The blog formerly known as   Fake Plastic Fish

May 22, 2008

When giving literally hurts

A few weeks ago, I decided to give a pint. Of blood, that is. What were you thinking? Guinness? I’m almost embarassed to admit that it was my very first time ever donating blood, and the only reason I even thought of it was because someone from the Red Cross cold called me and said, “We’re scheduling residents of North Oakland for their blood donations, can I put you down for Wednesday at 3pm?” And I was like, “Um… no… how about Monday?”

I don’t know why I hadn’t thought of it before. I guess it’s like how I never really worried about plastic until I saw the picture of the dead albatross a year ago. So maybe I’ll become a blood-donating addict. But probably not. Because, even though my experience was very positive, and I’ll certainly do it again, there are some worrisome things about the way the Red Cross collects and stores blood that are of concern for Fake Plastic Fishies.

We all know that hospitals are full of plastic. Plastic tubing and sheets and gloves and trays and bags. Plastic equipment and plastic wrappers to keep that equipment sterile. Certainly there is more plastic in hospitals than necessary, but for the most part, I kinda feel like it’s there to protect us. Mostly. But some of it does actual harm, and that’s what I am writing about tonight.

For years, many hospitals used IV and blood bags and tubing made from PVC, a plastic that contains phthalates like DEHP in order to make it soft. DEHP can leach from PVC medical devices and is linked to reproductive birth defects and other illnesses. (Here’s a link to all you ever wanted to read about PVC/DEHP.) That’s why the organization Healthcare Without Harm was formed in 1996. It’s a coalition of “hospitals and health care systems, medical professionals, community groups, health-affected constituencies, labor unions, environmental and environmental health organizations and religious groups” that are working to transform our healthcare system so that it is “ecologically sustainable and no longer a source of harm to public health and the environment.” The organization originated around the issue of PVC in medical waste and has gone on to (among other things) promote safer substitutes for products that contain mercury, polyvinyl chloride (PVC) plastic and brominated flame retardants.

I was happy to learn that Kaiser Permanente, my current healthcare provider, is included in Healthcare Without Harm’s list of healthcare institutions doing away with PVC and DEHP (PDF). (Check the list and see if your hospital or healthcare provider is listed.) Here’s what Kaiser has to say about PVC and other environmental issues on its own web site.

But notice that the Red Cross is not on that list. In fact, when I came home from donating blood, I Googled “Red Cross PVC” and couldn’t really find anything about what type of blood bags and tubing they use. So, of course, I emailed them. And I found out that they do in fact use PVC bags with DEHP. Below I’ve copied the entire e-mail correspondence for those who are interested. Here’s a list of Red Cross Blood Services Regions. Why not find yours and e-mail or call to express your concern about DEHP-containing bags and tubing?

I’m happy to donate my blood to save someone’s life. Apparently, I have more than I need. But it makes me sad to think that the blood I give may be contaminated with a chemical that can be harmful to the recipient, especially if the recipient is a tiny baby. Perhaps a little DEHP won’t really hurt an adult who needs a one-time transfusion in an emergency. But some people have disorders that require them to receive blood regularly. Why give them contaminated blood when DEHP-free alternatives exist?

And one last thing I have to say about giving blood, and then I’ll sign off. Eat and drink a lot before you go, and take your own snacks with you. The recovery area is full of plastic-wrapped energy bars and cookies. I was happy to see that my Red Cross provided juice from a machine, rather than individual bottles, so I was able to fill up my Klean Kanteen with zero waste apple juice. But probably not all centers will have that kind of setup, so be prepared.

Okay, here are my emails to and from Johonna D. Marsh, Red Cross Compliance Manager for Northern California. Are you inspired to send your own email?

Date: Mon, 5 May 2008 23:35:27 -0700 (PDT)
From: “Beth Terry”
Subject: Question from donor about PVC/DEHP
Hello. I came in to the Oakland Blood Center today and donated for the very first time. It was a very positive experience, and I plan to do it again.

But I do have some questions about the equipment used at the center to draw the blood. Does the Oakland Blood Center use blood bags and tubing made from PVC plastic containing the plasticizer DEHP? I have been reading about this chemical and am concerned as it is a hormone disruptor and can leach into the blood from the plastic.

Many hospitals, including Kaiser, have given up DEHP bags and tubing. There is more information at the site, Healthcare Without Harm:

I searched online to find out the Red Cross’s policy on PVC and DEHP, but I couldn’t find anything. Can you please clarify this issue for me?


Beth Terry
Oakland, CA

—————————— wrote:
Dear Beth,
The American Red Cross in Northern California utilizes Baxter/Fenwal blood collection sets. I telephoned Baxter and spoke with a representative there. He indicated that Baxter does utilize PVC/DEHP in their blood collection sets.

I did some further research on the Baxter website and found this informative article about the use of PVC in blood collection sets. I hope this answers your question Beth. Please feel free to contact me if you have further questions.

Again, thank you for being a blood donor with the American Red Cross!


Johonna D. Marsh
Compliance Manager, Collections

American Red Cross
Northern California Blood Services Region
6230 Claremont Avenue
Oakland, CA 94618
(510) 594-5124 (p)
(510) 295-7603 (c)
(510) 601-7954 (f)


From: Beth Terry
Sent: Thursday, May 08, 2008 11:22 AM
To: Marsh, Johonna
Subject: RE: Your inquiry regarding American Red Cross Collection Sets

Thank you so much for researching this issue for me. I am happy to give blood, but I remain concerned about the PVC/DEHP issue. There are other options out there that many hospitals have switched to.

I notice that the article you linked to addresses discharges from PVC plants, which is an issue, but it doesn’t directly address the issue of phthalates (DEHP) entering the blood supply. This is what concerns many hospitals, especially where infants are concerned. DEHP has been found to be a hormone disruptor and would be especially harmful in blood given to a new born.

There are DEHP-free alternatives. Healthcare without Harm has compiled a list here: and I notice that Baxter is actually on the list as offering DEHP-free PVC blood bags. I wonder if the rep you spoke to understood the difference between PVC bags with and without DEHP.

I hope that you don’t mind me pursuing this issue a bit further with you. I know that you are very, very busy. But our bodies are overwhelmed these days with toxic chemicals from hundreds of sources, and so I do whatever I can to advocate for less toxic choices whenever I have the chance.

Thanks so much,
Beth Terry

—————————— wrote:
Hi Beth—
I am not too busy to look into issues such as these—I appreciate your concern! When I spoke with the Baxter representative I did specifically ask about DEHP and he had indicated that DEHP was used in the Baxter collection sets. He did not mention that there are DEHP free alternatives, but I do see from the Baxter website that there are some products advertised as DEHP free.

I am going to forward your concern to our Safety Manager as well as to the Associate Director of Collections. It is possible that we may also be able to send your concern along to Baxter. Unfortunately, at this point in time, I do not anticipate that we will be able to change the type of blood collection sets that we order from Baxter (the reasons are extensive, but long story short—we are standardized with the types of collection sets that we purchase throughout the Red Cross and we have policies and procedures in place to support the use of the collection sets that we currently use, we have contracts with Baxter for the supplies, possible cost increases, etc).

I would like to commend you for submitting your concern. At this point, even if our supply doesn’t change at least your concern is a start and helps to make people aware of this issue!

Thank you again for being such a thoughtful and caring donor! Please do not hesitate to contact me again if need be.


Johonna D. Marsh
Compliance Manager, Collections

American Red Cross
Northern California Blood Services Region
6230 Claremont Avenue
Oakland, CA 94618
(510) 594-5124 (p)
(510) 295-7603 (c)
(510) 601-7954 (f)

Sounds like this issue may not go away any time soon. The more people they hear from, the better.

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15 years ago

Thanks to all for donating blood, my daughter had her 1st transfusion at 3 weeks of age, and had a total of 7 transfusions by the time she was 2. Yes the chemicals scare me, and no I don’t agree with all of the politics, but I hope all of these things do not stop anyone from continuing to donate. I am eternally grateful for my daughter, and for those individuals who donated and continue to donate blood.
Keep writing letters, and please keep donating if you can – your donation makes all the difference in the world!

Beth Terry
15 years ago

Chrystal, thanks for commenting! I’ll check into donating directly.

15 years ago

Hi Beth…long time reader…first time poster.

As a two-time cancer survivor I applaud you for donating blood. It’s truly a heroic act :)

For your next donation please consider donating directly to your local hospital (hopefully a trauma and/or transplant center). The Red Cross charges hospitals for your blood. Here is a link:

Thanks again for donating! :)


15 years ago

Thanks Beth. I also go to Kaiser and I am so happy to hear they are making healthier, greener efforts in there establishments.
Just the thought of those tiny little 2 pound premie babies getting horrible toxins from the plastic that holds that life giving blood. I give blood at times and I will write the RC also.
Your blog is a great resource, thanks for helping me be a healthier person and helping the earth get healthier too.

15 years ago

Welcome to the blood donor club. I was sorry to see mention of the snacks in your post because the whole reason I give is to get FREE OREOS!!!

Seriously, there is a donation procedure called ALYX that takes twice the blood in one sitting. That might reduce the amount of plastic used per amount of blood taken. You have to wait 16 weeks to give again instead of the usual 8, though.

The number of those who give is a small percentage of the population and the risk of plastic leaching is small compared to the risk of not having blood available, so until they get an alternative, it seems to me a good idea to keep giving.

15 years ago

——– Original Message ——–
Subject: RE: DEHP
Date: Fri, 23 May 2008 13:47:38 +0100
From: Dr Richard Jones
To: Jessica

Thank you for sharing your concerns. We will keep this matter under observation and act in accordance with any future regulatory requirements.

Dr R M Jones

From: Jessica
Sent: 23 May 2008 13:36
To: Dr Richard Jones
Subject: Re: DEHP

I strongly disagree with your assertion that there is no evidence of patient harm caused by DEHP. According to to the Health Care Without Harm web site, “DEHP…is classified by the EU as [a] reproductive toxicant. Animal studies have connected exposure to phthalates with damage to the liver, kidneys, lungs and reproductive system – particularly the developing testes.” Additionally, there are suitable alternatives available. I urge you to reconsider your position on this matter.

Jessica [last name omitted]

Dr Richard Jones wrote:
> Dear Mrs [last name omitted]
> Thank you for your email.
> DEHP is a plasticiser commonly used in many licensed medical devices in addition to blood bags.The Welsh Blood Service (WBS) is aware of the leaching properties of this compound however it should be recognised that it has been in use for over 40 years without any evidence of patient harm and toxic levels have not been found in patients who have been transfused. Medical devices such as blood bags are strictly regulated within the EU. In UK the Medicines and Healthcare products Regulatory Agency (MHRA) is the responsible authority and the WBS complies fully with all regulatory requirements. Government agencies in Europe and America continue to actively monitor the evolving clinical and scientific evidence and also the bag manufacturers themselves continue to search for newer compounds that provide a more suitable storage environment however, for the present, it is thought that the benefits of DEHP outweigh the risks.
> Dr R M Jones
> Medical Director
> Welsh Blood Service

15 years ago

I used to work at the National Headquarters of the ARC back in 2005. They negotiate these contracts yearly like any other business. I think the best thing to do would be contact the blood services director and the new ARC president. Blood services also has a few national labs that you could contact.
Sorry I dont have email addresses or names! My former co-workers have all since left.

15 years ago

Very interesting post, Beth. While I agree that it doesn’t sound the RC will be doing anything soon, I am impressed with the tenor of the reply and obvious research (compare another bureaucracy, Clorox). I remember thinking during my own recent emergency room experience that I was rather more glad that the plastic was there than not. While I’m inclined to fight more personal consumer battles before I start researching and taking on the medical stuff, I continue to be impressed by your perseverance. I did notice the hospital I went was not on the list and that one I might have gone to was (but I probably wouldn’t go there for other reasons). Now I wonder how much “latex free” (important to me), translates to more PVC. Thanks again for making me think,

15 years ago

Great post, Beth! I’m always impressed at how you find ways for us to reduce plastic (or at least “bad plastic” in this case) in so many different areas of life. I e-mailed the “Quality and Safety” department of the hospital where I receive my primary care (and have had surgery/inpatient care) and asked them to consider joining the list. Thanks for the great info!

Anarres Natural Health
15 years ago

Wow, Beth! You actually got through.

My last job was as Manager of Homeless and Disaster Operations for the Canadian Red Cross. From my understanding of the top=down, national structure of the national RCs, it would take a lawsuit to change any purchasing practice. So maybe a legal threat from damaged babies will someday force the change.

I gave up on giving blood in 1990 at York University when I was asked on a pre screening questionnaire if I was intimate with known homosexuals. I couldn’t get through to them that this was the most ineffective way to screen against HIV infection. They should have asked me about my risk taking behaviours. Soon, Hepatitis victims shut down the Canadian RC’s blood services, and a new agency was formed called Canadian Blood Services. But the Canadian RC still feels like the victim. It’s a hellish burocracy.

Horray for raising the alarm there, though. I hope they contact a legal department.

Love & RRRevolution, Tracey

15 years ago

beth, you are one amazing activist! a super heroine…i can see your cape a-flying! wonderful emails, thanks for sharing. most sincerely, thanks for all you do, educating and inspiring all of us!