Forget juice and cookies. T-shirts, coupons and even paid days off are the way to go if you want to increase the public blood supply, according to an international study led by a University of Toronto professor.

“Field-based research shows that a vast array of economic incentives motivates people to donate more without negative consequences on blood safety,” said Nicola Lacetera, an assistant professor in the department of management at U of T’s Mississauga campus.

The research, to be published Friday in the journal Science, analyzed 13 large studies on the issue done in the United States, Argentina, Switzerland and Italy.

Lacetera and researchers from Johns Hopkins University and the University of Sydney found there is conclusive evidence that incentives — offered one time or occasionally — can induce people to donate blood in a way that does not compromise the safety of the blood supply.

For example, a paid day off work in Italy, funded by the government, resulted in a 40-per-cent increase in donations. In the United States, free T-shirts and coupons resulted in 16 per cent more donations.

The only reward that had no effect was a free cholesterol test offered in Switzerland.

Although it is not standard practice to offer incentives in this country, Canadian Blood Services occasionally has campaigns where donors get appreciation gifts valued at less than $10, such as T-shirts and mugs. It holds lotteries for costlier gifts, such as game tickets donated by hockey teams.

Because the study did not look at monetary rewards, the authors said the findings should not be interpreted as promoting the creation of cash-for-blood policies.

Giving everyone a gift, including those who cannot donate, addresses concerns that safety of the blood supply could be compromised by “less-than-ideal” donors, Lacetera said. (This is in keeping with Canadian Blood Services practice.)

Guidelines on who can donate vary from country to country. Unsuitable donors can include, for example, people potentially exposed to Creutzfeldt-Jakob disease or HIV/AIDS.

The World Health Organization and blood collection agencies in countries like Australia are opposed to rewards because of fear they could affect the safety of the blood supply and discourage strictly altruistic donations, Lacetera said.

But those positions, held for nearly 40 years, are based on earlier, less reliable studies and surveys in which people responded negatively when asked if they would donate blood in return for rewards, he said.

Ron Vezina, communications director for Canadian Blood Services, said the rewards it intermittently offers are intended as “thank-you gifts” rather than inducements to get people to donate.

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“Our experience in a volunteer system suggests saving and improving lives is what motivates people to donate blood and blood products. The appreciation items are a way of saying thanks and for us to create conversations to broaden awareness about the need for donors,” he said.

The Canadian government is looking at the controversial issue of allowing for-profit blood-plasma clinics to operate in Ontario. Canadian Plasma Resources wants to pay donors for plasma extracted from their blood.

While the study did not address this, Lacetera said he believes the clinics could poach donors who would otherwise go to Canadian Blood Services clinics.

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