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New FDA rules could lead to shortages of blood in N.J.

May 18, 2002 The Record (Bergen County, NJ) by Maia Davis
New Jersey hospitals and blood banks are bracing for possible blood shortages this year as the United States begins barring donations from anyone who has spent a few months in the United Kingdom or several years in Europe.

To prevent any spread of the human form of mad-cow disease, the U.S. Food and Drug Administration will begin May 31 to ban blood donations from anyone who has spent a total of three months in Britain from 1980 to 1996, or five years in France since 1980. This fall, the five-year limit extends to all of Europe.

Altogether, the metropolitan area could lose a quarter of its blood supply, the region's largest blood bank, the New York Blood Center, estimates.

"We're panicking. " said Rita Polchin, spokeswoman for the center's affiliate in this state, New Jersey Blood Services. "Without a dramatic increase in blood donations over the summer and throughout the year, our community will be at real risk. " Blood banks in New Jersey, with its high number of immigrants and European travelers, will have to turn away some eligible donors. But the biggest impact of the new rules will be felt at the New York Blood Center, which will have to stop importing 25 percent of its blood from Europe. Hospital officials say they are preparing for possible blood shortages, which could force postponement of elective surgeries.

Mad-cow disease, which has devastated European cattle, is believed to spread through feed that contains recycled meat and bones from infected animals. Its fatal human variant, Creutzfeldt-Jakob disease, which has killed about 100 Britons and 20 others worldwide, is thought to be caused when humans eat infected beef.

No one has contracted the disease through blood transfusions, but no test exists to screen blood for the disease. To guard against the theoretical possibility that it could spread through the blood supply, the FDA is restricting donations based on where people might have eaten infected beef.

Three years ago, the agency began banning blood donations from anyone who had spent a total of six months in the United Kingdom between 1980 and 1996, when mad cow was at its peak. Now, it is tightening that restriction, and adding rules for the rest of Europe.

The FDA expects the rules to reduce the number of eligible blood donors by 5 percent nationally, but predicts the New York area will feel the impact more severely because it has so many immigrants and travelers. Some estimate the loss of donors in New Jersey could range up to 10 percent.

For years, this region's need for blood has outstripped donations.

New Jersey alone has used more blood than it collected every year from 1996 to 2000, the latest data available. In 2000, state blood banks had to import nearly 68,000 pints from around the United States and Europe.

Only about 2.3 percent of state residents who are healthy and between 17 and 75 years old, the age limits for donors, give blood, said Polchin of New Jersey Blood Services. Nationally, the figure is about 5 percent.

"We're a very busy area," said Judy Daniels of The Blood Center of New Jersey, based in Essex County. "People seem to cite not enough time as a main reason why they don't donate. " Demand for blood is rising nationally because of the increasing frequency of organ transplants, the growing number of elderly who typically need more surgery, and the rising number of cancer patients who need transfusions.

As a result, sporadic blood shortages have become more common around the country, some blood bank operators say. They fear the new FDA rules will aggravate the situation.

Americans lined up at blood banks after the September terrorist attacks in such numbers that many had to be sent away. That generosity didn't last: Only 8 percent to 9 percent of the tens of thousands of people turned away by the New York Blood Center came back to donate later. Donated blood lasts up to 42 days.

Blood centers around the country saw collections falling to their usual low levels in the months following the attacks, perhaps partly because of the public's mistaken belief that the heavy donations in September took care of shortages.

"There's still a post-9/11 phenomenon," said Dennis Todd, president and chief executive officer of Community Blood Services in Paramus.

"Many people don't understand the blood has to be constantly renewed. " In October, the American Red Cross, which supplies half the nation's blood, enacted rules even more stringent than the FDA's. So far, the restrictions are forcing it to turn away fewer than 1 percent of people who try to donate, said Jerry Squires, chief scientific officer for the Red Cross. He estimates another 2 percent of eligible donors who would fall under the restrictions don't bother to try.

Even if the number of donations falls only a little in the New York area, this region will have to contend with the substantial loss of European blood. Although the rules do not explicitly ban imports, they have that effect.

The New York Blood Center is possibly the only blood bank in the country to import from Europe, according to America's Blood Centers, a national network of independent blood banks. It's also the largest provider in New Jersey, supplying, through New Jersey Blood Services, 60 hospitals in 13 counties.

The loss of European imports will have a ripple effect around the state, as hospitals normally supplied by New Jersey Blood Services turn to other centers for help, said Todd of Community Blood Services.

Blood banks are trying to avert any shortages through mail and telephone campaigns to regular donors. Hospitals are preparing for possible worst-case scenarios. During past blood shortages in New Jersey, some hospitals have postponed elective surgeries.

Dr. Bruce K. Schainker, director of pathology and laboratory medicine at Holy Name Hospital in Teaneck, said the FDA rules will probably begin to show their effects by midsummer, when blood supplies usually run low.

"This is hitting us right at the time of the nadir of donations normally," he said.

The nation's tight blood supply could get worse, Schainker and others warn. The FDA may decide, for example, to restrict donations from people who have spent time in Japan, where mad-cow disease has recently been detected, Schainker said.

But the United States. can avoid a crisis if donors step up to the plate, Schainker said. "We need a higher percentage of donation everywhere," he said.

(SIDEBAR, PAGE a08) Details of the FDA ban

Beginning May 31, the FDA will ban blood donations from: [BOX] Anyone who, from 1980 to 1996, spent time adding up to three months in England, Wales, Scotland, Northern Ireland, the Isle of Man, or the Channel Islands; [BOX] Anyone who, since 1980, has spent time adding up to five years in France; [BOX] Any current or former U.S. military personnel, civilian military employees, or dependents of personnel who spent time adding up to six months at bases in Northern Europe, Germany, the United.Kingdom, Belgium, or the Netherlands from 1980 to 1990, or at bases in Greece, Turkey, Spain, Portugal, or Italy from 1980 to 1996.

[BOX] Anyone who has received a blood transfusion in the United.Kingdom since 1980.

On Oct. 31, the ban extends to: [BOX] Anyone who, since 1980, has spent time adding up to five years anywhere in Europe, including Turkey, countries in the former Yugoslavia, and Eastern Europe.

To donate blood or locate area blood drives, contact: [BOX] Community Blood Services in Paramus, (201) 251-3703; toll-free, (866) 228-1500.

[BOX] New Jersey Blood Services, New Brunswick, (800) 933-BLOOD.

[BOX] The Blood Center of New Jersey, East Orange, (800) NJBLOOD or (973) 676-4700.

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