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Pica symptoms can be intense and addiction\u2010like and disrupt quality of life. It is strongly linked to iron deficiency. Since substantial iron loss occurs during blood donation, blood donors may be susceptible to development of pica behaviors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We investigated demographic, clinical, hematological, and biochemical factors associated with pica using univariable and multivariable logistic regression analysis in a cohort of 11,418 racially diverse blood donors. Pica was defined by questionnaire responses as consuming at least 8\u00a0oz of ice daily and\/or consumption of non\u2010ice substances regardless of the amount and frequency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Pica was present in 2.2% of the donors. The sensitivity and specificity of pica in iron\u2010deficient donors were 36% and 82%, respectively. Lower ferritin (<jats:italic>p<\/jats:italic>\u00a0=\u2009.001), non\u2010Asian race (<jats:italic>p<\/jats:italic>\u00a0&lt;\u2009.001), higher red cell distribution width (<jats:italic>p<\/jats:italic>\u00a0&lt;\u2009.001), younger age, and restless legs syndrome (<jats:italic>p<\/jats:italic>\u00a0=\u2009.008) were independently associated with pica. Female sex is associated with iron deficiency but was not an independent predictor of pica suggesting that iron deficient males and females were equally susceptible to the development of pica behaviors. Donors with normal ferritin levels also reported pica, reinforcing the role of non\u2010iron related factors in its presentation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We have identified demographic, clinical, and biochemical predictors of pica that help identify those most at risk for developing pica behaviors, and thereby assist in its clinical diagnosis and treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.16409","type":"journal-article","created":{"date-parts":[[2021,4,29]],"date-time":"2021-04-29T08:08:50Z","timestamp":1619683730000},"page":"2090-2098","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Demographic, clinical, and biochemical predictors of pica in a large cohort of blood donors"],"prefix":"10.1111","volume":"61","author":[{"given":"Hefei","family":"Liu","sequence":"first","affiliation":[{"name":"Blood Research Institute Versiti  Milwaukee Wisconsin USA"},{"name":"Department of Medicine Medical College of Wisconsin  Wauwatosa Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert T.","family":"Burns","sequence":"additional","affiliation":[{"name":"Blood Research Institute Versiti  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9008-9154","authenticated-orcid":false,"given":"Bryan R.","family":"Spencer","sequence":"additional","affiliation":[{"name":"Department of Scientific Affairs American Red Cross  Dedham Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grier P.","family":"Page","sequence":"additional","affiliation":[{"name":"BioStatEpi RTI International  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3740-0318","authenticated-orcid":false,"given":"Alan 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