Tuesday, December 06, 2005

Reflections of a blood eater

Updated: 16 May 2015 
December 1 is World AIDS Day and every year, despite the advances, HIV and AIDS continue to be major challenges for mankind:
Since its appearance in 1978, AIDS has had a profound effect on the blood industry, requiring screening questions and new expensive tests. Transfusion-associated HIV infection is now rare in the West but continues to occur in developing countries. The aftermath of the so-called "tainted blood scandals" occurred in all countries and continues today in some countries

As a blood banker I worked on the bench ("in the trenches") in the pre-AIDS days when syphilis and hepatitis B were the main concerns. We performed risky practices in those days and never gave safety a thought.
Here's a few memories from my past that I call "Reflections of a Blood Eater."

From the mid-60s to 1977 I worked as a medical laboratory technologist (aka clinical lab scientist) for the Canadian Red Cross in Winnipeg, which was a combination blood center and transfusion service along the lines of Puget Sound Blood Center in Seattle. Yes, mid-60s! We are definitely in the realm of old-geezers here. 

One of my most fond memories from that time was how we used to "shuck" (pour out) blood clots from 100s of donor specimens into kidney dishes before preparing 5% saline suspensions for red cell testing. All the while smoking and drinking coffee, of course. Time was a factor and those clots got tossed with wild abandon - it was the start of what could be a very long day depending on the clinic size. 

We worked until all blood was tested and sorted (put into inventory), no matter how long that took. For the 1000+ donor clinics after New Year's Day that could be from 07:00 to 23:00 hrs. No union to influence working hours in those days, either.

But I digress. To start each day we would shuck like crazy until the kidney dishes were full. Blood would splatter everywhere, including all over us, our smokes and coffee cups. No gloves, of course, only white lab coats that we wore everywhere including into the lunch room.

My most vivid memory from those days is the taste of blood on my cigarette filter. It tasted awful, probably more so as I'm a vegetarian. The second most vivid memory is of bloody finger streaks on the back of everyone's lab coat (after all, techs need to keep their hands clean and the buttocks was as good a wipe as any).

When hepatitis B testing was instituted (during my years there we went through counterimmunoelectropheresis, reverse passive hemagglutination, and radioimmune diffusion, now considered prehistoric), one year all lab staff were tested for both HBsAg and anti-HBs. 

Of the 20 or so technologists none were positive for HBsAg and only one (a good friend of mine still working there) was anti-HBs positive.
So, what does this contribute to the issue, i.e., the risk of disease transmission via drinking, eating, smoking in the lab? Probably not much. 

We were testing healthy blood donors for hepatitis and Canada had a relatively low prevalence rate, even given immigrants from higher prevalence countries. Mind you, some of the specimens tested were positive, and perhaps some of those made their way to my cigarette filters. Also, in the 1960s we bled donors from Manitoba's two penitentiaries. Indeed, once the rate of HBsAg in jails became known, prisoners were dropped as donor sources.

In retrospect, based on my experience working at the Red Cross in the pre-AIDS days, I suppose that I view the risk of contracting hepatitis and other blood-borne agents from activities such as drinking as being quite low. Certainly not zero, however. Consider that there were two technologists in Saskatchewan who contracted hepatitis B and died from mouth pipetting positive controls chemistry lab. We in the blood centres had luck on our side.

Also, Baruch Blumberg, awarded a Nobel Prize in 1976 for his discovery of HBsAg (initially called Australian antigen), tells the story of how his laboratory technologist came down with hepatitis B before they knew what the Australian antigen was (Source: ISI Current Contents).

Personally, I would not want to play Russian roulette with a million-bullet gun cartridge containing only one bullet. Sooner or later, someone gets the bullet. This scenario likely applies to all the rarer risks that we try to prevent by using universal precautions.

Today's students and younger lab professionals are astounded at these practices. In retrospect, even this vegetarian, once blood eater, finds them surreal.