83 KMUJ 2017, Vol. 9 No. 2 ORIGINAL ARTICLE IRON DEFICIENCY STATUS IN FIRST TIME, REPLACEMENT, VOLUNTARY AND REGULAR MALE BLOOD DONORS AT TERTIARY CARE HOSPITALS OF PESHAWAR, PAKISTAN Khadija Habib 1 , Nazish Farooq 2  , Sadia Fatima 3 , Rubina Nazli 4 , Zeeshan Kibria 5 INTRODUCTION B lood is donated worldwide so it is our ethical duty to prevent the blood donors from harm. 1 Iron deficiency in first time and repeat blood donors is challenging in transfusion medicine. 2 1 Department of Hematology, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan 2  Assistant Professor Department of Hematology, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan E-mail: drnazish.ibms@kmu.edu.pk Phone: 0333-9179631 3 Assistant Professor, Department of Biochemistry, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan 4 Professor, Department of Biochemistry, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan 5 Department of Public Health, Khyber Medical University, Peshawar, Pakistan Date Submitted: February 05, 2017 Date Revised: June 12, 2017 Date Accepted: June 18, 2017 ABSTRACT OBJECTIVES: To determine iron deficiency in first time, replacement, voluntary and regular male blood donors and to detect pre-clinical iron deficiency in blood donors at tertiary care hospitals of Peshawar, Pakistan by assessing serum ferritin levels. METHODS: In this cross-sectional descriptive study 152 male blood donors from North West General Hospital and Hayatabad Medical Complex, Peshawar, Pakistan were recruited from 1st December, 2012 to 30th May, 2013. Donors were divided into regular and non-regular (1st time, replacement and voluntary) groups based on number of do- nations in the past. Quantitative determination of serum ferritin levels was performed by Chemiluminescence immunoassay. Serum ferritin level >30µg/L were taken as normal, 15-30µg/L were reduced and <15µg/L were iron deficiency. Data was analyzed using descriptive statistics in SPSS version 20. RESULTS: Out of 23 regular donors, 17 (73.9%) while out of 129 non regular donors, 13 (10.1%) developed iron deficiency. The mean number of donations for all donors was 2.8±2.6 (range 0-20). Among non-reg- ular blood donors, 09% 1st time donors, 9.3% replacement donors and 15.8% voluntary donors had iron deficiency. Iron deficiency was recorded in 19.7% of the whole study sample. Statistically significant inverse relationship existed between number of donations and serum ferritin levels (r=-0.193, p 0.017). Also a weak positive relationship between time since last donation (months) and serum ferritin levels (r=0.109, p 0.18). CONCLUSION: Regular blood donations in males cause serious iron deficiency. Pre-donation serum ferritin analysis identifies and prevents iron deficiency in both regular and non-regular blood donors. KEY WORDS: Blood Donors (MeSH), Anemia (MeSH), Ferritin (MeSH), Iron (MeSH). THIS ARTICLE MAY BE CITED AS: Habib K, Farooq N, Fatima S, Nazli R, Kibria Z. Iron deficiency status in first time, replacement, voluntary and regular male blood donors at tertiary care hospitals of Peshawar, Pakistan. Khyber Med Univ J 2017; 9(2): 83-87. The influence of blood donation on the body’s iron status has been a subject of interest since 1970’s. 3 Blood can be do- nated safely, at a minimum of eight weeks interval but at the risk of developing iron deficiency with repeated donations. 4,5 A strong association has been observed be- tween donation frequency, time since last donation and iron stores. 4 The Hemoglo- bin (Hb) reaches the pre-donation level by 30 to 50 days in first time donors. 1 There is no major risk associated with blood donation, however, studies have documented that regular blood donors are iron depleted. 6,7 Inadequate dietary iron intake cannot resume iron balance in blood donors. 2 Eligibility criteria for blood donation is a cut-off Hb value of 12.5g/dL. 8 Use of Hb as a screening tool to exclude anaemic donors sometimes fails to identify iron deficient donors whose Hb is above the cutoff limits. 9 The reticulocytes, Hb content and percentage of hypochromic red cells are very helpful in detecting functional iron deficiency but they have not been validated in the past. 6 Each 1 mL of blood contains 0.5 mg of iron roughly, hence donation of one unit of whole blood removes 4-10% (approximately 250 mg) of the body iron and with resulting fall in Hb after 3 days. 8,10 It takes about 150 days to replenish 220-320 mg of iron lost by donation. Hence repeated donations cause further iron depletion. 1,11 Hemoglobin levels may not correlate significantly with the underlying iron status of the donor and is not a sensitive test to rule out the early stages in the development of iron deficiency. 6,12 For precise assessment of the body’s iron level and diagnosis of iron deficiency,