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Mathew J. Reiss, BA; David A. Labowitz, BS, MPH; Scott Forman, MD; Gary P. Wormser, MD

Arch Intern Med. 2001;161:461-465.

Background  Color blindness is a common hereditary X-linked disorder.

Objective  To investigate whether color blindness affects the ability to detect the presence of blood in body fluids.

Methods  Ten color-blind subjects and 20 sex- and age-matched control subjects were shown 94 photographs of stool, urine, or sputum. Frank blood was present in 57 (61%) of the photographs. Surveys were done to determine if board-certified internists had ever considered whether color blindness would affect detection of blood and whether an inquiry on color blindness was included in their standard medical interview.

Results  Color-blind subjects were significantly less able to identify correctly whether pictures of body fluids showed blood compared with non–color-blind controls (P = .001); the lowest rate of correct identifications occurred with pictures of stool (median of 26 [70%] of 37 for color-blind subjects vs 36.5 [99%] of 37 for controls; P<.001). The more severely color-blind subjects were significantly less accurate than those with less severe color deficiency (P = .009). Only 2 (10%) of the 21 physicians had ever considered the possibility that color blindness might affect the ability of patients to detect blood, and none routinely asked their patients about color blindness.

Conclusions  Color blindness impairs recognition of blood in body fluids. Color-blind individuals and their health care providers need to be made aware of this limitation.

From the Division of Infectious Diseases, Department of Medicine (Messrs Reiss and Labowitz and Dr Wormser), and the Department of Ophthalmology (Dr Forman), New York Medical College, Valhalla.

Corresponding author and reprints: Gary P. Wormser, MD, Division of Infectious Diseases, Department of Medicine, Room 209SE, Macy Pavilion, Westchester Medical Center, New York Medical College, Valhalla, NY 10595.

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