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Following development of the ferritin test four decades ago, investigators turned their attention to the iron status of blood donors1,2. Scrutiny of donation-related iron depletion is motivated by concern for donor health and wellbeing, and also by the operational impact of deferral for low haemoglobin, which leads to donor loss and lowers the efficiency of blood collection. Despite unequivocal evidence that blood donation plays an important -though not exclusive- causal role in the onset or exacerbation of iron deficiency in blood donors, the resulting clinical implications remain poorly documented. Indeed, an expert advisory group convened by the AABB, which publishes standards and provides accreditation services for blood collectors in the United States, recently issued a report noting the limited evidence for adverse effects in blood donors from non-anemic iron depletion, with the exception of pica (compulsive craving and ingestion of non-food items)3. Two recent reviews and two national cohort studies reach similar conclusions. [ ... ]

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Bryan R. Spencer - American Red Cross, Scientific Affairs, Dedham, MA, United States of America

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