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Good health is difficult to define, but certain associated parameters may be established from a brief medical history, observation and simple tests. Staff undertaking donor health and risk assessment should be well-trained in the observation of donor appearance and detection ld s of ill health.

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Regular ferritin measurement is a useful indicator for iron depletion in blood donors. Nevertheless, many BTS have an upper age limit of 60 years for first-time donors.

BP may be measured routinely for the purposes of health screening; however, the blood collection session is not gilr ideal setting for this. Menstruation is not a reason for deferral.

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Recommendation Prospective donors should be accepted only if they appear to be in good health and comply with donor selection criteria 4. Some of these concerns may be avoided by using low-dose iron preparations or carbonyl iron. Good health is difficult to define, but certain associated parameters may be established from a brief medical history, observation and simple tests.

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AGE 4. The upper age limit has been safely removed for regular blood donors in countries where healthy life expectancy is high 56616263 The interval before an apheresis platelet or plasma donation should be at least 4 weeks following a whole blood donation, an apheresis red cell donation or a failed return of red cells during apheresis However, women who report regular excessive menstrual bleeding and are found to have low haemoglobin levels should not donate blood and should be referred for medical assessment Donors should feel well on the day of donation and be able to perform their routine daily activities.

The lower limit of acceptable haemoglobin for blood donation should be set at a level that prevents the selection of anaemic individuals as blood donors and also minimizes the exclusion of healthy donors.

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If blood pressure is used as a selection criterion for blood donation, arbitrary acceptable limits of systolic BP of — mmHg and arbitrary acceptable limits of diastolic BP of 60—90 mmHg are suggested — Competence and experience of staff and their ability to perform techniques correctly 4. Adolescents of either gender are at risk of iron deficiency during the pubertal growth spurt when the average daily total requirement of absorbed elemental iron is 1. Plasma-rich blood components from multiparous women are more likely to cause TRALI and related disorders than those from males, because plasma from such women is likely to contain alloimmune-reactive antibodies; these include antibodies to human leucocyte antigens HLA or to human neutrophil antigens HNAwhich are transferred passively during transfusion, to the possible detriment of a recipient who possesses the corresponding antigen, They should be encouraged to return to donate when the anaemia has been successfully treated.

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There is now extensive published literature on the safety of blood donation in older individuals in both the allogeneic and autologous setting, indicating that vasovagal and other adverse reactions are infrequent in older donors who fulfil normal donor selection criteria 56575859 The age of 16 should therefore be an absolute lower limit for blood donation to ensure donor health and safety. Information about minor illnesses, exposure to communicable diseases, travel to disease endemic areas, pregnancy and lactation and medical and surgical interventions should be elicited so as to determine suitability for blood donation or the need for deferral.

They should have a sound mental status and not be under the influence of alcohol or drugs. A donation of ml of blood removes — mg of haem iron.

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Antecubital veins should be easily visible or palpable to enable proper venepuncture, thus avoiding any discomfort to the donor and minimizing the risk of major bruises or other soft tissue injury at the venepuncture site. Reducing the frequency of blood donation is likely to reduce the prevalence of iron deficiency among blood donorsas might implementing routine iron supplementation It is important to detect and manage the donation-induced iron depletion that inevitably accompanies regular blood donation Where possible, donors should have access to drinking water in the blood centre before donating.

Donors should be asked to confirm that they are free from such symptoms on the day of donation and that they have fully recovered from any recent infection s.

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Cor screening There are no rapid, simple and direct bedside methods for determining iron status. Iron supplementation of blood donors has been proposed for routine implementation and several pilot operational and clinical trials have been conducted Contracting and relaxing the muscles in the legs, arms and abdomen during donation may reduce the risk lookimg vasovagal reactions, particularly among female donors 9899, If a double red cell donation is given following whole blood donation, the interval should be 12 weeks for males and 16 weeks for females.

Accurate BP measurement requires the availability of calibrated equipment, suitable facilities, adequate time and appropriately skilled staff.

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In practice, this requires that plateletpheresis and plasmapheresis donors should weigh at least 50 kg. The more sophisticated red cell parameters on modern cell counters are even better forr of DIID onset, even possibly in the co-presence of thalassaemia trait, but are more expensive and usually not available at blood donation sites. Recommendation The BTS should consider providing ml drinking water to donors before donation to minimize the risk of vasovagal reactions 4.

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Hence, blood volume may be overestimated 69resulting in an increased risk of an adverse reaction. There is no evidence that minor infections such as common upper respiratory infections can be transmitted by transfusion, but it is nevertheless advisable as a precautionary measure to defer blood donation until any such infection has resolved If assistance is required, it should be provided by a staff member or kooking independent person and not a family member or friend.

Recommendations The BTS lokking encourage donors to practise applied muscle tension during blood donation Accept Female donors during menstruation, provided that they feel well and meet the minimum haemoglobin lookign for blood donation Defer Female donors during pregnancy and up to 6 months after delivery or termination of pregnancy Female donors during lactation 4.

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Pregnancy, lactation and menstruation The average woman needs about — mg additional iron to maintain iron balance during pregnancy 54 Upper age limit Upper age limits for blood donation of between 60 and 70 years have been implemented in the past because of concerns regarding the increasing incidence of cardiovascular disease with age and the potential risk of adverse reactions, which are more likely in first-time donors.

Staff undertaking donor health and risk assessment should be well-trained in the observation of donor appearance and detection of s of ill health. Low body weight ,ooking low blood volume have been shown to be independent predictors for vasovagal reactions 50 The average amount of stored iron ferritin and haemosiderin in a woman of reproductive age in the developed world is about mg; hence, the donation of a unit of blood requires the subsequent fl of much or all of this reserve Adolescents of both sexes are also at risk of iron deficiency during the pubertal growth spurt, when the average daily total requirement of dietary elemental iron to be absorbed is 1.

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The onset of DIID fpr be determined using full blood cell counts and red cell indices, including red blood cell distribution width RDWwhen measured serially in healthy donors from populations with a low prevalence of inherited conditions such as thalassaemia trait. Donors with sight or hearing impairment may be accepted provided clear and confidential communication can be established.

Body temperature A prospective donor who is febrile — defined as a core oral temperature more than The birl to detect ificant abnormalities of pulse rate or rhythm depends on the skill and experience of staff.

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However, a systematic review of the literature found no evidence that raised baseline blood pressure, treated hypertension or low blood pressure were predictive of increased adverse reactions, although the level of evidence was limited Fever can indicate any of medical conditions and lolking, but is usually associated with other symptoms also refer to Section 4.

The reasons for any obvious rapid weight loss should be ascertained.

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WEIGHT It is important to set weight limits for blood donation to protect donors from adverse effects, in particular vasovagal episodes and anaemia.

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