WASHINGTON -- Americans take for granted they'll get a blood transfusion whenever they need one, but soon that may not be the case: Blood donations are dropping so low that serious, nationwide shortages could hit as early as next year.
The government is so concerned that Surgeon General David Satcher has a committee hunting ways to get more people to donate blood more often, studying such incentives as giving donors time away from work or small rewards like T-shirts.
And some blood banks have started creative programs to lure donors -- one in Iowa even gives puppet shows and science demonstrations to school students, grooming them to donate as soon as they turn 17.
"We operate on a very thin margin of safety for the blood supply, and if that trend continues it would put us in a year-round shortage in a few years," said Dr. Arthur Caplan of the University of Pennsylvania, who heads a federal committee on blood issues.
The National Blood Data Resource Center is more pessimistic: Its studies predict that next year, Americans will donate just under 11.7 million units of blood -- but that hospitals will need 11.9 million units.
Blood donations are decreasing about 1 percent a year. Demand for blood is increasing by 1 percent a year.
Already, some cities routinely experience temporary blood shortages during holidays like the Fourth of July weekend and the summer, when regular blood donors go on vacation.
Adding to the pressure, the government soon will ban Americans from giving blood if they've traveled extensively in Great Britain -- trips that added together total six months since Britain's mad cow disease epidemic began in 1980. Mad cow disease has been linked to a human brain destroyer, so experts want the precaution of a donor ban even though there's no proof any mad cow-type illness could spread through human blood. But a ban would cut the blood supply another 2.2 percent a year.
"When you need surgery, when you need cancer treatment, when a woman gives birth -- we all assume the blood will be there," Caplan said. "You can't make that assumption anymore."
His committee just recommended one change that could provide up to 300,000 more pints a year: Use blood from people with a genetic disease called hemochromatosis that causes them to build up too much iron. Giving blood regularly alleviates iron buildup. That blood is healthy, but today it's thrown away because it's a medical treatment that patients pay for -- donations must be altruistic.
Why are donations dropping? Nobody really knows, although blood banks say younger generations have never shown the enthusiasm of post-World War II donors. About 60 percent of Americans are estimated to be eligible donors, but only 5 percent donate.
It's partly convenience and being reminded that blood is needed, said Satcher.
Even "when I give blood, it's in the context of the Red Cross coming around to where you work," he said. "There are people who would donate at least twice as much if they knew they were needed."
The Central Florida Blood Bank proved that Satcher's right: It created an automated program that leaves messages -- recorded by an Orlando TV personality -- on previous donors' answering machines saying, "Please donate blood this week." Last Memorial Day, a typical shortage period, the RealCall program prompted a 16 percent donation response.
The Mississippi Valley Regional Blood Center in Davenport, Iowa, gives puppet shows in hopes of grooming schoolchildren to become donors later in life -- and hook their parents, too.
"Joey scraped his knee so I raced right over," says Paula Platelet in a skit explaining how platelets help clot blood. Other skits feature Whitey White Cell and Penelope Plasma.
When kids get older, blood bank workers visit science classes yearly to explain donations and transfusions, and test students' blood type.
They can't yet measure the puppets' effects. But the first students to get yearly science-class visits turned 17 last year, and the annual high school blood drive showed a 23 percent increase in first-time donors.
Blood banks hope Satcher's advisers will consider such programs in looking for ways to replace the donors who will be lost under the pending British travel ban.
In addition, Rep. Thomas Bliley, R-Va., just asked the General Accounting Office to study how serious the shortage is, questioning the impact of that ban and of hemochromatosis donations.
--About 40,000 units of blood are used each day in the United States. One unit is about equal to a pint. Need varies: It can take just six units of blood to survive heart surgery, while a car crash victim may need 50.
--There are four main blood types: A, B, AB and O. Blood centers often run short of types O and B blood, but shortages of all types commonly occur during holidays and the summer because regular donors take vacation.
--Donated blood can be separated into such components as red blood cells, platelets or plasma, which are transfused according to specific medical need.
--People can give whole blood every eight weeks, plasma every four weeks and platelets 24 times a year. The minimum requirements are that donors be age 17 or older and weigh at least 110 pounds.
--To donate, call an area blood bank or join a blood drive. At the time of their appointment, donors must complete a confidential medical screening form that asks questions about health and lifestyle to assess risk for certain infections. For example, recent travelers to malaria-endemic countries or people who just received a tattoo may have to wait a year before donating. Blood accepted for donation also is strictly for tested for certain diseases.
Source: America's Blood Centers