What are the rules for those that may be colorblind and being able to document the visual inspection of a red cell prior to the unit being issued? Has anyone had this experience in their lab and how do you document their competency if allowed to perform this task?

Are we allowed to exclude those people based on 21CFR part 606.2© "Persons whose presence can adversely affect the safety and purity of the products shall be excluded from areas where the collection, processing, compatibility testing, storage or distribution of blood or blood components is conducted."

Interesting question! To exclude you would have to document incompetency, and to do that, you have to show how you document competency in the first place!

True color blindness is really rare if I am not mistaken. A few years ago, one of our managers was instructed to document color competency based on a reading of some regulation--maybe the same one you cited. There are a few color-blindness tests on the internet you can google for. She had all of us take the test and document our scores.

The results were that several of us (including me - I already knew) were found to have red-green "color blindness", which is relatively common, especially in males. We see red and green, but the tone is different from what others see. But anyway, she ended up documenting the results, but never really did anything with them (no one was found to be totally color blind--if someone was, that would be a problem in many areas besides BB!)

Scott

I think CAP used to require a color-blindness test for all of us. We used to have to take it periodically. I could never see why we had to take it more than once. I don't think color-blindness is acquired, although I guess cataracts can alter your view of color. So leave an expired RBC unit in the fridge for another 6 weeks and have all staff see if they can tell that it is dark and starting to hemolyze. It doesn't matter whether they can see red and green so long as they can tell the difference between good unit and bad unit as seen by their eyes. There is an island somewhere that almost everyone there is severely color-blind (they have a common ancestry) and they have very intricate weaving that is all textures and not colors.

I think I also read somewhere that people with red-green deficiency can see through camoflage better. So there may be some evolutionary advantage I suppose.

Scott