Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: May 1, 2023
Open Peer Review Period: May 1, 2023 - May 15, 2023
Date Accepted: Jan 31, 2024
(closed for review but you can still tweet)
Exploration of Health Donor Effects Among 0.6 Million Donors in China: Longitudinal Study
ABSTRACT
Background:
The World Health Organization emphasizes the importance of 100% voluntary blood donation to maintain safe and sustainable blood supplies. However, the benefits of blood donation for donors, such as reducing the risk of disease, remain a topic of debate due to the existence of the healthy donor effect (HDE). This effect arises because of inherent health differences between blood donors and the general population, and it is also considered a methodological issue.
Objective:
This study aims to generate a more detailed health profile of blood donors from a donor cohort study to mitigate and quantify the HDE and properly interpret the association between blood donation and disease outcomes among blood donors.
Methods:
A retrospective cohort study was conducted between January 2012- December 2018 among donors before their first donation. A one-to-one propensity score matching was conducted through a random selection of individuals without any blood donation from Electronic Health Records. We conducted passion regression between blood donors and non-blood donors before the first donation for estimating the relative risk of slected blood donation-related diseases as defined by thirteen categories of ICD-10 codes.
Results:
Of the 0.6 million blood donors, 15,115 had an inpatient record before their first donation, while 17,356 non-blood donors had an inpatient record. For the overall population, the HDE (the disease relative risk between non-blood donors and blood donors) was (ARR=1.152, 95%CI[1.127-1.178]). Among disease categories that China suggested not to donate blood, the strongest HDE was observed in Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89) (3.225, [2.402-4.330]). After age stratification, we found that people who had their first blood donation between 46-55 years old had the strongest HDE (1.816, [1.707-1.932]). Both male and female donors have demonstrated significant HDE (1.082, [1.05-1.116] and 1.236, [1.196-1.277], respectively) compared with matched non-blood donors.
Conclusions:
Our research findings suggest that the healthy donor effect (HDE) is present among blood donors, particularly among female donors and those who donate blood between the ages of 46 and 55. Clinical Trial: ChiCTR2200055983
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