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Estimates of Infectious Disease Risk Factors in US Blood Donors
Alan E. Williams, PhD;
Ruth A. Thomson, MPH;
George B. Schreiber, DSc;
Kevin Watanabe, MS;
James Bethel, PhD;
Annie Lo, MS;
Steven H. Kleinman, MD;
Charles G. Hollingsworth, DrPH;
George J. Nemo, PhD
JAMA. 1997;277(12):967-972.
Abstract
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Objective.
—Individuals who do not respond accurately to questions about infectious disease risk factors at the time of blood donation represent a potential threat to the safety of the blood supply. This study was designed to estimate the prevalence of undetected behavioral and other risks in current blood donors.
Design.
—Anonymous mail surveys to collect demographic, medical, and behavioral information were administered to individuals who had donated blood within the previous 2 months. Sampling weights were used in the analysis to adjust for differential sampling and response rates among demographic groups to provide prevalence estimates for the donor population.
Setting.
—Five geographically and demographically diverse US blood centers.
Participants.
—A stratified probability sample of 50162 allogeneic blood donors.
Main Outcome Measures.
—Estimated prevalence rates for risk behaviors that would have been a basis for deferral if reported at the time of the donor screening interview (deferrable risk).
Results.
—Completed questionnaires were received for 34 726 donors (69.2% of the sample). A total of 186 per 10 000 respondents (1.9%) reported a deferrable risk that was present at the time of their past donation, while 39 per 10 000 (0.4%) reported this behavior within the 3 months prior to donation. Rates (with 95% confidence intervals [Cls]) of deferrable risk behaviors were 1.4 (95% CI, 1.2-1.6) times higher for men than women, 1.6 (95% CI, 1.3-2.0) times higher for first-time vs repeat donors, 2.7 (95% CI, 2.0-3.6) times higher for donors with reactive screening tests, and 7.6 (95% CI, 3.6-15.8) times higher for donors who used the confidential unit exclusion option.
Conclusions.
—Despite the high degree of transfusion 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.
Author Affiliations
for the Retrovirus Epidemiology Donor Study
From the American Red Cross Blood Services, Holland Laboratory, Rockville, Md, and the Greater Chesapeake and Potomac Region, Baltimore, Md (Dr Williams); Westat Inc, Rockville, Md (Drs Schreiber and Bethel, Mss Thompson and Lo, and Mr Watanabe); American Red Cross Blood Services, Southern California Region, Los Angeles (Dr Kleinman); and the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md (Drs Hollingsworth and Nemo).
Footnotes
A list of the Retrovirus Epidemiology Donor Study (REDS) staff members who contributed to this study appears at the end of this article.
Reprints: Alan E. Williams, PhD, American Red Cross Holland Laboratory, 15601 Crabbs Branch Way, Rockville, MD 20855.
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