Iron supplementation by blood donors: demographics, patterns of use, and motivation

Cable, Ritchard G.; Spencer, Bryan R.

doi:10.1111/trf.15407

Cited by 11 publications

(17 citation statements)

References 16 publications

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“…One limitation of CHILL is that dietary iron consumption and use of multivitamins and iron supplements were not measured. One previous study found donors aged 17 to 25 were less than one-half as likely to report use of supplemental iron as older age groups (8% vs. 18%-30%), 26 a finding consistent with population-based surveys. 27 It may be that younger donors in CHILL were less likely to take iron supplementation, putting them at increased risk of NAID or IDA, and such behavioral differences might partly confound the reported associations with age.…”

Section: Discussionsupporting

confidence: 70%

Elevated risk for iron depletion in high‐school age blood donors

et al. 2019

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BACKGROUND High school students 16 to 18 years‐old contribute 10% of the US blood supply. Mitigating iron depletion in these donors is important because they continue to undergo physical and neurocognitive development. STUDY DESIGN AND METHODS Study objectives were to determine the prevalence of iron depletion in 16‐ to 18‐year‐old donors and whether their risk for iron depletion was greater than adult donors. Successful, age‐eligible donors were enrolled from high school blood drives at two large US blood centers. Plasma ferritin testing was performed with ferritin less than 12 ng/mL as our primary measure of iron depletion and ferritin less than 26 ng/mL a secondary measure. Multivariable repeated‐measures logistic regression models evaluated the role of age and other demographic/donation factors. RESULTS Ferritin was measured from 4265 enrollment donations September to November 2015 and 1954 follow‐up donations through May 2016. At enrollment, prevalence of ferritin less than 12 ng/mL in teenagers was 1% in males and 18% in females making their first blood donation, and 8% in males and 33% in females with prior donations. Adjusted odds for ferritin less than 12 ng/mL were 2.1 to 2.8 times greater in 16‐ to 18‐year‐olds than in 19‐ to 49‐year‐olds, and for ferritin less than 26 ng/mL were 3.3‐ to 4.7‐fold higher in 16‐ to 18‐year‐olds. Progression to hemoglobin deferral was twice as likely in 16‐ to 18‐year‐old versus 19‐ to 49‐year‐old females. CONCLUSION Age 16 to 18 years‐old is an independent risk factor for iron deficiency in blood donors at any donation frequency. Blood centers should implement alternate eligibility criteria or additional safety measures to protect teenage donors from iron depletion.

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Section: Discussionsupporting

confidence: 70%

Elevated risk for iron depletion in high‐school age blood donors

et al. 2019

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“…The cross‐sectional data collection does not allow for identifiability of potential confounding by indication, and we did not elicit donor motivations for iron supplementation or gastric acid reducing medications. It is possible that some donors had recently initiated iron supplementation in response to blood center messaging, but available evidence indicates a large majority of donors either do not supplement with iron (80%) or report motivations for supplementation unrelated to blood donation (10%), suggesting negligible to modest impact . Finally, these findings do not address the clinical relevance of specific ferritin levels in the absence of anemia.…”

Section: Discussionmentioning

confidence: 99%

Iron status and risk factors for iron depletion in a racially/ethnically diverse blood donor population

et al. 2019

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I ron depletion (ID) is common in blood donors, with estimated prevalence of intermediate ID (ferritin <26 ng/mL) of 33% to 40% in United States and Canadian donors. 1,2 Other jurisdictions have also found high rates of ID in their donor populations. [3][4][5] No US blood center uniformly tests the iron status of all donors and little systematic testing is performed elsewhere, 6,7 but donor age, sex, and donation frequency are routinely documented risk factors for ID. [2][3][4][5][8][9][10][11] Iron deficiency, particularly with concurrent anemia, has been associated with a number of adverse outcomes, including cognitive dysfunction, fatigue, decreased exercise endurance, pica, and pregnancy-related complications. 12 This study identifies similarities and ABBREVIATIONS: AIS = absent iron stores; ID = iron depletion; LF = low ferritin; NHW = non-Hispanic white.

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“…Another reflection of the subjects' high commitment is their reported iron supplementation practices, both at baseline and in response to the LF letters. The proportion of platelet donors reporting iron supplementation surpassed 30% of those who provided information, far beyond the 21% of whole blood donors, from a recently reported study of one ARC region, who said they took iron regularly . Also, the survey findings that nearly two‐thirds of donors receiving the LF letter responded by taking iron both confirms donor willingness to take steps to maintain fitness for donation and suggests that ferritin testing can, within certain contexts at least, promote donor retention and stable platelet collections.…”

Section: Discussionmentioning

confidence: 91%

“…Platelet donations were grouped in increments of four procedures, which, based on our internal procedures, is roughly equivalent to one whole blood donation (estimated RBC loss for plateletpheresis with reinfusion is 54 mL). A brief, five‐question paper survey on iron supplementation practices was administered in participating regions during the study period, but completion was voluntary and not required for donation. The prevalence of LF, AIS, and associated risk factors were assessed at the first plateletpheresis visit tested for ferritin during the study period.…”

Section: Methodsmentioning

confidence: 99%

Prevalence, risk factors, and ferritin testing to mitigate iron depletion in male plateletpheresis donors

et al. 2020

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BACKGROUND Most single‐donor platelet (SDP) donors transition to plateletpheresis after prior red blood cell (RBC) donation. Recruitment may follow identification of a high platelet count, a marker associated with iron depletion (ID). SDP donors may have underrecognized risk for iron depletion. STUDY DESIGN AND METHODS To assess the prevalence of ID, we performed ferritin testing on male plateletpheresis donors with hemoglobin levels less than 13.5 g/dL. Multivariable logistic regression identified risk factors for low ferritin (LF; ferritin ≤26 ng/mL) and absent iron stores (AIS; ferritin <12 ng/mL). To assess the impact of notifying donors of LF results, we compared donation behavior of “Test” subjects before and after sending an LF notification letter to that of “Control” subjects before and after increasing the minimum hemoglobin for male donors. An electronic survey to Test donors inquired about iron supplementation practices. RESULTS Prevalence of LF was 50% and AIS was 23%, with increase in risk associated with more frequent SDP donation, both controlling for RBC donation and in donors with no recent RBC donations. Donation frequency after intervention declined less in 1272 Test donors (19%, from 13.9 to 11.2 annualized donations) than in 878 Control donors (49%, from 12.3 to 6.3 donations). Only 20% of Test donors reported taking supplemental iron when they received the LF letter; 64% of those not taking iron initiated iron supplementation following the letter. CONCLUSIONS Donors were responsive to notification of LF and attendant messaging on iron supplementation. Ferritin testing potentially benefits donor health and a stable platelet supply.

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Iron supplementation by blood donors: demographics, patterns of use, and motivation

Cited by 11 publications

References 16 publications

Elevated risk for iron depletion in high‐school age blood donors

Elevated risk for iron depletion in high‐school age blood donors

Iron status and risk factors for iron depletion in a racially/ethnically diverse blood donor population

Prevalence, risk factors, and ferritin testing to mitigate iron depletion in male plateletpheresis donors

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