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Open Access Debate

Does a perception of increased blood safety mean increased blood transfusion? An assessment of the risk compensation theory in Canada

Mo Amin124*, Kumanan Wilson3, Alan Tinmouth4 and Paul Hébert4

Author Affiliations

1 Department of Economics, University of Ottawa, 2 Saddle Crescent, Ottawa, ON, K1G 5L4, Canada

2 Canadian Coordinating Office for Health Technology Assessment, 600-865 Carling Avenue, Ottawa, ON, K1G 5L4, Canada

3 Department of Medicine, University of Toronto, 190 Elizabeth Street, Suite 3-805, Toronto, ON, M5G 2C4, Canada

4 Clinical Epidemiology Programme, Ottawa Health Research Institute, 501 Smyth Road, Box 201, Ottawa, ON, K1H 8L6, Canada

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BMC Public Health 2004, 4:20  doi:10.1186/1471-2458-4-20

Published: 7 June 2004



The risk compensation theory is a widely used concept in transport economics to analyze driver risk behaviour. This article explores the feasibility of applying the theory in blood transfusion to raise important questions regarding the increased blood safety measures and their possible effects on blood usage (e.g., the appropriateness in transfusion). Further, it presents the findings of a pilot survey of physicians in Canada.


While studies have attempted to define transfusion appropriateness, this article argues that if the risk compensation theory holds true for transfusion practice, physicians may actually be transfusing more. This may increase the possibility of contracting other unknown risks, such as the variant Creutzfeldt-Jakob Disease (vCJD), as well as increasing the risk of non-infectious transfusion risks, such as transfusion reactions.


A much larger study involving psychosocial assessment of physician decision making process to fully assess physician behaviour within the context of risk compensation theory and transfusion practice in Canada is needed to further explore this area.