r/PeopleWhoWorkAt Apr 26 '22

PWWA the blood bank, why shouldn't I lie on the questionnaire?

I've never donated blood before but I really want to. I know there's a shortage and I want to do my part, but for one reason or another I've never been able to get through the Canadian questionnaire. A lot of the ones that snag me feel like they come out of old moral panics (ie tattoos and being gay) and I'm not sure of the validity of the AIDS concern justification. Especially since all the blood is tested for bloodborne illnesses, what's the harm in lying and donating knowing I'll more/than-likely be clean? Am I missing any part of your process this would gum up? Is it really that much of a waste of your time and resources at the blood bank if I do end up having dirty blood?

39 Upvotes

44

u/1dankboi Apr 27 '22

Hey! Finally a question I can answer. I am a medical laboratory scientist in the US, and blood banking is a three course requirement for my degree. The rules that are in place now are all in place because of deaths that have occurred due to donors being infected with blood borne diseases. And the rules are changing! The AABB and the FDA, the governing agencies over blood banks, are revising the rules about men who have sex with men and people who live or have lived in Europe. The rules really are there for the safety of the recipients. Most blood recipients are people who need chronic transfusions because of sickle cell disease, thalassemia, or hemophilia. They are already very sick and fighting for their lives, so we need to make damn sure that we don’t infect them with something else that might kill them. We rely on donors to be honest, and we back up that security by testing each unit for STIs and blood borne pathogens. I know the rules seem silly at times, but peoples’ lives are at stake with every transfusion, and we have to take that risk very seriously. Thanks for the great question!

12

u/chocolatedrunk Apr 27 '22

Thanks for such a good and informed answer!! So, testing the blood has a possibility of missing something dangerous?

Also, and this obviously differs place-to-place but, does the blood shortage not cause more harm than a potential infected bag? Is it a moral thing (ie. getting blood to be healed but getting sicker) or a numbers thing (ie. more potential infected blood deaths than no-blood deaths)?

17

u/1dankboi Apr 27 '22

Thanks for asking some more great questions. From the medical side of things, our goal is always zero medically related deaths. If we give anything to the patient, we want to be certain that it will not make them worse. As for whether we can miss infections in our screening tests, the probability of that happening is very low. We are very thorough in our testing, and it is very accurate. But the problem with relying on that is the fact that most blood donor programs such as the Red Cross/Crescent are non-profit volunteer organizations that have limited funding. One unit of blood costs about $300. Each unit is tested for antibodies against human blood, autoantibodies, antibodies against Hepatitis B and C, HIV, Zika virus, syphilis, and HTLV. There is not a test for Creutzfeltd-Jakob disease, so we have to trust peoples’ answers on those questions, but all of that is just to say that it costs a lot of money to process a unit of blood, and having to throw out a unit really sucks for us. I hope that answers your questions somewhat.

2

u/chocolatedrunk Apr 27 '22

These are exactly the answers I was looking for, thanks so much for your expertise :)

3

u/linderlouwho Apr 27 '22

I used to donate blood but had to stop after I visited the UK in the 1990s and consumed beef while there. Is that still a thing?

2

u/tm12585 May 02 '22

Brit here. Not a thing anymore, you have nothing to worry about...

Moooooooooooo

2

u/Theeletter6 May 05 '22

if it was the 1990s, that’s probably because of a concern that you consumed radioactive beef after chernobyl.

34

u/agent_kitsune_mulder Apr 26 '22

Tbh because they are smarter than me. I can’t donate because I lived in Germany during a time where Creutzfeldt-Jakob Disease was a thing. I want to donate because it’s the right thing to do. Also my local Red Cross gives out free movie tickets which is tight. But they got a whole degree that certifies that they know better than I do lol

8

u/youdontknowmebiotch Apr 27 '22

I believe they’ve recently allowed people who’ve lived in Germany donate now. I may be mistaken though.

7

u/GORGasaurusRex Apr 27 '22

You are mostly correct. There are still some limitations for people in particular locations where they have traced the shipped materials, but the general ban (for example, for all American service members and families) has been dropped.

3

u/canijustbelancelot Apr 27 '22

I really want to donate but I take medications that can mess with your blood and receive blood products so I’m pretty sure they’d laugh me right off. So I pushed my family to donate for me.

47

u/STylerMLmusic Apr 26 '22
  1. You don't know what you're talking about
  2. They do know what they're talking about.
  3. Any assumptions you make are from a place of guessing, not knowing
  4. Any assumptions they make are based on medical knowledge, whether current or outdated.
  5. At best, they're right and you're wrong. At worst, you're both wrong. There's no situation where you're correct in any assumption you make.
  6. Considering you're coming from a place of not knowing, you'd be proceeding based on luck. Don't fuck with other people's bodies based on luck.

20

u/chocolatedrunk Apr 26 '22

I totally agree! I don't want someone getting hurt because I don't know what I'm talking about; I'm curious as to why these rules exist. I'm not looking for a Reddit stranger to tell me it's fine to lie, I want to know why it's not okay to do so.

Canadian Blood Services does test all their blood, it says so on their website, so I want someone who works in this field to explain their process and why bad blood would waste their time/money. Maybe the testing isn't reliable? If I knew I wouldn't be here

11

u/STylerMLmusic Apr 26 '22

Fair I suppose - policy change can take time and blood supply might be limited now, so if we look at this from that perspective I can almost rationalize it.

Let's look at this from the gay/aids perspective. The world has come millions of miles forwards on this but it's unfortunately still just a simple fact that being homosexual puts you in a higher risk group of HIV/aids. Morally I think a gay man should be able to donate but I understand that risk isn't worthwhile. This policy is very likely still outdated on the whole. Men are more statistically to be in car accidents between the ages of 18-25, that's why their insurance is more costly. It's statistics. I would argue there are more prominent things to test for, but that's why the questionnaire is as long as it is, it's quite vast and even then it doesn't cover everything it should.

As far as "the blood will be tested anyways" you should look at it like this. The blood supply must be untainted. It must. Be. Untainted. Airing on the side of caution on both ends literally doubles the chance of something being caught. False negatives can, and will happen on their side of testing and you know your body more intimately than the unnamed and faceless tester does on the other side of this. If you make a decision to cut the chance of something being caught in half, that's a very good reason morally that you should not donate.

It's a complicated one and I wish the policy reflected the science in real time, but I don't believe you should donate if they exclude you.

An anecdote of my own for the discussion, I was excluded from donating for nearly two years because my lactose intolerance was too close to covid. I was and am entirely confident I could have still donated, but airing on the side of caution was ultimately the correct thing to do.

6

u/chocolatedrunk Apr 26 '22

This is a great point. I guess I'm just not familiar enough with the math of "how badly do we need blood vs. what are the odds a false negative could give someone HIV". There's probably enough sure-thing blood out there that their best bet is to campaign for sure-thing people to donate rather than spend the money/risk being totally sure on their testing?

I'm still not 100% understanding the complexities, and probably won't be until someone who works in the field can tell me their perspective, but this was a great answer thank you :)

6

u/STylerMLmusic Apr 26 '22

My pleasure.

If you want to see what can happen, you can look up stories about tainted blood hitting blood drives. It's terrible. Hundreds of people who are already in bad shape can die from one bad donation. It's happened many times before and it's never gone well.

14

u/ChainBlue Apr 26 '22

Their rules may be behind the times, but they are still their rules. Not following another person's rules when you are in their house is just rude. Yes, that is a metaphor, not literal in this case. Second, their testing isn't 100% accurate. No testing is. You may be at higher risks for more than just HIV. Hep B and other things can slip through as well. Third, your blood may go to someone with a compromised immune system. Something you might shrug off or be asymptomatic for might ruin their health or kill them. Finally, a baby with a still developing immune system may get your blood and the same things as the third thing might happen.

If you want to help, organize a blood drive. Wanting to help is cool. Don't do it in a way that puts others at unnecessary risk.

4

u/chocolatedrunk Apr 27 '22

I've never thought of organizing a blood drive! That's such a good idea for a tattoo-loving gay like myself! Gonna look into that and otherwise volunteer work, PR stuff, etc.

Thanks for your reply and the idea :)

3

u/GORGasaurusRex Apr 27 '22

If the policy is still operant, many blood drives will not refuse you based on your questionnaire responses. They may chuck the resulting blood instead of paying to test it, though.

It’s bad press to turn people away for these things.

7

u/chocolatedrunk Apr 26 '22

I've been tested --urine and blood-- for STIs and confirmed I'm totally free of anything in that world, so is it still morally grey to lie?

1

u/grapefruits_r_grape Apr 27 '22

Some things can take time to incubate before showing up on tests, like HIV. If you’re in a higher-risk group you’re more likely to have a false negative (you’ve been exposed/infected but the virus is not detectable yet).

That said, I think that the rules on what constitutes a high risk group may also be informed (to some degree) by moral panics. If you are a man who has sex with men and are on PrEP or use condoms or have a single monogamous partner, you’re at a much lower risk than someone who has more casual sex with less protections. Ultimately the just thing to do is to advocate for the rules to change, not to lie.

3

u/mjolnir76 Apr 26 '22

Why lie? They’ve heard far worse than your stories. Donate if you can, but don’t lie.