Blood and Tissue (Transmissible Diseases) Amendment Regulations 1999 (WA)

474 GOVERNMENT GAZETTE, WA [12 February 1999

HEALTH

HE301*

Health Act 1911

Blood and Tissue (Transmissible Diseases)

Amendment Regulations 1999

Made by the Governor in Executive Council.

1.            Citation

These regulations may be cited as the Blood and Tissue
(Transmissible Diseases) Amendment Regulations 1999.

2.             The regulations amended

The amendments in these regulations are to the Blood and
Tissue (Transmissible Diseases) Regulations 1985*.
[* Published in Gazette 8 February 1985, pp. 517-19.

For amendments to 29 January 1999 see 1997 Index to
Legislation of Western Australia, Table 4, p. 123.]

3.             Regulation 6 amended

Regulation 6 is amended by deleting "the Schedule" and inserting instead —

be safe for people to be given your blood or blood products. The

" Schedule 1 ".

4.            Schedule replaced

The Schedule is repealed and the following Schedule is inserted instead—

Schedule 1 — Blood donor declaration

[r. 6]

There are some people in the community who MUST NOT give blood as it may transmit infections to people who receive it. So before you give blood we need you to answer some questions to ensure that it will

12 February 19991 GOVERNMENT GAZETTE, WA 475

following questions are a vital part of our effort to eliminate these
diseases from the blood supply.

Even though there are a lot of questions they are all important and you need to answer every question on the form truthfully and to the best of your ability. Answering these questions truthfully is important because there are severe penalties including fines and/or imprisonment for giving false or misleading answers to any of the questions.

All donations of blood are tested for the presence of Hepatitis B and C, HIV 1 and 2 (AIDS virus), syphilis and HTLV I and II. Should your blood test be positive for any of these diseases or show a significantly abnormal result you will be notified.

DECLARATION

Thank you for answering the following questions.

If you are uncertain about how you should answer any of the questions please discuss your concerns with the interviewer.

You will be asked to sign this declaration in the presence of the interviewer once you have answered all the questions.

476 GOVERNMENT GAZETTE, WA 112 February 1999

To the best of your ktiow ledge	Within the last 12 months have
have you:	you:
(please circle your answer)	(please circle your answer)
1. In the last 6 months had an	8. Had male to male sex?
illness with swollen glands	YES NO

and a rash, with or without a	9.	Had sexual activity with a
fever?	male who you think might be

YES NO bisexual?

2 Ever thought you could be YES NO

infected with HIV or have	10. Been a male or female sex
AIDS?	worker (e.g. received payment

YES NO for sex in money, gifts or

3 Ever "used drugs" or been drugs)?

injected, even once, with	YES NO
drugs not prescribed by your	11. Engaged in sexual activity
doctor or dentist?	with a male or female sex

YES NO worker?

4 Ever had treatment with YES NO

clotting factors such as Factor	12. Been injured with a used
VIII or Factor IX?	needle (needlestick)?

YES NO YES NO

5 Ever had a test which showed 13. Had a blood/body fluid splash

you had Hepatitis B, Hepatitis	to eyes, mouth nose or to
C, HIV or HTLV?	broken skin?

YES NO YES NO

6 In the last 12 months have

you engaged in sexual activity	14. Had a tattoo (including
with someone you might think	cosmetic tattooing), skin
would answer "yes" to any of	piercing, electrolysis or
questions 1-5?	acupuncture?

YES NO YES NO

'4 Since your last donation or in	15. Been imprisoned in a prison
the last 12 months have you	or lock-up?
had sexual activity with a new	YES NO

partner who currently lives or	16. Had a blood transfusion?
who has previously lived	YES NO
overseas?	17. Had (yellow) jaundice or

YES NO hepatitis or been in contact
with someone who has?

YES NO

Supplementary question/s	YES	NO
If YES interviewer to note details:

12 February 1999] GOVERNMENT GAZETTE, WA 477

In making this declaration I understand that —

•	as scientific knowledge advances, I may be asked to undergo further blood tests; and
•

my donation is a gift, which may be used for therapeutic agents and research.

I have also been advised by the interviewer that —

• there are some possible risks associated with donating blood; and

• I must follow the instructions of the staff to minimize those risks.

I hereby declare that I have answered the above questions truthfully

Donor's	witness'
signature: _	signature:

—

Print full	Print full
name:	name:
Donation	Category of
number:	authorization:
Date and time of declaration:

By Command of the Governor,

M. C. WAUCHOPE, Clerk of the Executive Council.