was 1.2% (95% CI 0.5 to 1.9) and the aHR was 2.98 (95% CI 1.82 to 4.90). Medicinal poisoning was the most common poisoning among anabolic androgenic steroid users, with an aHR of 3.53 (95% CI 1.94 to 6.41). Anabolic androgenic steroid use is associated with an increased risk of both injuries and poisonings, thereby quantifying a substantial risk of external harm among users.

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