Search

Background Leukoreduction of blood components was introduced in the United Kingdom during 1998. Human T-lymphotropic virus (HTLV) screening of blood donations was introduced in 2002. NHS Blood and Transplant conducted an HTLV lookback on blood components issued before 2002. A proportion of included components were nonleukoreduced, although the majority were subject to white blood cell reduction measures. Study Design and Methods A standard lookback was conducted on untested cellular blood components from donors later confirmed to be HTLV positive, for the 4 to 5 years before 2002, and on the last tested negative donation from donors who had seroconverted. Results A total of 437 red blood cell and platelet components were included and an outcome was reported for 84% of these. Just over half of identified recipients were dead at the time of lookback; blood samples for testing were obtained from 77% of identified living recipients. HTLV infection was confirmed in seven recipients, but one was discounted as not transfusion transmitted. Conclusion Although numbers are small, our results provide evidence of the efficacy of leukoreduction in reducing the likelihood of HTLV transmission through transfusion of cellular blood components. The HTLV-positive rate in recipients of leukoreduced components was 3.7%, a reduction of 93% compared with nonleukoreduced components. Importantly, the one infected recipient of a leukoreduced component had existing risk factors for HTLV infection. HTLV lookback was much less efficient in identifying infected recipients than was hepatitis virus C lookback.

This paper presents a model in which production technology (scale and capital-intensity) explains interindustry differences in the earnings of workers with similar skill in similarly attrative jobs. The empirical analysis shows that manufacturing industires fall into three segments with broadly similar production technologies, and that prodcut market and employment characteristics vary as expected across these segments. Capital intensity and job-skill requirements are found to have positive wage effects for the full set of industries, but the resluts by segment suggest that the capital-intensity effect increases, and the skill effects decreases, with the capital-intensity of prodcution.

In a retrospective comparison between countermigration immunoelectrophoresis (CIEP) and reverse passive haemagglutination (RPHA) for screening 260,500 blood donations, the latter's 10-fold increase in sensitivity resulted in 36% more HBsAg detections. In a prospective comparison between RPHA and radioimmunoassay (RIA) the latter's 40-fold increase in sensitivity over RPHA resulted in 11% more detections than RPHA in 27,094 new donors. One in 500 new donors was HBsAg-positive by RPHA, compared with 1 in 11,000 established donors who had donated and been tested previously. Acute hepatitis B infections, though uncommon, accounted for a greater proportion of the HBsAg-positives found in ‘established’ rather than new donors. Reported post-transfusion hepatitis cases have declined following the introduction of screening tests in 1971. The feasibility of RIA testing at a transfusion centre supplied simply with the two basic RIA reagents has been demonstrated.