title: Improving health profile of blood donors as a consequence of transfusion safety efforts.
abstract: BACKGROUND
  Transfusion safety rests heavily on the health of blood donors. Although they are perceived as being healthier than average, little is known about their long-term disease patterns and to which extent the blood banks' continuous efforts to optimize donor selection has resulted in improvements. Mortality and cancer incidence among blood donors in Sweden and Denmark was investigated.
  
  
  METHODS
  All computerized blood bank databases were compiled into one database, which was linked to national population and health data registers. With a retrospective cohort study design, 1,110,329 blood donors were followed for up to 35 years from first computer-registered blood donation to death, emigration, or December 31, 2002. Standardized mortality and incidence ratios expressed relative risk of death and cancer comparing blood donors to the general population.
  
  
  RESULTS
  Blood donors had an overall mortality 30 percent lower (99% confidence interval [CI] 29%-31%) and cancer incidence 4 percent lower (99% CI 2%-5%) than the background population. Mortality rates and cancer incidence were lowest for outcomes that are recognized as being related to lifestyle factors such as smoking or to the selection criteria for blood donation. Blood donors recruited in more recent years exhibited a lower relative mortality than those who started earlier.
  
  
  CONCLUSIONS
  Blood donors enjoy better than average health. Explicit and informal requirements for blood donation in Scandinavia, although mostly of a simple nature, have successfully refined the selection of a particularly healthy subpopulation.
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Gustaf
authors.initials: G
authors.lastname: Edgren
authors.forename: Trung Nam
authors.initials: TN
authors.lastname: Tran
authors.forename: Henrik
authors.initials: H
authors.lastname: Hjalgrim
authors.forename: Klaus
authors.initials: K
authors.lastname: Rostgaard
authors.forename: Agneta
authors.initials: A
authors.lastname: Shanwell
authors.forename: Kjell
authors.initials: K
authors.lastname: Titlestad
authors.forename: Agneta
authors.initials: A
authors.lastname: Wikman
authors.forename: Rut
authors.initials: R
authors.lastname: Norda
authors.forename: Casper
authors.initials: C
authors.lastname: Jersild
authors.forename: Louise
authors.initials: L
authors.lastname: Wideroff
authors.forename: Gloria
authors.initials: G
authors.lastname: Gridley
authors.forename: Johanna
authors.initials: J
authors.lastname: Adami
authors.forename: Mads
authors.initials: M
authors.lastname: Melbye
authors.forename: Olof
authors.initials: O
authors.lastname: Nyrén
authors.forename: Marie
authors.initials: M
authors.lastname: Reilly
mesh_terms: D001782:Blood Donors; D001803:Blood Transfusion / Q000592:standards*; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D006262:Health; D006801:Humans; D012189:Retrospective Studies; D012449:Safety / Q000592:standards*; D013548:Sweden / Q000453:epidemiology