Objective : To identify the factors affecting donation-associated adverse reactions among volunteer blood donors, so as to provide the evidence for improving the quality of blood donation services. Methods : The volunteer blood donors in Quzhou Blood Center in 2019 were recruited. The Self-rating Anxiety Scale ( SAS ), Social Support Rating Scale ( SSRS ) and Pittsburgh Sleep Quality Index ( PSQI ) scores were measured prior to blood donation, and the presence of donation-associated adverse reactions was observed in the field of blood donation and within one week through short-message-service follow-up. The factors affecting donation-associated adverse reactions were identified using multivariable logistic regression analysis. Results : A total of 8 240 volunteer blood donors were enrolled, and adverse reactions occurred in 236 subjects, with an incidence rate of 2.86%. The SSRS, PSQI and SAS scores were 37.68±7.14, 5.97±1.25 and 52.82±3.25 among the donors with adverse reactions, respectively. Multivariable logistic regression analysis identified the educational level ( high school, OR=0.508, 95%CI: 0.289-0.891; diploma and above, OR=0.306, 95%CI: 0.253-0.734 ), SSRS score ( OR=0.399, 95%CI: 0.175-0.913 ), PSQI score ( OR=1.962, 95%CI: 1.116-3.450 ) and SAS score ( OR=2.013, 95%CI: 1.279-3.903 ) as factors affecting donation-associated adverse reactions. Conclusion The development of donation-associated adverse reactions correlates with educational level, social support, sleep quality and anxiety among volunteer blood donors.