Epidemiology & Surveillance Canadian – Blood Services
University of Ottawa
- Doctor of Philosophy, University of Western Australia
- Bachelor of Applied Science (Nursing), Curtin University, Western Australia
- Bachelor of Applied Science (Applied Statistics), Murdoch University, Western Australia
Canadian Blood Services
1800 Alta Vista Dr.
Ottawa, ON, Canada K1G 4J5
Epidemiology – understanding and minimizing the infectious risks associated with blood transfusion
Dr. O’Brien examines donor deferral criteria which address infectious risks to recipients as well as donor safety, and conducts surveillance of blood borne pathogens.
Why is it important?
Ensuring the safety of the blood supply from pathogens involves a multifaceted approach, including donor selection and education, testing for known pathogens, gathering surveillance data and horizon scanning for emerging pathogens.
Canadian Blood Services tests every blood donation for known transmissible diseases, notably for HIV, hepatitis B and hepatitis C. Testing is very effective and the chance of a blood recipient becoming infected with HIV, hepatitis C or hepatitis B from a blood transfusion is extremely low. However, because blood is derived from people and because tests will never be 100 per cent reliable, the risk will never be zero. In addition, not all infectious agents can be tested for and are addressed by deferral (eg the agents responsible for malaria and variant Creutzfeldt Jakob Disease, both travel-related). Ensuring the continued safety of the blood supply from pathogens requires a multifaceted approach. Donor education, selection and health screening are all important. Dr. O’Brien’s research has looked at donor compliance to selection criteria, for example, criteria related to tattoos and piercings. She has examined the effect of changes to travel restrictions on the rate of blood donor deferrals.
High quality and timely surveillance of infectious diseases is key to the safety of the blood supply. Surveillance includes monitoring of transmissible disease testing in blood donors, investigation of possible transfusion transmitted infections in blood recipients (including bacterial infections) and horizon scanning for new, emerging pathogens that may pose a risk now or in the future. This information allows Canadian Blood Services to put additional safeguards in place to reduce any risk to recipients of blood products. Dr. O’Brien, along with Dr. Margaret Fearon, gathers and analyzes surveillance data and publishes her findings in an annual report to stakeholders.
Together with Dr. Mindy Goldman, Dr. O’Brien recently investigated iron deficiency in Canadian donors – a major aspect of donor health being investigated by blood operators worldwide, and discovered that many female donors have low or absent iron stores.
Why is it important?
Approximately 600,000 people, or 2% of the Canadian adult population, enable lifesaving treatments for their fellow citizens by donating blood. Iron deficiency is a common problem in the Canadian population, particularly in women of child-bearing age and blood donation has a significant impact on iron stores in frequent donors.
Iron stores can be precarious, particularly in women of child-bearing age. Although Canadian Blood Services screens every donor’s hemoglobin levels, we do not routinely check their iron stores. There is a worry that whole blood donors who donate frequently may run the risk of developing iron deficiency. This potential risk may not be recognized by either donors or their doctors. Dr. O’Brien and the research team investigated hemoglobin levels and iron stores to determine the incidence of iron deficiency in donors. They also looked into the attitudes of donors towards managing and maintaining their iron levels.
- O'Brien SF, Delage G, Scalia V, Lindsay R, Bernier F, Dubuc S, Germain M, Pilot G, Yi QL, Fearon MA. Seroprevalence of Babesia microti infection in Canadian blood donors. Transfusion. 2015; 56:237-243.
- O’Brien SF, Xi G, Fan W, Yi QL, Osmond L, Delage G, Goldman M: Are donors in Canada compliant with deferral for tattoos and piercing? Blood Transfusion 2014; 12:141
- Goldman M, Uzicanin S, Scalia V, O'Brien SF: Iron Deficiency in Canadian Blood Donors. Transfusion 2014; 54:775-779.
- O'Brien SF, Uzicanin S, Choquet K, Yi QL, Fan W, Goldman M: Impact of Changes to Policy for Mexican Risk Travel on Canadian Blood Donor Deferrals. Blood Transfus 2013; 11:580-584.
- O’Brien SF: ResearchUnit: What is the risk of a transfusion-transmitted infection? 2013; Blood.ca website
- O’Brien SF, Yi Q-L, Fan W, Scalia V, Fearon M, Allain J-P.: Current incidence and residual risk of HIV, HBV and HCV at Canadian Blood Services. Vox Sang 2012; 103:83-86.
- O’Brien SF, Goldman M, Scalia V, yi Q-L, Fan W, Xi G, Dines IR, Fearon M: The epidemiology of human T-cell lymphotropic virus types I and II in Canadian blood donors. Transfus Med 2013; 23:358-366
Click to see Leadership Roles:
|2014 - Current||Chair, The AABB Donor History Questionnaire Task Force|
|2003 – 2014||Member, The AABB Donor History Questionnaire Task Force|
|2009 – Current||Coordinator Surveillance, Risk Assessment and Policy Subgroup, Transfusion Transmitted Infectious Diseases Working Party, The International Society for Blood Transfusion|
|2003 – Current||Member, Canadian Standards Association Technical Committee on Blood and Blood Components|
For general enquiries about research at Canadian Blood Services, please contact us at:
Centre for Innovation
Canadian Blood Services
1800 Alta Vista Drive
Ottawa, Ontario K1G 4J5