Director, Data Science American Red Cross Scientific Affairs Belmont, Massachusetts, United States
Background/Case Studies: Iron supplementation (IS) improves recovery kinetics of both iron stores and hemoglobin, supporting donor health and donation fitness. Use of IS is not part of routine blood donor screening in the United States, and relatively little is known about donor IS practices and their ability to accurately report such practices at the donation site. As Blood Collection Organizations (BCO) evaluate the feasibility and impact of personalized donation intervals, an important consideration may be whether donors take exogenous iron and the accuracy of self-reporting.
Study
Design/Methods: Blood donors in a large regional BCO were routinely queried during online completion of the donor health history about use of multivitamins (MV), whether they contain iron, and use of separate iron supplement pills (IP). Donors between August 2021 and December 2022 who reported taking MV or IP were sent a new electronic survey asking them to confirm regular intake of MV or IP, provide the brand name, and to either transcribe the iron content or upload a photo of the MV or IP bottle label. Donors were asked to complete the survey at home with their pill bottles at hand and completed the survey only once. Responses and images were reviewed manually using standardized procedures. Eligibility was restricted to successful donations for linkage to drawn units, and the study was approved by the BCO’s Institutional Review Board.
Results/Findings: Among 46970 donors completing the initial survey, 10579 had an email on file, reported regularly taking MV or IP, and were invited to the follow-up survey. Among 3331 (31%) respondents, 1933 (58%) donors were evaluable with complete responses. Of 512 subjects reporting use of IP at initial survey, 76% also reported regularly taking IP at the follow-up survey. In contrast, among 734 subjects reporting iron use in the form of MV at initial survey a narrow majority of 51% reported taking MV with iron in the follow-up survey (Table 1). A near-majority of these 734 subjects (41%) reported no longer taking MV or confirmed it contained no iron. Relatively few subjects reporting MV without iron at initial survey (9% of 555) or uncertain of their MV iron content (16% of 257) confirmed taking MV containing iron at follow-up. Total responses for MV or IP at follow-up exceed 1933 because some subjects reported taking both products. Conclusions: Blood donor use of exogenous iron is one of the few modifiable factors with a substantial impact on recovery of hemoglobin and iron stores following a blood donation. Protection of donor health and avoidance of low hemoglobin deferrals would benefit from incorporating supplemental iron use into machine learning algorithms guiding personalized donation intervals, but model performance may not be adequate if the quality of self-reported iron-taking is insufficient.
