FOR RELEASE: 3 p.m. (CT) Tuesday, March 25, 1997 Media Advisory: To contact Alan E. Williams, Ph.D., call Don Kirchoffner at 703/807-5253.
Some Blood Donors Still Fail to Report Risk Factors Study suggests need for further refinements in blood donor process
Despite the high degree of transfusion safety in the United States today, a measurable percentage of blood donors still hold back reporting risk factors at the time of donation, according to an article in this week's issue of The Journal of the American Medical Association (JAMA).
Alan E. Williams, Ph.D., of the American Red Cross Blood Services, Holland Laboratory and Greater Chesapeake and Potomac Region, Baltimore, Md., and colleagues surveyed 50,162 donors at blood centers in Detroit, San Francisco, Los Angeles, Oklahoma City, and in the Baltimore/Washington D.C. area. Anonymous mail surveys were used to collect demographic, medical and behavioral information from donors who had given blood within the previous two months. A total of 34,726 donors (69.2 percent) completed and returned the anonymous questionnaires.
The researchers write: "Despite the high degree of safety in the United States today, a measurable percentage of active blood donors when assessed by anonymous survey report risks for human immunodeficiency virus and other infections not reported at the time of screening, suggesting the need for further refinements in the blood donor qualification process."
They found: "A total of 186 per 10,000 (1.9 percent) respondents reported a deferrable risk that was present at the time of their past donation, while 39 per 10,000 (0.4 percent) reported this behavior within the three months prior to donation." Men were 1.4 times more likely to report a risk than women.
The risk factors include injection drug use, sex with a known injection drug user, sex with a man who has ever had sex with another man, sex with a male or female prostitute, men having sex with other men since 1977, a history of syphilis or gonorrhea in the past year, and a history of blood transfusion or needle sticks in the past year.
All donated blood is tested for seven infectious disease factors, including HIV antibodies, before it is released for transfusions. But the researchers write: "Our study shows that only 8.2 percent of those who reported risks were screened out by laboratory testing."
Laboratory testing is part of the multi layer system designed to screen donated blood for HIV, hepatitis B and C, syphilis and other infections that can be transmitted by blood. The process includes a voluntary blood donor pool to eliminate those who would donate primarily for money, and intensive donor and history based screening procedures at U.S. blood centers.
Confidential unit exclusion (CUE) and call back procedures allow donors who believe they are at risk, and may have given blood under peer pressure, to indicate later that their blood might not be suitable for transfusion.
The combination of donor screening and laboratory testing has reduced the residual risk of transmitting HIV through blood transfusion to an estimated current level of two per one million units.
The researchers write: "Our study demonstrates a low level of behavioral risk that is not eliminated through the combination of oral questioning, laboratory screening, and CUE procedures."
But they point out that the behavioral risks reported by accepted blood donors are five to ten fold less than the same risks reported among the general population, as indicated by other studies. They suggest this is "presumably due, at least in part, to the combined battery of donor screening procedures."
They conclude: "While the prevalence of deferrable risk factors in blood donors is low, the public health consequences of these observations are substantial considering the fact that 12 million donations ... are drawn annually in the United States, and that these risk factors may be associated with a range of transfusion transmissible agents ... not just HIV."
# For more information: contact the AMA's Science News Department at 312/464 5374. AMA web site: http://www.ama assn.org
RSS