NBC：美国中产阶级靠卖血浆维持生计
正文翻译
Last year, people in the U.S. made an estimated $4.7 billion selling their plasma. Donation centers are popping up in middle-class neighborhoods, including suburban strip malls and college towns.
去年，美国人通过卖血浆获得了约47亿美元的收入。献血中心如雨后春笋般出现在中产阶级社区，包括郊区商业街和大学城。
Inside a suburban Philadelphia strip mall, between the Hair Cuttery and a Citizens Bank, a dozen people lay on black ergonomic beds a few feet apart, hooked up through a needle in the crook of their arms to machines pumping blood out of their veins. They were there to sell their plasma in exchange for $65 on a prepaid debit card.
在费城郊区一家小型购物中心里，位于美发店和市民银行之间，十几个人躺在相隔几英尺的黑色人体工学床上，手臂弯处插着针头，连接着抽取血液的机器。他们来这里是为了出售血浆，换取65美元的预付借记卡付款。
Ian Pleasant, 43, had come that morning to get some extra money for toilet paper and pet food.
43岁的伊恩·普莱森特那天早上来这里是为了挣点外快买卫生纸和宠物食品。
“I’m making enough money now doing DoorDash to keep up with the bills, but for anything else in the house, this is going to help out,” he said, as he waited for an employee at the B Positive plasma center in Holmes, Pennsylvania, to insert a thick needle into his arm.
“我现在靠送外卖挣的钱够付账单了，但家里其他开销，这点钱就派上用场了。”他一边说着，一边在宾夕法尼亚州霍姆斯市的B型阳性血浆中心等待工作人员将一根粗针头扎进他的手臂。
About an hour later, the employee came back to collect a container of his straw-colored plasma that would be tested, frozen and turned into medicines sold for a profit to patients around the world.
大约一个小时后，工作人员回来取走了他那淡黄色的血浆，这些血浆将被检测、冷冻，然后制成药品，出售给世界各地的患者以获取利润。
It’s a scene repeated by an estimated 200,000 people a day across the country as part of a multibillion-dollar business fueled by a growing number of Americans willing to trade their blood for money in an economy where many have seen their job prospects weaken, costs rise and savings dwindle. Despite data that shows a relatively stable economy, middle-class Americans say they have had to start selling their plasma over the past year to cover basic expenses, from medical bills to a winter coat for their child.
据估计，全美每天约有20万人重复着这样的场景，这构成了一个价值数十亿美元的产业，而推动这一产业发展的，正是越来越多的美国人愿意用自己的血液换取金钱。在经济形势严峻、许多人就业前景黯淡、生活成本上升、储蓄缩水的当下，这种现象尤为突出。尽管数据显示经济相对稳定，但美国中产阶级表示，过去一年里，他们不得不开始出售血浆来支付基本生活开支，从医疗费用到孩子的冬衣，无所不包。
“I’m angry that I’m working this much, that I’m educated, that I’m articulate, that I have marketable skills, and that I’m reduced to selling my plasma,” said Jill Chamberlain, in Phoenix, who has gone from making $87,000 a year to $16.11 an hour after being laid off from her job overseeing the finances of a local business in 2024. “I was ashamed at first, but now I’m angry. This is not how things are supposed to be.”
“我很生气，我辛辛苦苦工作了这么多年，我受过良好的教育，我口齿伶俐，我拥有市场所需的技能，却沦落到卖血浆的地步，”来自凤凰城的吉尔·张伯伦说道。她之前在一家当地企业负责财务，2024年被裁员后，年收入从8.7万美元骤降至每小时16.11美元。“起初我感到羞愧，但现在我感到愤怒。事情本不该是这样的。”
Last year, people in the U.S. made an estimated $4.7 billion selling about 62.5 million liters of their plasma, a more than 30% increase in the amount of plasma collected since 2022, according to Peter Jaworski, a professor at Georgetown University who studies the ethics and economics of the plasma business.
据乔治城大学研究血浆产业伦理和经济学的教授 Peter Jaworski 称，去年美国人通过出售约 6250 万升血浆，获得了约 47 亿美元的收入，比 2022 年的血浆采集量增长了 30% 以上。
The transactions occur in more than 1,200 plasma centers — there are now more places to sell plasma than there are Costco stores — and more are popping up in solidly middle-class neighborhoods, including suburban strip malls and college towns, Jaworski said. As America’s economic divide widens, with the top 1% of households owning more than 30% of the country’s wealth, the payments people receive for selling plasma are playing a quiet role in keeping households above water financially.
据贾沃斯基称，这些交易在超过1200家血浆中心进行——现在出售血浆的地点比好市多（Costco）门店还多——而且越来越多的血浆中心涌现于中产阶级聚居区，包括郊区商业街和大学城。随着美国经济差距的扩大，最富有的1%家庭拥有全国超过30%的财富，人们出售血浆所获得的报酬在维持家庭经济运转方面发挥着默默的作用。
Meteoric increase
迅猛增长
The number of plasma centers in the U.S. more than doubled in the past decade.
过去十年间，美国的血浆治疗中心数量增加了一倍多。
Margo Thompson and her husband make around $120,000 a year in a rural corner of Idaho, but the couple started selling their plasma about a year ago to cover their car payment and one-time expenses, like new tires and medical bills. In Oklahoma City, Larry Jones, 64, started selling his plasma in April after his rent increased to $800 a month, taking a significant chunk out of the $1,800 a month in take-home pay he gets as a school bus monitor for children with disabilities. Erin Ragnetti started selling plasma in the past year to pay off debt and bills not covered by her cleaning jobs and her husband’s salary at a heating and cooling company in Fresno, California.
玛戈·汤普森和她的丈夫在爱达荷州的一个乡村地区生活，年收入约12万美元。但大约一年前，为了支付车贷和一些一次性开支，例如更换轮胎和医疗费用，这对夫妇开始出售血浆。
在俄克拉荷马城，64 岁的拉里·琼斯于今年 4 月份开始卖血浆，因为他的房租涨到了每月 800 美元，这让他每月 1800 美元的到手工资大幅缩水。他是一名残疾儿童校车监护员。
艾琳·拉格内蒂去年开始出售血浆，以偿还她清洁工作的收入和她丈夫在加州弗雷斯诺一家供暖制冷公司工作的工资加在一起还不足以支付的债务和账单。
"Because the economy is what it is right now, everything’s just so much more expensive,” Ragnetti said. “I realized, if we’re going to make ends meet, I’ve got to find a way to make more money.”
“因为现在的经济形势不好，所有东西都贵了很多，”拉格内蒂说。“我意识到，如果我们想维持生计，我就必须想办法赚更多的钱。”
Researchers have found that when a new plasma center opens in a neighborhood, foot traffic at local grocery stores increases, interest in payday loans declines and crime goes down, an indication of the way money from plasma props up households’ finances for necessities.
研究人员发现，当一个社区开设新的血浆中心时，当地杂货店的客流量会增加，人们对发薪日贷款的兴趣会下降，犯罪率也会下降，这表明血浆带来的收入可以支撑家庭的财务，满足生活必需品的需求。
It’s a uniquely American economic phenomenon. Only a handful of countries allow people to be paid for their plasma and donate as frequently as the U.S. does — up to twice a week, though there is limited data on the long-term health effects, and some people report dizziness, bruising and exhaustion after the process. People lose 10% of their blood volume when they donate; a healthy person should be able to regenerate that within hours to days.
这是一种独特的美国经济现象。只有少数几个国家允许人们有偿献血并且捐献频率像美国一样高——最多可达每周两次，尽管关于长期健康影响的数据有限，而且有些人反映捐献后会出现头晕、瘀伤和疲惫等症状。捐献血浆会消耗人体10%的血容量；健康人通常能在数小时到数天内恢复这些血容量。
The looser rules in the U.S. have turned plasma into a significant export: America supplies 70% of the world’s plasma, shipping $6.2 billion worth overseas in 2024.
美国较为宽松的监管规定使血浆成为一项重要的出口商品：美国供应全球 70% 的血浆，2024 年向海外出口价值 62 亿美元的血浆。
“The U.S. has created a very attractive market for plasma centers,” said Emily Gallagher, a business professor at University of Colorado Boulder who has studied the economic impact of plasma collection. “Not only does it allow for paid donation of up to twice a week, but we also have a country where there’s a lot of poverty and a social system that doesn’t help that much.”
“美国为血浆中心创造了一个极具吸引力的市场，”科罗拉多大学博尔德分校的商学教授艾米丽·加拉格尔说道，她曾研究过血浆采集的经济影响。“这不仅允许人们每周最多两次有偿献血，而且我们国家贫困人口众多，社会保障体系也未能提供足够的帮助。”
In the suburbs of Minneapolis, Michelle Eagan drops her son off at preschool then drives 35 minutes across town twice a week to sell her plasma to help cover his $700-a-month tuition.
在明尼阿波利斯郊区，米歇尔·伊根每周两次开车 35 分钟穿过市区去卖血浆，以帮助支付儿子每月 700 美元的学费。
“It’s a nice preschool. Sometimes I do think, ‘I bet there are no other parents here that are donating plasma to pay for this preschool,’” said Eagan, who has made around $400 a month from her plasma since September.
“这是一家不错的幼儿园。有时候我会想，‘我敢肯定这里没有其他家长像我一样捐献血浆来支付这所幼儿园的费用，’”伊根说道。自九月份以来，她每月通过捐献血浆获得约 400 美元的收入。
The money has become a necessity for Eagan’s family after she left her job making $75,000 a year as a paralegal for UnitedHealth Group to care for her son full time. Even living in a relatively affordable part of Minneapolis, her husband’s $90,000 salary as a business manager hasn’t been enough for the family of three to get by, and their credit card balances have been steadily rising.
伊根辞去了在联合健康集团担任律师助理、年薪7.5万美元的工作，全职照顾儿子后，这笔钱对她家来说成了必需品。即使住在明尼阿波利斯相对便宜的地区，她丈夫作为企业经理的9万美元年薪也难以维持一家三口的生活，他们的信用卡欠款一直在稳步增长。
Eagan sells her plasma to BioLife, which is a part of the Japanese drugmaker Takeda; many plasma centers are run by a handful of biopharmaceutical companies that turn the fluid into medicine. BioLife, like others, uses incentives to keep her coming. For instance, her first payment of the week is $45, but if she goes back a second time that week, she gets $65. In November, the company ran a “Sweater Weather” promotion where clients who sold their plasma eight times that month would get entered into a raffle to win $1,000. In December, BioLife offered reward points for people who donated seven times in a month or for three consecutive months that they could redeem for gift cards.
伊根将血浆卖给BioLife公司，该公司隶属于日本制药公司武田制药。许多血浆中心都由少数几家生物制药公司运营，这些公司将血浆转化为药品。BioLife和其他公司一样，通过各种激励措施来吸引伊根定期献血。例如，她每周第一次献血可获得45美元，但如果她当周第二次献血，则可获得65美元。11月，该公司推出了一项名为“毛衣天气”的促销活动，当月献血八次的客户将有机会参加抽奖，赢取1000美元奖金。12月，BioLife为每月献血七次或连续三个月献血的客户提供奖励积分，这些积分可以兑换礼品卡。
“It’s like a drug dealer — once they have you in there, they have to keep you coming back,” Eagan said. “But they’re not a charity. They can get people to come in there for that amount of money, if it’s worth your time, and clearly it’s worth my time.”
“这就像毒贩一样——一旦你进去了，他们就得让你不断回来，”伊根说。“但他们不是慈善机构。如果值得你花时间，他们就能用那点钱让你进去，而显然值得我花时间。”
BioLife declined to comment on how it determines its compensation structure. The company, like others, said that it isn’t paying individuals for their plasma, which the company says they are donating, but rather compensating them for their time. (People are generally only paid, though, if they give their plasma; they aren’t paid if they try to donate but are turned away, for example if they are dehydrated or have low protein levels.)
BioLife公司拒绝就其薪酬结构做出评论。该公司与其他公司一样表示，他们并非为捐献者提供的血浆支付报酬，而是为他们的付出时间支付报酬。（不过，通常情况下，只有在成功捐献血浆后，人们才能获得报酬；如果他们尝试捐献但因脱水或蛋白质水平过低等原因被拒绝，则不会获得报酬。）
“People choose to donate plasma for a variety of reasons. Whether for personal motivations, a desire to give back, or to receive compensation for their time and commitment, we recognize and appreciate everyone who graciously donates plasma,” BioLife said in a statement. “In line with industry practice, BioLife compensates plasma donors in recognition for their time and effort. The level of compensation may vary depending on center location and if someone is an existing or new donor.”
“人们捐献血浆的原因多种多样。无论是出于个人动机、回馈社会的愿望，还是为了获得时间和付出的补偿，我们都感谢每一位慷慨捐献血浆的人，”BioLife在一份声明中表示。“根据行业惯例，BioLife会向血浆捐献者支付补偿，以感谢他们的时间和付出。补偿金额可能因捐献中心所在地以及捐献者是新老捐献者而有所不同。”
Turning plasma from an individual donor into a treatment for a patient can be a complex process that takes up to a year. The plasma is tested for viruses and then goes through a purification and manufacturing process, where the proteins and antibodies are extracted. It can take plasma from more than 100 people to support one patient each year, according to the plasma Protein Therapeutics Association.
将捐献者的血浆转化为患者的治疗药物是一个复杂的过程，可能需要长达一年的时间。血浆首先要进行病毒检测，然后经过纯化和生产过程，提取其中的蛋白质和抗体。据血浆蛋白治疗协会称，每年可能需要从100多人身上提取血浆才能治疗一名患者。
plasma industry officials said they see their business as a win-win: Patients get the plasma they need to treat potentially fatal conditions, like hemophilia, burns and rare immune disorders, and those selling their plasma get extra money to help out with their household expenses.
血浆行业官员表示，他们认为自己的生意是双赢的：患者可以获得治疗血友病、烧伤和罕见免疫系统疾病等潜在致命疾病所需的血浆，而出售血浆的人可以获得额外的收入来补贴家用。
“We hope that when people consider donating plasma, it is not only something that you would consider at a time of need, but something that you might make part of your altruistic endeavors,” Anita Brikman, head of the plasma Protein Therapeutics Association, said. “People think about blood donation that way, and we hope that more people would think about plasma donation.”
“我们希望人们在考虑捐献血浆时，不仅将其视为一种在需要时才会考虑的选择，更将其视为一种利他行为，”血浆蛋白治疗协会主席安妮塔·布里克曼 (Anita Brikman) 表示。“人们会这样看待献血，我们也希望更多的人能够考虑捐献血浆。”
While there are altruistic reasons for giving plasma, without the financial incentive, there wouldn’t be enough supply to meet the demand for plasma-based treatments, Jaworski, the plasma researcher, said. Countries that don’t allow payment for plasma, such as Australia and the U.K., don’t have enough plasma-based therapies available to treat patients, making them dependent on plasma from the U.S., he said.
血浆研究员贾沃斯基 (Jaworski) 指出，虽然捐献血浆有其利他主义的理由，但如果没有经济激励，血浆的供应量将不足以满足基于血浆的治疗需求。他表示，像澳大利亚和英国这样不允许支付血浆费用的国家，其基于血浆的疗法不足以治疗患者，因此不得不依赖来自美国的血浆。
“The model of not compensating people just doesn’t lead to enough plasma,” Jaworski said. “In the United States, we don’t pay people to donate blood, but we have enough blood. However, when it comes to plasma, we need much more participation, and we need people to donate much more often.” (Donating blood can be faster than donating plasma, which takes about an hour, as a machine filters the plasma from the donor’s blood and returns what remains back into the donor’s body.)
“不支付报酬的模式根本无法提供足够的血浆，”贾沃斯基说道。 “在美国，我们不付钱请人献血，而且血液供应充足。但是，在血浆捐献方面，我们需要更多的人参与，也需要人们更频繁地捐献。”（献血比捐献血浆快，捐献血浆大约需要一个小时，因为机器会将血浆从捐献者的血液中过滤出来，并将剩余的物质输回捐献者体内。）
plasma sellers interviewed by NBC News said the benefit to patients was an added bonus, but it was the money that drew them in and kept them coming back.
接受NBC新闻采访的血浆捐献者表示，对患者的益处固然是额外的好处，但真正吸引他们并让他们不断重复捐献的还是金钱。
“They are all about how you’re helping to save lives. But honestly, no one’s there for that,” Eagan said.
“他们总是说你在帮助拯救生命。但说实话，根本没人是冲着这个来的。”伊根说道。
At the B Positive plasma center near Philadelphia, workers bounce among a steady flow of patients, inserting needles, removing tubes and canisters still coated in blood, and ferrying plasma into a walk-in freezer before it’s shipped to pharmaceutical companies to be turned into medicines. 在费城附近的B Positive血浆中心，工作人员穿梭于络绎不绝的病人之间，穿插着针头，取出仍沾有血液的试管和容器，并将血浆运送到步入式冷冻库，之后再运往制药公司加工成药品。
Ben Ruder, the company’s CEO, said the business operates on relatively narrow margins, similar to those of a restaurant, and is vulnerable to spikes in the cost of supplies and labor. The expenses add up: hiring staff, buying equipment and medical supplies, testing the plasma, and meeting all the regulatory requirements of a plasma center.
公司首席执行官本·鲁德表示，该业务的利润率相对较低，与餐厅类似，很容易受到耗材和人工成本上涨的影响。各项开支加起来可不少：雇佣员工、购买设备和医疗用品、检测血浆，以及满足血浆中心的所有监管要求。
“You’re spending significant amounts of money to open a center, which then you obviously have to recoup,” Ruder said. “The incentive is commensurate with maintaining a healthy margin, just like any business would.”
“开设一家中心需要投入大量资金，显然你必须收回成本，”鲁德说道，“就像其他任何企业一样，保持健康的利润率是其动力所在。”
Donors say that the amount companies pay varies throughout the year, apparently as demand ebbs and flows. Payments tend to go down in December, for instance, when there is an uptick in people wanting to make extra money around the holidays. When tax refunds start hitting bank accounts at the start of the year, the number of sellers tends to go down, so the payments appear to go up to draw people in, sellers said.
捐赠者表示，公司支付的金额全年都在变化，显然是随着需求的波动而变化。例如，12月往往支付金额会下降，因为节假日期间人们都想赚点外快。卖家们说，年初退税款项开始到账时，卖家数量往往会减少，所以为了吸引更多人参与，支付金额看起来会上涨。
For the plasma sellers, the process can come with a physical price. The most common side effects are bruising where the needle is inserted, fatigue and lightheadedness, which can be managed with proper hydration and nutrition, according to the Department of Health and Human Services.
对于献血者来说，这个过程可能会带来一些身体上的不适。据美国卫生与公众服务部称，最常见的副作用是针头插入部位出现瘀青、疲劳和头晕，这些症状可以通过补充足够的水分和营养来缓解。
A small number of people can have an allergic reaction to a substance used to prevent clotting, causing chills, a tingling sensation and in rare cases more severe reactions that can require hospitalization, according to the Food and Drug Administration.
据美国食品药品监督管理局称，少数人可能对用于预防血凝块的物质产生过敏反应，导致发冷、刺痛感，在极少数情况下，还会出现需要住院治疗的更严重的反应。
While the FDA has allowed companies to collect a person’s plasma as frequently as twice a week since the 1970s, there is little research on the long-term health effects. Some studies have shown that regular plasma donors have a decrease in certain proteins and antibodies in their blood, but it’s unclear if that has health consequences. An industry-funded study found that people who sold their plasma more than once a week didn’t self-report significantly more health problems than those who did so less frequently.
自20世纪70年代以来，美国食品药品监督管理局（FDA）允许企业每周最多两次采集血浆，但关于长期健康影响的研究却很少。一些研究表明，定期献血浆者血液中某些蛋白质和抗体的含量有所下降，但这是否会对健康造成影响尚不明确。一项由行业资助的研究发现，每周献血浆超过一次的人，其自我报告的健康问题并没有比献血浆频率较低的人明显更多。
“We don’t see outcomes that appear to be related to plasma donation that are serious,” said Mark Weinstein, a retired FDA official who worked in the division that oversaw plasma products. “But should a person be wary of it? Personally, I wouldn’t be overly enthusiastic about giving twice a week.”
“我们目前尚未发现与血浆捐献相关的严重后果，”曾任职于负责监管血浆制品的FDA部门的退休官员马克·温斯坦表示，“但人们是否应该对此保持警惕呢？就我个人而言，我不会热衷于每周捐献两次。”
Doing larger-scale, controlled studies that follow donors over time and measure their health outcomes would be complex and expensive, Weinstein said.
温斯坦指出，开展更大规模的对照研究，长期追踪捐献者并评估其健康状况，将是一项复杂且成本高昂的工作。
On a recent Thursday morning, Jill Chamberlain, 57, arrived at a Kedplasma center in a Phoenix shopping center at 6:40 a.m. so she could be among the first in line when the doors opened. She was hoping to have enough time to sell her plasma before going to her full-time job doing administrative work for a local school district. As she waited in the cold, dark parking lot, nine other people joined her, and soon after opening, the waiting area was mostly full.
最近一个星期四的早晨，57岁的吉尔·张伯伦早上6点40分就来到了凤凰城一家购物中心的Kedplasma血浆中心，希望能赶在开门营业时成为第一批排队的人。她希望能在去当地学区做行政工作之前，有足够的时间卖掉自己的血浆。她在寒冷黑暗的停车场里等候时，又有九个人加入了她，开门后不久，等候区就几乎坐满了人。
It’s a place she never would have expected to be two years ago, before losing her job, when she was living comfortably in a four-bedroom home with a pool in Scottsdale, Arizona, and vacationing in Tokyo. Now, she’s counting on the money from her plasma to pay this month’s electric bill. If she sells her plasma twice a week, she can make at least $400 a month. 两年前，在她失业之前，她住在亚利桑那州斯科茨代尔一栋带游泳池的四居室豪宅里，过着舒适的生活，还经常去东京度假。那时，她做梦也想不到自己会落到今天这步田地。如今，她却要靠卖血浆的收入来支付这个月的电费。如果她每周卖两次血浆，每月至少能挣到400美元。
plasma sellers have to pass a screening that involves a blood test to check for protein levels and a physical exam to ensure they are healthy. Chamberlain said she tries to eat a balanced diet and stay well hydrated to pass the screening.
献血浆者必须通过一项筛选，包括血液检查（检测蛋白质水平）和体检（确保身体健康）。张伯伦说，为了通过筛选，她尽量保持均衡饮食和充足的水分。
Each time she goes, she must answer dozens of questions, like whether she’s had any recent vaccinations or is pregnant. Most plasma centers exclude people at risk for having an infectious disease, like those who recently received a tattoo or were released from prison.
每次去献血浆中心，她都要回答几十个问题，比如最近是否接种过疫苗，或者是否怀孕。大多数血浆中心都会排除那些有感染传染病风险的人，例如最近纹身的人或刚出狱的人。
Chamberlain said the process has taken a toll. Recently, she said an employee improperly inserted the needle twice, leaving her with large bruises on her arms. Even when the needle is inserted properly, she said it is still painful, and when the anti-clotting agent is injected, she shivers uncontrollably.
张伯伦说，这个过程让她身心俱疲。最近，她说有一名工作人员两次错误地插入针头，导致她手臂上留下了大片淤青。她说，即使针头正确插入，仍然会感到疼痛，注射抗凝血剂时，她会不由自主地颤抖。
She hopes to pick up more side work and stop selling her plasma as soon as possible. In addition to her full-time job for the school district, she works part time as a bookkeeper for a landscaping company and picks up extra shifts for the school district doing security at sporting events and evening janitorial work.
她希望尽快找到更多兼职，并停止出售血浆。除了在学区全职工作外，她还在一家园林绿化公司兼职做簿记员，并额外为学区做体育赛事安保和晚间清洁工作。
With those jobs and the plasma money, she takes home about $3,200 a month, about half of which goes to the rent for the two-bedroom apartment she shares with her 18-year-old son, who has been struggling to find a job since graduating from high school.
加上这些兼职和血浆收入，她每月大约能拿到3200美元，其中大约一半用来支付她和18岁儿子合租的两居室公寓的房租。她的儿子高中毕业后一直找不到工作。
“We always heard the middle class was disappearing,” she said. “But really, really quickly, the rich are getting richer and the rest of us are sinking.”
“我们总是听说中产阶级正在消失，”她说，“但现在看来，富人越来越富，而我们其他人却在不断下沉。”
Last year, people in the U.S. made an estimated $4.7 billion selling their plasma. Donation centers are popping up in middle-class neighborhoods, including suburban strip malls and college towns.
去年，美国人通过卖血浆获得了约47亿美元的收入。献血中心如雨后春笋般出现在中产阶级社区，包括郊区商业街和大学城。
Inside a suburban Philadelphia strip mall, between the Hair Cuttery and a Citizens Bank, a dozen people lay on black ergonomic beds a few feet apart, hooked up through a needle in the crook of their arms to machines pumping blood out of their veins. They were there to sell their plasma in exchange for $65 on a prepaid debit card.
在费城郊区一家小型购物中心里，位于美发店和市民银行之间，十几个人躺在相隔几英尺的黑色人体工学床上，手臂弯处插着针头，连接着抽取血液的机器。他们来这里是为了出售血浆，换取65美元的预付借记卡付款。
Ian Pleasant, 43, had come that morning to get some extra money for toilet paper and pet food.
43岁的伊恩·普莱森特那天早上来这里是为了挣点外快买卫生纸和宠物食品。
“I’m making enough money now doing DoorDash to keep up with the bills, but for anything else in the house, this is going to help out,” he said, as he waited for an employee at the B Positive plasma center in Holmes, Pennsylvania, to insert a thick needle into his arm.
“我现在靠送外卖挣的钱够付账单了，但家里其他开销，这点钱就派上用场了。”他一边说着，一边在宾夕法尼亚州霍姆斯市的B型阳性血浆中心等待工作人员将一根粗针头扎进他的手臂。
About an hour later, the employee came back to collect a container of his straw-colored plasma that would be tested, frozen and turned into medicines sold for a profit to patients around the world.
大约一个小时后，工作人员回来取走了他那淡黄色的血浆，这些血浆将被检测、冷冻，然后制成药品，出售给世界各地的患者以获取利润。
It’s a scene repeated by an estimated 200,000 people a day across the country as part of a multibillion-dollar business fueled by a growing number of Americans willing to trade their blood for money in an economy where many have seen their job prospects weaken, costs rise and savings dwindle. Despite data that shows a relatively stable economy, middle-class Americans say they have had to start selling their plasma over the past year to cover basic expenses, from medical bills to a winter coat for their child.
据估计，全美每天约有20万人重复着这样的场景，这构成了一个价值数十亿美元的产业，而推动这一产业发展的，正是越来越多的美国人愿意用自己的血液换取金钱。在经济形势严峻、许多人就业前景黯淡、生活成本上升、储蓄缩水的当下，这种现象尤为突出。尽管数据显示经济相对稳定，但美国中产阶级表示，过去一年里，他们不得不开始出售血浆来支付基本生活开支，从医疗费用到孩子的冬衣，无所不包。
“I’m angry that I’m working this much, that I’m educated, that I’m articulate, that I have marketable skills, and that I’m reduced to selling my plasma,” said Jill Chamberlain, in Phoenix, who has gone from making $87,000 a year to $16.11 an hour after being laid off from her job overseeing the finances of a local business in 2024. “I was ashamed at first, but now I’m angry. This is not how things are supposed to be.”
“我很生气，我辛辛苦苦工作了这么多年，我受过良好的教育，我口齿伶俐，我拥有市场所需的技能，却沦落到卖血浆的地步，”来自凤凰城的吉尔·张伯伦说道。她之前在一家当地企业负责财务，2024年被裁员后，年收入从8.7万美元骤降至每小时16.11美元。“起初我感到羞愧，但现在我感到愤怒。事情本不该是这样的。”
Last year, people in the U.S. made an estimated $4.7 billion selling about 62.5 million liters of their plasma, a more than 30% increase in the amount of plasma collected since 2022, according to Peter Jaworski, a professor at Georgetown University who studies the ethics and economics of the plasma business.
据乔治城大学研究血浆产业伦理和经济学的教授 Peter Jaworski 称，去年美国人通过出售约 6250 万升血浆，获得了约 47 亿美元的收入，比 2022 年的血浆采集量增长了 30% 以上。
The transactions occur in more than 1,200 plasma centers — there are now more places to sell plasma than there are Costco stores — and more are popping up in solidly middle-class neighborhoods, including suburban strip malls and college towns, Jaworski said. As America’s economic divide widens, with the top 1% of households owning more than 30% of the country’s wealth, the payments people receive for selling plasma are playing a quiet role in keeping households above water financially.
据贾沃斯基称，这些交易在超过1200家血浆中心进行——现在出售血浆的地点比好市多（Costco）门店还多——而且越来越多的血浆中心涌现于中产阶级聚居区，包括郊区商业街和大学城。随着美国经济差距的扩大，最富有的1%家庭拥有全国超过30%的财富，人们出售血浆所获得的报酬在维持家庭经济运转方面发挥着默默的作用。
Meteoric increase
迅猛增长
The number of plasma centers in the U.S. more than doubled in the past decade.
过去十年间，美国的血浆治疗中心数量增加了一倍多。
Margo Thompson and her husband make around $120,000 a year in a rural corner of Idaho, but the couple started selling their plasma about a year ago to cover their car payment and one-time expenses, like new tires and medical bills. In Oklahoma City, Larry Jones, 64, started selling his plasma in April after his rent increased to $800 a month, taking a significant chunk out of the $1,800 a month in take-home pay he gets as a school bus monitor for children with disabilities. Erin Ragnetti started selling plasma in the past year to pay off debt and bills not covered by her cleaning jobs and her husband’s salary at a heating and cooling company in Fresno, California.
玛戈·汤普森和她的丈夫在爱达荷州的一个乡村地区生活，年收入约12万美元。但大约一年前，为了支付车贷和一些一次性开支，例如更换轮胎和医疗费用，这对夫妇开始出售血浆。
在俄克拉荷马城，64 岁的拉里·琼斯于今年 4 月份开始卖血浆，因为他的房租涨到了每月 800 美元，这让他每月 1800 美元的到手工资大幅缩水。他是一名残疾儿童校车监护员。
艾琳·拉格内蒂去年开始出售血浆，以偿还她清洁工作的收入和她丈夫在加州弗雷斯诺一家供暖制冷公司工作的工资加在一起还不足以支付的债务和账单。
"Because the economy is what it is right now, everything’s just so much more expensive,” Ragnetti said. “I realized, if we’re going to make ends meet, I’ve got to find a way to make more money.”
“因为现在的经济形势不好，所有东西都贵了很多，”拉格内蒂说。“我意识到，如果我们想维持生计，我就必须想办法赚更多的钱。”
Researchers have found that when a new plasma center opens in a neighborhood, foot traffic at local grocery stores increases, interest in payday loans declines and crime goes down, an indication of the way money from plasma props up households’ finances for necessities.
研究人员发现，当一个社区开设新的血浆中心时，当地杂货店的客流量会增加，人们对发薪日贷款的兴趣会下降，犯罪率也会下降，这表明血浆带来的收入可以支撑家庭的财务，满足生活必需品的需求。
It’s a uniquely American economic phenomenon. Only a handful of countries allow people to be paid for their plasma and donate as frequently as the U.S. does — up to twice a week, though there is limited data on the long-term health effects, and some people report dizziness, bruising and exhaustion after the process. People lose 10% of their blood volume when they donate; a healthy person should be able to regenerate that within hours to days.
这是一种独特的美国经济现象。只有少数几个国家允许人们有偿献血并且捐献频率像美国一样高——最多可达每周两次，尽管关于长期健康影响的数据有限，而且有些人反映捐献后会出现头晕、瘀伤和疲惫等症状。捐献血浆会消耗人体10%的血容量；健康人通常能在数小时到数天内恢复这些血容量。
The looser rules in the U.S. have turned plasma into a significant export: America supplies 70% of the world’s plasma, shipping $6.2 billion worth overseas in 2024.
美国较为宽松的监管规定使血浆成为一项重要的出口商品：美国供应全球 70% 的血浆，2024 年向海外出口价值 62 亿美元的血浆。
“The U.S. has created a very attractive market for plasma centers,” said Emily Gallagher, a business professor at University of Colorado Boulder who has studied the economic impact of plasma collection. “Not only does it allow for paid donation of up to twice a week, but we also have a country where there’s a lot of poverty and a social system that doesn’t help that much.”
“美国为血浆中心创造了一个极具吸引力的市场，”科罗拉多大学博尔德分校的商学教授艾米丽·加拉格尔说道，她曾研究过血浆采集的经济影响。“这不仅允许人们每周最多两次有偿献血，而且我们国家贫困人口众多，社会保障体系也未能提供足够的帮助。”
In the suburbs of Minneapolis, Michelle Eagan drops her son off at preschool then drives 35 minutes across town twice a week to sell her plasma to help cover his $700-a-month tuition.
在明尼阿波利斯郊区，米歇尔·伊根每周两次开车 35 分钟穿过市区去卖血浆，以帮助支付儿子每月 700 美元的学费。
“It’s a nice preschool. Sometimes I do think, ‘I bet there are no other parents here that are donating plasma to pay for this preschool,’” said Eagan, who has made around $400 a month from her plasma since September.
“这是一家不错的幼儿园。有时候我会想，‘我敢肯定这里没有其他家长像我一样捐献血浆来支付这所幼儿园的费用，’”伊根说道。自九月份以来，她每月通过捐献血浆获得约 400 美元的收入。
The money has become a necessity for Eagan’s family after she left her job making $75,000 a year as a paralegal for UnitedHealth Group to care for her son full time. Even living in a relatively affordable part of Minneapolis, her husband’s $90,000 salary as a business manager hasn’t been enough for the family of three to get by, and their credit card balances have been steadily rising.
伊根辞去了在联合健康集团担任律师助理、年薪7.5万美元的工作，全职照顾儿子后，这笔钱对她家来说成了必需品。即使住在明尼阿波利斯相对便宜的地区，她丈夫作为企业经理的9万美元年薪也难以维持一家三口的生活，他们的信用卡欠款一直在稳步增长。
Eagan sells her plasma to BioLife, which is a part of the Japanese drugmaker Takeda; many plasma centers are run by a handful of biopharmaceutical companies that turn the fluid into medicine. BioLife, like others, uses incentives to keep her coming. For instance, her first payment of the week is $45, but if she goes back a second time that week, she gets $65. In November, the company ran a “Sweater Weather” promotion where clients who sold their plasma eight times that month would get entered into a raffle to win $1,000. In December, BioLife offered reward points for people who donated seven times in a month or for three consecutive months that they could redeem for gift cards.
伊根将血浆卖给BioLife公司，该公司隶属于日本制药公司武田制药。许多血浆中心都由少数几家生物制药公司运营，这些公司将血浆转化为药品。BioLife和其他公司一样，通过各种激励措施来吸引伊根定期献血。例如，她每周第一次献血可获得45美元，但如果她当周第二次献血，则可获得65美元。11月，该公司推出了一项名为“毛衣天气”的促销活动，当月献血八次的客户将有机会参加抽奖，赢取1000美元奖金。12月，BioLife为每月献血七次或连续三个月献血的客户提供奖励积分，这些积分可以兑换礼品卡。
“It’s like a drug dealer — once they have you in there, they have to keep you coming back,” Eagan said. “But they’re not a charity. They can get people to come in there for that amount of money, if it’s worth your time, and clearly it’s worth my time.”
“这就像毒贩一样——一旦你进去了，他们就得让你不断回来，”伊根说。“但他们不是慈善机构。如果值得你花时间，他们就能用那点钱让你进去，而显然值得我花时间。”
BioLife declined to comment on how it determines its compensation structure. The company, like others, said that it isn’t paying individuals for their plasma, which the company says they are donating, but rather compensating them for their time. (People are generally only paid, though, if they give their plasma; they aren’t paid if they try to donate but are turned away, for example if they are dehydrated or have low protein levels.)
BioLife公司拒绝就其薪酬结构做出评论。该公司与其他公司一样表示，他们并非为捐献者提供的血浆支付报酬，而是为他们的付出时间支付报酬。（不过，通常情况下，只有在成功捐献血浆后，人们才能获得报酬；如果他们尝试捐献但因脱水或蛋白质水平过低等原因被拒绝，则不会获得报酬。）
“People choose to donate plasma for a variety of reasons. Whether for personal motivations, a desire to give back, or to receive compensation for their time and commitment, we recognize and appreciate everyone who graciously donates plasma,” BioLife said in a statement. “In line with industry practice, BioLife compensates plasma donors in recognition for their time and effort. The level of compensation may vary depending on center location and if someone is an existing or new donor.”
“人们捐献血浆的原因多种多样。无论是出于个人动机、回馈社会的愿望，还是为了获得时间和付出的补偿，我们都感谢每一位慷慨捐献血浆的人，”BioLife在一份声明中表示。“根据行业惯例，BioLife会向血浆捐献者支付补偿，以感谢他们的时间和付出。补偿金额可能因捐献中心所在地以及捐献者是新老捐献者而有所不同。”
Turning plasma from an individual donor into a treatment for a patient can be a complex process that takes up to a year. The plasma is tested for viruses and then goes through a purification and manufacturing process, where the proteins and antibodies are extracted. It can take plasma from more than 100 people to support one patient each year, according to the plasma Protein Therapeutics Association.
将捐献者的血浆转化为患者的治疗药物是一个复杂的过程，可能需要长达一年的时间。血浆首先要进行病毒检测，然后经过纯化和生产过程，提取其中的蛋白质和抗体。据血浆蛋白治疗协会称，每年可能需要从100多人身上提取血浆才能治疗一名患者。
plasma industry officials said they see their business as a win-win: Patients get the plasma they need to treat potentially fatal conditions, like hemophilia, burns and rare immune disorders, and those selling their plasma get extra money to help out with their household expenses.
血浆行业官员表示，他们认为自己的生意是双赢的：患者可以获得治疗血友病、烧伤和罕见免疫系统疾病等潜在致命疾病所需的血浆，而出售血浆的人可以获得额外的收入来补贴家用。
“We hope that when people consider donating plasma, it is not only something that you would consider at a time of need, but something that you might make part of your altruistic endeavors,” Anita Brikman, head of the plasma Protein Therapeutics Association, said. “People think about blood donation that way, and we hope that more people would think about plasma donation.”
“我们希望人们在考虑捐献血浆时，不仅将其视为一种在需要时才会考虑的选择，更将其视为一种利他行为，”血浆蛋白治疗协会主席安妮塔·布里克曼 (Anita Brikman) 表示。“人们会这样看待献血，我们也希望更多的人能够考虑捐献血浆。”
While there are altruistic reasons for giving plasma, without the financial incentive, there wouldn’t be enough supply to meet the demand for plasma-based treatments, Jaworski, the plasma researcher, said. Countries that don’t allow payment for plasma, such as Australia and the U.K., don’t have enough plasma-based therapies available to treat patients, making them dependent on plasma from the U.S., he said.
血浆研究员贾沃斯基 (Jaworski) 指出，虽然捐献血浆有其利他主义的理由，但如果没有经济激励，血浆的供应量将不足以满足基于血浆的治疗需求。他表示，像澳大利亚和英国这样不允许支付血浆费用的国家，其基于血浆的疗法不足以治疗患者，因此不得不依赖来自美国的血浆。
“The model of not compensating people just doesn’t lead to enough plasma,” Jaworski said. “In the United States, we don’t pay people to donate blood, but we have enough blood. However, when it comes to plasma, we need much more participation, and we need people to donate much more often.” (Donating blood can be faster than donating plasma, which takes about an hour, as a machine filters the plasma from the donor’s blood and returns what remains back into the donor’s body.)
“不支付报酬的模式根本无法提供足够的血浆，”贾沃斯基说道。 “在美国，我们不付钱请人献血，而且血液供应充足。但是，在血浆捐献方面，我们需要更多的人参与，也需要人们更频繁地捐献。”（献血比捐献血浆快，捐献血浆大约需要一个小时，因为机器会将血浆从捐献者的血液中过滤出来，并将剩余的物质输回捐献者体内。）
plasma sellers interviewed by NBC News said the benefit to patients was an added bonus, but it was the money that drew them in and kept them coming back.
接受NBC新闻采访的血浆捐献者表示，对患者的益处固然是额外的好处，但真正吸引他们并让他们不断重复捐献的还是金钱。
“They are all about how you’re helping to save lives. But honestly, no one’s there for that,” Eagan said.
“他们总是说你在帮助拯救生命。但说实话，根本没人是冲着这个来的。”伊根说道。
At the B Positive plasma center near Philadelphia, workers bounce among a steady flow of patients, inserting needles, removing tubes and canisters still coated in blood, and ferrying plasma into a walk-in freezer before it’s shipped to pharmaceutical companies to be turned into medicines. 在费城附近的B Positive血浆中心，工作人员穿梭于络绎不绝的病人之间，穿插着针头，取出仍沾有血液的试管和容器，并将血浆运送到步入式冷冻库，之后再运往制药公司加工成药品。
Ben Ruder, the company’s CEO, said the business operates on relatively narrow margins, similar to those of a restaurant, and is vulnerable to spikes in the cost of supplies and labor. The expenses add up: hiring staff, buying equipment and medical supplies, testing the plasma, and meeting all the regulatory requirements of a plasma center.
公司首席执行官本·鲁德表示，该业务的利润率相对较低，与餐厅类似，很容易受到耗材和人工成本上涨的影响。各项开支加起来可不少：雇佣员工、购买设备和医疗用品、检测血浆，以及满足血浆中心的所有监管要求。
“You’re spending significant amounts of money to open a center, which then you obviously have to recoup,” Ruder said. “The incentive is commensurate with maintaining a healthy margin, just like any business would.”
“开设一家中心需要投入大量资金，显然你必须收回成本，”鲁德说道，“就像其他任何企业一样，保持健康的利润率是其动力所在。”
Donors say that the amount companies pay varies throughout the year, apparently as demand ebbs and flows. Payments tend to go down in December, for instance, when there is an uptick in people wanting to make extra money around the holidays. When tax refunds start hitting bank accounts at the start of the year, the number of sellers tends to go down, so the payments appear to go up to draw people in, sellers said.
捐赠者表示，公司支付的金额全年都在变化，显然是随着需求的波动而变化。例如，12月往往支付金额会下降，因为节假日期间人们都想赚点外快。卖家们说，年初退税款项开始到账时，卖家数量往往会减少，所以为了吸引更多人参与，支付金额看起来会上涨。
For the plasma sellers, the process can come with a physical price. The most common side effects are bruising where the needle is inserted, fatigue and lightheadedness, which can be managed with proper hydration and nutrition, according to the Department of Health and Human Services.
对于献血者来说，这个过程可能会带来一些身体上的不适。据美国卫生与公众服务部称，最常见的副作用是针头插入部位出现瘀青、疲劳和头晕，这些症状可以通过补充足够的水分和营养来缓解。
A small number of people can have an allergic reaction to a substance used to prevent clotting, causing chills, a tingling sensation and in rare cases more severe reactions that can require hospitalization, according to the Food and Drug Administration.
据美国食品药品监督管理局称，少数人可能对用于预防血凝块的物质产生过敏反应，导致发冷、刺痛感，在极少数情况下，还会出现需要住院治疗的更严重的反应。
While the FDA has allowed companies to collect a person’s plasma as frequently as twice a week since the 1970s, there is little research on the long-term health effects. Some studies have shown that regular plasma donors have a decrease in certain proteins and antibodies in their blood, but it’s unclear if that has health consequences. An industry-funded study found that people who sold their plasma more than once a week didn’t self-report significantly more health problems than those who did so less frequently.
自20世纪70年代以来，美国食品药品监督管理局（FDA）允许企业每周最多两次采集血浆，但关于长期健康影响的研究却很少。一些研究表明，定期献血浆者血液中某些蛋白质和抗体的含量有所下降，但这是否会对健康造成影响尚不明确。一项由行业资助的研究发现，每周献血浆超过一次的人，其自我报告的健康问题并没有比献血浆频率较低的人明显更多。
“We don’t see outcomes that appear to be related to plasma donation that are serious,” said Mark Weinstein, a retired FDA official who worked in the division that oversaw plasma products. “But should a person be wary of it? Personally, I wouldn’t be overly enthusiastic about giving twice a week.”
“我们目前尚未发现与血浆捐献相关的严重后果，”曾任职于负责监管血浆制品的FDA部门的退休官员马克·温斯坦表示，“但人们是否应该对此保持警惕呢？就我个人而言，我不会热衷于每周捐献两次。”
Doing larger-scale, controlled studies that follow donors over time and measure their health outcomes would be complex and expensive, Weinstein said.
温斯坦指出，开展更大规模的对照研究，长期追踪捐献者并评估其健康状况，将是一项复杂且成本高昂的工作。
On a recent Thursday morning, Jill Chamberlain, 57, arrived at a Kedplasma center in a Phoenix shopping center at 6:40 a.m. so she could be among the first in line when the doors opened. She was hoping to have enough time to sell her plasma before going to her full-time job doing administrative work for a local school district. As she waited in the cold, dark parking lot, nine other people joined her, and soon after opening, the waiting area was mostly full.
最近一个星期四的早晨，57岁的吉尔·张伯伦早上6点40分就来到了凤凰城一家购物中心的Kedplasma血浆中心，希望能赶在开门营业时成为第一批排队的人。她希望能在去当地学区做行政工作之前，有足够的时间卖掉自己的血浆。她在寒冷黑暗的停车场里等候时，又有九个人加入了她，开门后不久，等候区就几乎坐满了人。
It’s a place she never would have expected to be two years ago, before losing her job, when she was living comfortably in a four-bedroom home with a pool in Scottsdale, Arizona, and vacationing in Tokyo. Now, she’s counting on the money from her plasma to pay this month’s electric bill. If she sells her plasma twice a week, she can make at least $400 a month. 两年前，在她失业之前，她住在亚利桑那州斯科茨代尔一栋带游泳池的四居室豪宅里，过着舒适的生活，还经常去东京度假。那时，她做梦也想不到自己会落到今天这步田地。如今，她却要靠卖血浆的收入来支付这个月的电费。如果她每周卖两次血浆，每月至少能挣到400美元。
plasma sellers have to pass a screening that involves a blood test to check for protein levels and a physical exam to ensure they are healthy. Chamberlain said she tries to eat a balanced diet and stay well hydrated to pass the screening.
献血浆者必须通过一项筛选，包括血液检查（检测蛋白质水平）和体检（确保身体健康）。张伯伦说，为了通过筛选，她尽量保持均衡饮食和充足的水分。
Each time she goes, she must answer dozens of questions, like whether she’s had any recent vaccinations or is pregnant. Most plasma centers exclude people at risk for having an infectious disease, like those who recently received a tattoo or were released from prison.
每次去献血浆中心，她都要回答几十个问题，比如最近是否接种过疫苗，或者是否怀孕。大多数血浆中心都会排除那些有感染传染病风险的人，例如最近纹身的人或刚出狱的人。
Chamberlain said the process has taken a toll. Recently, she said an employee improperly inserted the needle twice, leaving her with large bruises on her arms. Even when the needle is inserted properly, she said it is still painful, and when the anti-clotting agent is injected, she shivers uncontrollably.
张伯伦说，这个过程让她身心俱疲。最近，她说有一名工作人员两次错误地插入针头，导致她手臂上留下了大片淤青。她说，即使针头正确插入，仍然会感到疼痛，注射抗凝血剂时，她会不由自主地颤抖。
She hopes to pick up more side work and stop selling her plasma as soon as possible. In addition to her full-time job for the school district, she works part time as a bookkeeper for a landscaping company and picks up extra shifts for the school district doing security at sporting events and evening janitorial work.
她希望尽快找到更多兼职，并停止出售血浆。除了在学区全职工作外，她还在一家园林绿化公司兼职做簿记员，并额外为学区做体育赛事安保和晚间清洁工作。
With those jobs and the plasma money, she takes home about $3,200 a month, about half of which goes to the rent for the two-bedroom apartment she shares with her 18-year-old son, who has been struggling to find a job since graduating from high school.
加上这些兼职和血浆收入，她每月大约能拿到3200美元，其中大约一半用来支付她和18岁儿子合租的两居室公寓的房租。她的儿子高中毕业后一直找不到工作。
“We always heard the middle class was disappearing,” she said. “But really, really quickly, the rich are getting richer and the rest of us are sinking.”
“我们总是听说中产阶级正在消失，”她说，“但现在看来，富人越来越富，而我们其他人却在不断下沉。”
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