USA: Increased risk of iron deficiency in young blood donors

A study that adolescent blood donors may be at risk of developing low iron levels and anemia as a result of the donation process. This may have considerable consequences as adolescents' brains are still developing.

Researchers call for better safety precautions for blood donations

Adolescent blood donors suffer from a higher risk of developing low iron levels and anemia resulting from iron deficiency than adult women. A study now shows that this side effect of donating blood could have considerable consequences for the adolescent brain, which is still in development.

Researchers at the John Hopkins University School of Medicine, USA, found that blood donation can lead to an increased risk of iron deficiency because 200 to 250mg of iron is removed per donation. The study found that the lower blood volume in adolescents would result in a higher loss of hemoglobin and iron, which would result in less oxygen entering the brain. Young female donors would have an even greater risk of iron deficiency due to menstruation.

The study leaders, Dr. Eshan Patel, and Dr. Aaron Tobian stated that no previous study had investigated the link between iron deficiency and the resulting anemia in blood donors and non-donors, especially adolescents. Until the end of the study, the research team examined data from the long-term National Health and Nutrition Examination study. For this study, blood samples were collected from 1999 to 2010 and questions about personal blood donation history were collected during the last year.

Lower iron indicators compared to non-donors

The researchers examined a total of 9,647 blood donors aged 16 to 49, of whom 2,419 were adolescents aged 16 to 19. Serum ferritin levels were significantly lower among blood donors than among non-donors, both adolescents and adults.

The incidence of iron deficiency was 9.5% among young donors and 7.9% among adult donors. Although these figures are low, they are significantly higher compared to non-donors, who have an iron deficiency incidence of 6.1%. In addition, 22.6% of adolescents and 18.3% of the adults in the donor group had deficient iron reserves. The authors of the study point out that their results clearly substantiate the susceptibility of young blood donors to iron deficiency.

Patel and Tobian note that despite existing precautions and regulations, more protective measures are needed for young donors. For this, they suggest iron supplements, a longer interval between blood donations or the donation of other blood products to reduce iron loss. Dr. Tobian notes: "We are not saying that suitable donors should not donate blood. There are already enough problems due to a lack of blood supply. However, new regulations or accreditation standards could make blood donations for young donors even safer."

Eshan U. Patel, Jodie L. White, Evan M. Bloch, Mary K. Grabowski, Eric A. Gehrie, Parvez M. Lokhandwala, Patricia A. R. Brunker, Ruchika Goel, Beth H. Shaz, Paul M. Ness, Aaron A. R. Tobian. Association of blood donation with iron deficiency among adolescent and adult females in the United States: a nationally representative study. Transfusion, 2019; DOI: 10.1111/trf.15179