In the past few years there has been increasing concern about blood transfusion safety. Avoidable transfusion errors, mostly in patient identification, remain a serious cause of injury and death. There is also heightened awareness of the risk of transmission of viral and bacterial infections. Of particular concern in Britain is the (theoretical) possibility of transmission of variant Creutzfeldt-Jakob disease.

This review puts these risks in perspective (table) and describes the new measures that have been introduced to improve blood safety. It also describes changes in attitude and practice that will affect users of blood in all disciplines, including general practitioners advising patients of the pros and cons of transfusion. Finally it emphasises the need for careful education and training of all those involved in blood prescribing and blood component administration.