Impact of environmental factors on adverse events in whole blood donation

Roni Roy; Farah Anjum Sonia; Subarna Saha; M. Shahnaz Perveen; Mohammad Mehedi Hasan; Rajat Kanti Karmaker

doi:10.18203/2320-6012.ijrms20260940

Authors

Roni Roy Department of Transfusion Medicine, Narayangang 300 Bed Hospital, Narayangang, Bangladesh
Farah Anjum Sonia Department of Transfusion Medicine, Bangladesh Medical University, Dhaka, Bangladesh
Subarna Saha Department of Transfusion Medicine, Bangladesh Medical University, Dhaka, Bangladesh
M. Shahnaz Perveen Department of Transfusion Medicine, Dhaka Medical College Hospital, Dhaka, Bangladesh
Mohammad Mehedi Hasan Department of Transfusion Medicine, OSD, DGHS, Dhaka, Bangladesh
Rajat Kanti Karmaker Department of Medicine, OSD, DGHS, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2320-6012.ijrms20260940

Keywords:

Whole blood donation, Adverse reaction, Environment factors, Temperature

Abstract

Background: Whole blood for transfusion is essential in medical treatment; for surgeries, trauma treatment and managing diseases like anemia and cancer. However, the adverse reactions (ARs) such as vasovagal syncope, dizziness and fainting are still concerning for donor safety. Reactions are influenced by age, sex and general health status; however, the impact of environmental factors temperature, humidity and air quality are not well studied. The aim of this study was to examine environmental factors affecting the incidence and severity of adverse events during whole blood donation.

Methods: Total of 170 voluntary whole blood donors were included in the study. Donor demographic, health and reporting records were obtained from the center during the study period. Environmental factors such as temperature, humidity and air quality were collected from monitoring stations located nearby the locality. Bivariate analyses using chi-square tests and logistic regression were performed to evaluate the relationship between environmental factors and adverse events.

Results: Adverse events were observed in 15% of donors (12% mild and 3% severe). High temperatures (>25 C), relative humidity >60%, and AQI >70 were associated significantly with the increased rate of adverse events. High temperatures were significantly associated with more serious reactions, particularly in male donors, whereas high relative humidity was correlated with mild reactions among women.

Conclusions: Environmental factors have greatly influenced on the incidence and severity of adverse reactions with whole blood donation. These results indicate the importance of adjusting environmental parameters such as temperature, humidity and air quality in blood donation centers for donor safety and comfort.

Metrics

Metrics Loading ...

References

World Health Organization. Blood safety and availability. 2020. Available at: https://www.who.int/ news-room/fact-sheets/detail/blood-safety-and-availability. Accessed on 12 January 2026.

Gibson S, Miller T, Brown R, Clark D, Evans J, Wilson P, et al. Adverse events in blood donation: A review of incidence and impact on donor health. J Blood Donation. 2021;29(3):193-202.

Morris CS, Patel R, Singh A, Johnson L, Ahmed S, Green K, et al. Determinants of adverse reactions in blood donation: A systematic review. Transfus Med. 2022;32(5):332-40.

Bangladesh Medical University Blood Bank. Annual report on blood donation trends and adverse events. Dhaka: BMU. 2023.

Fuchs AK, Schneider M, Weber T, Hoffmann J, Klein R, Bauer S. Environmental temperature and its effects on adverse reactions in blood donors: A cross-sectional study. J Transfus Med. 2021;45(2):107-14.

Kim HS, Lee JH, Park SH, Choi YK, Kim JY, Lim YS. Air quality and adverse reactions in whole blood donation. Environ Health Perspect. 2021;129(4):461-7. DOI: https://doi.org/10.1289/EHP7351

Liumbruno GM, Franchini M, Lippi G, Marano G, Mengoli C, Pupella S. Prevalence of adverse events in blood donors: A global perspective. Transfus Med Rev. 2020;34(3):161-8.

Jones SJ, Carter B, Williams D, Evans M, Thomas G, Lewis P. Humidity and blood donation: Investigating environmental conditions in donor adverse events. J Environ Health. 2020;84(7):53-60.

Newman BH, Newman DT, Ahmad R, Roth AJ. The effect of whole-blood donor adverse events on blood donor return rates. Transfusion. 2006;46(8):1374-9. DOI: https://doi.org/10.1111/j.1537-2995.2006.00905.x

Eder AF, Hillyer CD, Dy BA, Notari EP, Benjamin RJ. Adverse reactions to allogeneic whole blood donation by 16- and 17-year-olds. JAMA. 2008;299(19):2279-86. DOI: https://doi.org/10.1001/jama.299.19.2279

Wiltbank TB, Giordano GF, Kamel H, Tomasulo P, Custer B. Faint and prefaint reactions in whole-blood donors: An analysis of predonation measurements and their predictive value. Transfusion. 2008;48(9):1799-808. DOI: https://doi.org/10.1111/j.1537-2995.2008.01745.x

Bravo M, Kamel H, Custer B, Tomasulo P. Factors associated with fainting: Before, during and after whole blood donation. Vox Sang. 2011;101(4):303-12. DOI: https://doi.org/10.1111/j.1423-0410.2011.01494.x

Goldman M, Osmond L, Yi QL, Cameron-Choi K. Frequency and predictors of donor reactions in Canadian blood donors. Transfusion. 2014;54(12):3033-40.

France CR, France JL, Himawan LK, Stephens KY, Frame-Brown TA, Venable GA. Blood donation fears and preferences: Implications for donor recruitment and retention. Transfusion. 2014;54(8):2012-8.

Trouern-Trend JJ, Cable RG, Badon SJ, Newman BH, Popovsky MA. A case-controlled multicenter study of vasovagal reactions in blood donors. Transfusion. 1999;39(3):316-20. DOI: https://doi.org/10.1046/j.1537-2995.1999.39399219291.x

Kamel H, Tomasulo P, Bravo M, Wiltbank T, Cusick R, James RC, et al. Delayed adverse reactions to blood donation. Transfusion. 2010;50(3):556-65. DOI: https://doi.org/10.1111/j.1537-2995.2009.02397.x