Impact of Frequent Blood Donation on Iron Status at Blood Bank of Sulaymaniyah City/Kurdistan Region/Iraq
DOI:
https://doi.org/10.31530/cjnst.2026.2.2.1Keywords:
Ferritin, Iron Profile, Blood Donation, Hemoglobin, Red Blood Cell IndicesAbstract
Background: Iron is a micronutrient that is essential for the production of hemoglobin (Hb) and maintaining the proper functioning of human body cells. Blood donation is an essential component of transfusion medicine for patient care, but it also causes donors to lose iron. To safeguard donors' health, blood banks should monitor their iron levels and ensure they have an adequate amount of iron.
Aim: The objective of this study is to assess the iron status of regular blood donors at the Sulaymaniyah City Blood Bank, evaluate the efficacy of Hb as a sole criterion for donor selection, and examine the relationship between donation frequency and variations in red blood cells (RBC) indices and iron profile parameters.
Methodology: This comparative cross-sectional study included 221 male blood donors (172 repeat donors and 49 first-time donors). A structured, validated questionnaire was utilized to get information about the donors' age, gender, donation history, diet, and lifestyle. Blood samples were collected from donors to analyze the level of hematological parameters and iron-related parameters.
Results: A total of 221 whole blood donors were enrolled; all were male. most participants in both groups were aged 25–39 years, with a higher proportion among first-time donors (73.5%) compared to repeat donors (48.3%). Polycythemia was the main cause of blood donation among repeat donors (84.9%) compared with first-time donors (26.5%), whereas replacement donation was more common in first-time donors (67.3% vs. 7.6%). Lifestyle factors showed notable differences; smoking was more prevalent among repeat donors than first-time donors (70.9% vs. 40.8%). No first-time donors had depleted ferritin level, while 23.3%) of repeat donors exhibited low ferritin. Repeat donors had significantly lower ferritin levels (P value = 0.0001), transferrin saturation (P = 0.002), and mean corpuscular volume (MCV) (P value = 0.003) and higher red cell distribution width (RDW) (P value = 0.0001) compared to first-time donors.
Conclusion: Hb levels remained within normal ranges, and ferritin declined progressively with increasing donation frequency, which may not be detected by Hb measurement alone. Monitoring iron stores and red blood cell indices is crucial to maintain donor health and a sustainable blood supply.
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References
[1] Conway D, Henderson MA. Iron metabolism. Anaesthesia & Intensive Care Medicine. 2022;23(2):123-5. https://doi.org/10.1016/j.mpaic.2021.10.021.
[2] Zeidan RS, Martenson M, Tamargo JA, McLaren C, Ezzati A, Lin Y, et al. Iron homeostasis in older adults: balancing nutritional requirements and health risks. The Journal of nutrition, health and aging. 2024;28(5):100212. https://doi.org/10.1016/j.jnha.2024.100212.
[3] Sukhbaatar N, Weichhart T. Iron regulation: macrophages in control. Pharmaceuticals. 2018;11(4):137. https://doi.org/10.3390/ph11040137.
[4] Dev S, Babitt JL. Overview of iron metabolism in health and disease. Hemodialysis International. 2017;21(1):S6-S20. https://doi.org/10.1111/hdi.12542.
[5] Ryan BJ, Charkoudian N, McClung JP. Consider iron status when making sex comparisons in human physiology. Journal of Applied Physiology. 2022;132(3):699-702. https://doi.org/10.1152/japplphysiol.00582.2021.
[6] Mahfouz MS, Ryani M, Hamzi ASN, Zaeri DA, Dahdoh AA, Almalki AJ, et al. Blood donation among university students: practices, motivations, and barriers in Saudi Arabia. Avicenna journal of medicine. 2021;11(2):70-76. https://doi.org/10.4103/ajm.ajm_113_20.
[7] Moazzen S, Sweegers MG, Janssen M, Hogema BM, Hoekstra T, Van den Hurk K. Ferritin trajectories over repeated whole blood donations: results from the FIND+ study. Journal of Clinical Medicine. 2022;11(13):3581. https://doi.org/10.3390/jcm11133581.
[8] Mantadakis E, Panagopoulou P, Kontekaki E, Bezirgiannidou Z, Martinis G. Iron deficiency and blood donation: links, risks and management. Journal of blood medicine. 2022;13(1):775-86. https://doi.org/10.2147/JBM.S375945.
[9] World Health Organization. Blood donor selection: guidelines on assessing donor suitability for blood donation. World Health Organization. 2012. Available from: https://iris.who.int/server/api/core/bitstreams/440f386c-facc-4ac1-85d4-6a1775d9469c/content
[10] Narwal N, Mahajan P, Garg S. A Systematic Review on Effect of Whole Blood Donation on Iron Profile in Blood Donors. ECS Transactions. 2022;107(1):9601. https://doi.org/10.1149/10701.9601ecst.
[11] Gaff MSA, Ani MA, Babka SS. Body iron status in blood donors in Erbil. Zanco Journal of Medical Sciences (Zanco J Med Sci). 2010;14(3 Special):1-8. https://zjms.hmu.edu.krd/index.php/zjms/article/view/492.
[12] Spencer BR, Guo Y, Cable RG, Kiss JE, Busch MP, Page GP, et al. Iron status and risk factors for iron depletion in a racially/ethnically diverse blood donor population. Transfusion. 2019;59(10):3146-56. https://doi.org/10.1111/trf.15448.
[13] Reddy K V, Shastry S, Raturi M, Baliga B P. Impact of regular whole-blood donation on body iron stores. Transfusion Medicine and Hemotherapy. 2020;47(1):75-9. https://doi.org/10.1159/000499768.
[14] Tailor HJ, Patel PR, Prasad Pandya AKN, Mangukiya S. Study of Various Hematological Parameters and Iron Status among Voluntary Blood Donors. International Journal of Medicine & Public Health. 2017;7(1):61. https://doi.org/10.5530/ijmedph.2017.1.11.
[15] Galiba Atipo-Tsiba FO, Gayaba Mouyabi EQ, Angounda BM, Mokono SO, Ocko Gokaba LT, Elira Dokekias A. Prevalence of Iron Deficiency, Anemia, and Associated Factors in a Blood Donor Population in Brazzaville, Congo. Anemia. 2023;2023(1):8827984. https://doi.org/10.1155/2023/8827984.
[16] Oyedeji OA, Ajie OI, John-Olabode SO, Olorunfemi G. Predonation iron and hematological status of whole blood donors in lagos, Nigeria: Impact on blood supply. The Nigerian Journal of General Practice. 2020;18(1):22-6. https://doi.org/10.4103/NJGP.NJGP_8_19.
[17] Sevgi M, Mehta RP. Symptomatic iron deficiency without anemia: an underrecognized phenomenon. Blood. 2023;142(1):1092. https://doi.org/10.1182/blood-2023-173737.
[18] Dijkstra, A., van den Hurk, K., Bilo, H.J., Slingerland, R.J. and Vos, M.J. Repeat whole blood donors with a ferritin level of 30 μg/L or less show functional iron depletion. Transfusion. 2019:59(1):21-25. https://doi.org/10.1111/trf.14935.
[19] Vinkenoog M, van den Hurk K, van Kraaij M, van Leeuwen M, Janssen MP. First results of a ferritin‐based blood donor deferral policy in the Netherlands. Transfusion. 2020;60(8):1785-92. https://doi.org/10.1111/trf.15906.
[20] SINGH R, KUMAR M, SINGH DK, KHARBANDA P, VERMA S. Comparative Analysis of Red Cell Parameters of First-time and Repeat Blood Donors: A Descriptive Study. Journal of Clinical & Diagnostic Research. 2023;17(5):5. https://doi.org/10.7860/JCDR/2023/63179.17814.
[21] Adu P, Bennin D, Edzie RA, Owusu-Poku AG, Hakeem TU, Baba GO, et al. Depleted iron stores in voluntary blood donors: a three-center cross-sectional study in Ghana. Asian Journal of Transfusion Science. 2020;14(2):149-57. https://doi.org/10.4103/ajts.AJTS_112_18.
[22] Singh AP, Saxena R, Saxena S. Professional blood donors: Ethical concerns and complexities. Journal of International Research in Medical and Pharmaceutical Sciences. 2024;19(1):17-23. https://doi.org/10.56557/JIRMEPS/2024/v19i18603.
[23] KumAr AS, GeethA A, Joe J, CHACKO A. Estimation of Serum Ferritin Levels in Blood Donors and its Association with Frequency of Blood Donation and Blood Indices. Journal of Clinical & Diagnostic Research. 2021;15(4):16-20. https://doi.org/10.7860/JCDR/2021/48168.14810.
[24] Li C, Feng Q, Zhang J, Xie X. A multivariate analysis of the risk of iron deficiency in plateletpheresis donors based on logistic regression. Transfusion and apheresis science. 2023;62(1):103522. https://doi.org/10.1016/j.transci.2022.103522.
[25] Khoshnaw, N.S., Ahmad, S.M., Ghafoor, D.D., Kamil, R.M., Mousa, S.H., Baram, S.S., Hamaali, S.M. and Hussein, Z.S. Comparative effects of vaping and cigarette smoking on hematological parameters in young male university students. Iraqi Journal of Hematology. 2025;14(1):42-48. https://doi.org/10.4103/ijh.ijh_88_24.
[26] Wang H-H, Liao L-N, Chang C-W, Chang Y-C, Wu K-H, Ko J-L. The alteration of ferritin and transferrin saturation under body mass index and blood pressure in first-time and regular male blood donors in Taiwan. Medicine. 2019;98(22):e15854. https://doi.org/10.1097/MD.0000000000015854.
[27] Waheed U, Arshad M, Sultan S, Saeed M, Arshad A, Irfan SM, et al. Iron deficiency and iron deficiency anemia in blood donors at a tertiary care hospital in Islamabad, Pakistan. Global Journal of Transfusion Medicine. 2018;3(1):17-20. https://doi.org/10.4103/GJTM.GJTM_55_17.
[28] Vhanda D, Chinowaita F, Nkomo S, Timire C, Kouamou V. Effects of repeated blood donation on iron status of blood donors in Zimbabwe: a cross‐sectional study. Health science reports. 2021;4(4):e426. https://doi.org/10.1002/hsr2.426.
[29] Qassadi M. Impact of regular blood donation on body iron stores at Saudi blood donors. Open Journal of Blood Diseases. 2024;14(3):65-80. https://doi.org/10.4236/ojbd.2024.143008.
[30] Abbas AA, Mahmmoud MA, Ali SFA. Assessment Of serum ferritin level, hemoglobin concentration and red blood cell indices in apparently healthy Sudanese blood donors attending central blood bank Gezira State–Sudan (2020). World Journal of Advanced Research and Reviews. 2022;16(2):833-47. https://doi.org/10.30574/wjarr.2022.16.2.1214.
[31] Karregat JH, Meulenbeld A, Quee FA, Novotny VM, Swinkels DW, van den Born B-JH, et al. Ferritin-guided iron supplementation as an alternative or complement to prolonged blood donation intervals (FORTE): a double-blind, randomised, controlled trial. The Lancet Haematology. 2025;12(9):e694-e704. https://doi.org/10.1016/S2352-3026(25)00167-X.
[32] Kebalo AH, Gizaw ST, Gnanasekaran N, Areda BG. Lipid and haematologic profiling of regular blood donors revealed health benefits. Journal of blood medicine. 2022;2022(13):385-94. https://doi.org/10.2147/JBM.S367990.
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