As one poster said, the blood supply often isn’t distributed effectively. Your area could be in shortage while across the nation they are fine.
Or it could be a specific type they are after or such. Usually in Chicago, the new is good at saying when the local blood supply is short and then after they say it is, the people donate quickly.
Well, you’ve got to pay for:
-The phlebotomists/nurses who screen donors and take the blood
-The blood collection unit thing with it’s satellite bags (any kind of medical equipment/consumable is hideously expensive)
-The couriers to get the blood to the processing centre in time
-The tech time to manipulate the blood into it’s component parts (spinning down, expressing plasma off, making platelet units, cryoprecipitate, etc)
-The cost of reagents, equipment and techs to test for all the things they test for (blood type, syphilis, hepatitis, HIV, HTLV, CMV, west nile, etc.)
-The cost of tech time (and reagents) to phenotype blood for recipients with antibodies
-Transportation costs to get the blood where it needs to go
-I’m sure there’s other things I’m not thinking about
Also, I would think that ‘risk groups’ are not based arbitrarily; rather they’re based on statistical models of populations. If Haitians (or Grenovians, or whoever) statistically have higher rates of infection for disease X, that’s why they’re deferred, not because we don’t like Haitians (or ‘race y’). In Canada at least, anyone who’s been to the UK for (some period of time, a month or something) ever since (some year, like 1980) is permanently deferred. Is this overcautious? Certainly. Better safe than sorry. If it was you getting transfused I’m sure you’d agree that extraordinary measures should be taken to ensure the safety of the blood supply and probably more importantly, the public perception of the safety of the blood supply. (see also: HCV and Red Cross in Canada in the early 90s)
They are arbitrary (not that all of the questions are arbitrary but some are) in the sense of 1) Based on broad categories of humans instead of specific behavior (Haitians, gays) 2) Overturned in some cases (Haitians) but not others (gays) for merely political reasons 3) Ignores obvious risk categories especially those to do with behaviors 4) Gives the false impression that anyone who isn’t screened out is automatically safe
I’m actually more concerned about the potential for infection having given blood and knowing what their screening process is. I’d rather they assume that anyone could be a potential problem and screen all of the blood. Or at least base it on specific risky behaviors rather than categories of people.
This is true in the United States also.
They do screen all the blood for diseases. The questions and screening process are in place to try and eliminate some of the donors more likely to test positive for things and thus not waste everyone’s time and energy. Cheaper to just not draw someone’s blood for donation than to have them test positive further down the line. As the situation changes, the requirements and restrictions will change. If the need ever got really extreme, they may decide to look at a few questions and figure out the risk/benefit to the population if they dropped them.
About the constant “situation is critical” message you often hear at blood drives… it’s mostly because there’s a need for a constant flow of donations to maintain inventory. Blood’s only good for about 40 days, depending on the anticoagulant used. Also, levels of certain blood types can get pretty low - lately it’s harder to get Bneg units from the Red Cross than it is to get the precious Onegs. Also, there are some patients who have developed antibodies and need specially matched blood for their safety, and having a wider donor pool gives us more units to look through. We had a patient whose surgery was delayed for two weeks because we couldn’t find compatible blood, even with a call put out to the reference lab. We finally got some shipped in from Montana.
jackdavinci writes:
> But that principle has nothing to do with knowing less than the people who
> make the rules, since some of the rules are beyond ridiculous to anyone with
> half a brain or common sense.
The world does not need another person who thinks that they are smarter than the people who make the rules, even though they don’t have all the facts that the people who make the rules have. People who are absolutely convinced that they are smarter than the people in charge are dangerous. The people who make the rules have looked at all the facts. It’s possible of course that they have incorrectly interpreted those facts, since anybody can make a mistake when there is a large, complicated set of facts, but that doesn’t make them stupid. I don’t trust anybody who’s convinced that the people making the rules lack common sense or are stupid.
Not to mention the fact that it’s simply absurd to think that there are people who sit around dreaming up ways to exclude perfectly good donations. Reasonable people can (and do) discuss and debate what specific restrictions should be in place, of course, but the rules aren’t arbitrary, homophobic, racist or whatever.
A lot of rules are stupid and it’s not wrong to question them.
But the missing fact in the issue of blood donation is that they simply don’t need blood all that much.
OTOH, there’s no reason they couldn’t ask “do you have anal sex” instead of “are you gay.”
At least in Canada that is included in the question ‘Have you had sex with …’. So, the questions are along this lines of:
…
Males: Have you had sex with a man since 1977?
…
All: Have you had sex with someone who has done any of the above
So there’s no question about the respondent being gay (not a risk factor) but there is one about having sex with another male (a risk factor).
Sex is defined as (source: http://www.bloodservices.ca/CentreApps/Internet/UW_V502_MainEngine.nsf/resources/Blood+Donation/$file/WYMKTGBlood08.pdf ):
Sex refers to any of the following activities even if a condom or barrier device was used:
Also, you can test blood all you want and some of the units are going to have test negative for (disease x) yet are still capable of transmitting (disease x) due to the window period.
The window period varies based on the typical time needed to seroconvert (which varies by disease and by individual immune response) and the technology used in the testing method.
So the idea is to automatically exclude any group whose lifestyle puts them at higher risk for those diseases.
ANNNNND…gay men are at higher risk for HIV infection. It irritates me when people say that excluding gay men from blood donation is a ‘political decision’. Cite.
What if they’re a gay man that hasn’t had sex since, say 1980? Is there any conceivable way the “window period” could be 29 years?
I could understand if they had a ban on donating blood if you had gay sex in the last 6 months, or a year, or even a couple years. But a blanket ban since 1977? How does that make sense?
My guess would be that the 1977 restriction is because it was around that time that the AIDS epidemic started to take off. Conceivably, if you had sex with another man any time since 1977 you could’ve gotten HIV and never known it. Besides the window period, no test is 100% reliable 100% of the time. If you start allowing high risk groups into your donor pool, it is a certainty that more units would make it through that tested negative that in actuality carried infectious disease. The current estimated risk per blood unit in Canada as a whole is 1 in 913 000 with current restrictions in place.Cite. We should strive to make that risk as low as possible while balancing the needs of blood demand.
Alas, yes, and I ran afoul of it. I, who donated blood as often as I could for many years (once to the point that I became borderline anemic, despite following the guidelines for frequency of donations, and my doctor suggested I give a little less often). Then the Red Cross changed its rules and anyone who’d spent more than a cumulative six months in the U.K. since 1980, I think it was, is now disqualified from giving blood due to fear of Mad Cow Disease. That included me. So now I can’t donate, and I have to admit, it irritates the hell out of me to hear all the radio announcements of “blood emergencies.” Seems like an arbitrary rule for a remote risk of disease, and there’s still no premortem test for MCD.
OK, this may be a stupid question with a simple answer I’m just not seeing, but, if having spent 1+ months in the UK makes you ineligible to donate, how do people in the UK donate blood? Is there blood donation there?
Yes. They have blood there from local donors, but it (presumably) carries a higher risk of CJD transmission. They have to accept that risk. US and Canada do not.
I think I may have chosen the wrong word when I used doctors, and I guess its really the decision makers who placed her on the list of people who are not allowed to donate. She is part of a group of people who they won’t accept donations from, and she is on somewhat of a crusade to be allowed to donate. I’m almost positive she doesn’t lie to try to get her donations accepted, and instead tries to donate “the right way” when they have a blood drive, and is almost always rejected. I don’t know all the details about the process for donating blood, but I think she basically will go down there with the “intent” to donate (probably knowing full well she’ll be refused), completes the survey or whatever tests they do, and be rejected. I think she is pretty much trying to make a point and she wants to be allowed to donate with full disclosure, and is not trying to fool anyone.
I guess I asked the question about how necessary the donations are, because I think in her mind they are hurting themselves (and therefore patients in need of blood) by refusing her donations, but it sounds from this thread like they really almost always have more than enough to go around. It sounds like whether or not their reasons for excluding her are valid or not is pretty much irrelevant, since they really don’t need her donation (or those from her group) at all, and can afford to err on the side of caution.
Going to the blood donation centre and trying to convince the people there that she should be eligible to donate is like going to the DMV after the courts take your licence away and trying to convince the clerks there to give you another one. Blood policy is drafted by committee at the national level. The people who collect the blood have absolutely zero leeway in applying policy.
Of course you’re right, but that lady is my new heroine.
This always struck me as funny. How do people in the UK get their blood? Are they not allowed to donate because their blood sucks?
I always have to go through with this whenever I donate, since I was in the Navy, and spent a small amount of time in Europe on port calls. They ask if I have ever spent time in a few countries, one of which is the UK, and I say yes, then we have to determine how much time I spent there, which is always determined to within an acceptable limit. Every time. Its quite annoying.
I would love to ask the nurses what, exactly, they think people from the UK are up too, but I refrain since its not their decision. and they surely don’t need the headache. I’ll keep going though, since they like my O-neg.