Drug use histories and screening questions:a significant challenge

Sexual behaviour of Croatian blood donors as a threat to the health of blood recipients

BACKGROUND

In this cross-sectional study we assessed the prevalence of the various blood safety sexual risk behaviours among blood donors from East Croatia and the possibilities for improving the present blood donor screening procedure.

MATERIALS AND METHODS

The study included 423 blood donors of both sexes who completed a specially designed anonymous questionnaire immediately after their blood donations. The questionnaire contained questions on demographic data, sexual preferences, and possible sexual risk behaviours in the period before the blood donation.

RESULTS

The study revealed that the most common forms of sexual risk behaviour among Croatian blood donors had been irregular condom use during sexual contacts with new partners (294/423; 69.5%) and five or more sexual partners during the lifetime (213/423; 50.4%). More male than female subjects had had five or more sexual partners during their lifetime (p<0.0001). Compared to married donors, single subjects more frequently reported sexual contacts without using a condom with their new partners in the period from the last blood donation (p<0.0001) and also in the period of 1 month before current blood donation (p=0.0060). A larger number of younger than older subjects had practiced different types of sexual intercourses during the lifetime (p=0.0002) but more older than younger subjects reported irregular use of condom on sexual contacts with a new partner during their lifetime (p=0.0231).

CONCLUSION

Blood donors who were involved in various forms of sexual risk behaviour represent a serious threat to the health of blood recipients. In this respect a new approach to blood donor screening procedure with additional questions on sexual behaviour in anonymous donor questionnaires would improve the safety of transfusion treatment in East Croatia.

Does blood donor history accurately reflect the use of prescription medications? A comparison of donor history and serum toxicologic analysis

BACKGROUND

Blood donor screening is performed to accomplish several goals, including donor safety during collection and recipient safety during transfusion. Donors taking certain medications such as teratogens or platelet-inhibiting drugs are deferred from donation. Studies investigating the accuracy of the donor history are limited and only provide data on select groups of drugs. This study compares the results of an extended serum toxicology analysis to the medication use reported on the donor questionnaire.

STUDY DESIGN AND METHODS

Whole-blood samples were collected from 108 volunteer blood donors. A serum toxicology analysis was performed with high-performance liquid chromatography with photodiode array detection. The results were compared to those reported on the donor history questionnaire.

RESULTS

The medication history was consistent with the reported medications in 96 (89%) donors. Serum toxicology testing detected medications that were not reported on the donor history form in 12 (11%) donors. Most of the donors who did not accurately report their medication use (8 or 67%) were taking psychotropic medications.

CONCLUSION

Eleven percent of the donors did not fully disclose their recent medication history. Although none of the omitted medications would have been grounds for deferral, the finding of underreporting questions the reliability of donor screening. Despite a negative medication history, blood donor centers cannot assume that donors are medication-free. This study reveals a bias to omit psychotropic medications such as antidepressants and anxiolytics.

Prevalence of illicit drug use in plasmapheresis donors

BACKGROUND AND OBJECTIVES

No data are presently available concerning the frequency of illicit drug use in plasmapheresis donors. We therefore examined source plasma units produced in the United States (US) and in Germany for evidence of illicit drug use among donors.

MATERIALS AND METHODS

Seventy-five US plasma units from 10 different US states and 75 German plasma units that had been analysed principally for their protein composition were screened for drugs. Determinations were made, using automated immunoassays, of the presence of cannabis, cocaine, amphetamine, methamphetamine, methylenedioxymethamphetamine (MDMA), methylenedioxyethylamphetamine (MDE) and opiates. Positive results were confirmed by gas chromatography-mass spectrometry.

RESULTS

Eleven US plasma units were found to be positive for cocaine (14.6%), whereas all German samples were cocaine negative (P = 0.0007). Fifteen US plasma units (20%) and one German unit (1.3%) were confirmed as positive for cannabis (P = 0.0003). Three out of 75 US plasma units were positive for both cannabis and cocaine. In none of the 150 samples were amphetamine, methamphetamine, MDMA, MDE or opiates detected.

CONCLUSIONS

Our results strongly suggest differences in cocaine and cannabis consumption between US and German plasmapheresis donors. If these results are confirmed by larger-scale studies, random drug screening (including cocaine) of donors should be implemented in order to reduce the number of drug-containing plasma units, especially in the USA.