Most people are familiar with bisphenol A or BPA, the notorious chemical in polycarbonate plastic which was previously used to make baby bottles, sippy cups and sport water bottles. Fortunately, these products are now made of BPA-free plastic, so we don’t need to worry about exposure to hormone-disrupting BPA in these products anymore.
While many people are aware of BPA’s negative reputation, fewer people know that BPA and its chemical cousin BPS (bisphenol S) are widely present in thermal receipts, used widely in commerce in grocery stores, theaters and malls. One study found BPA in 94% of the 103 receipts tested from 4 countries and 100% of the U.S. receipts contained BPA. Another study found that BPS is just as widely used as BPA in receipt paper. Of fifty receipts tested, 53% contained BPS and 44% had BPA.
The BPA in thermal receipt paper reacts with heat to imprint the ink. Merchants like this system, because it’s inexpensive and works well. The problem is the BPA is not bound to the paper, so it easily rubs off when handled and is absorbed into your skin. BPA-tainted receipts in your wallet will also transfer BPA to paper currency, providing an additional exposure when handling money. Because of extensive paper recycling, BPA is also routinely detected in paper products, such as napkins and toilet paper.
Exposure to BPA in food packaging and thermal receipts is so widespread that the CDC has detected this hormone disrupter in 93% of Americans tested. Children aged 6-11 have higher levels of BPA in their bodies than adults. Fetuses and young children are at highest risk, because they are still developing and young children’s behavior such as putting fingers in their mouths increases exposure. Even low dose exposure to BPA is associated with increased risk of reproductive and developmental problems, cancer and even obesity. In adults higher urinary concentrations of BPA were associated with hypertension, obesity and diabetes. Working as a cashier can significantly increase exposure to BPA. Pregnant women who worked as cashiers were found to have the highest urinary levels of BPA compared with pregnant women in other occupations.
Toxic Mixture – Hand Sanitizers and Thermal Receipts
Using hand sanitizer while handling thermal receipts increases exposure to BPA. Hand sanitizers contain mixtures of dermal penetration-enhancing chemicals to increase chemical absorption by up to 100-fold. Unfortunately, they also increase penetration of BPA. In one study they measured the amount of BPA absorbed from handling BPA-tainted receipts with dry hands compared with using hand sanitizer before handling receipts and found that absorption significantly increased with use of hand sanitizer. They found even higher levels of BPA in the hand sanitizer group that ate French fries after handling receipts. The take away message is – using hand sanitizer before handling BPA-tainted receipts, increases the absorption of BPA and handling food without first washing hands with soap and water will further increase BPA levels in the body.
Reduce your exposure to BPA in receipt paper
The U.S. EPA did an extensive study of BPA in thermal receipt papers and examined 19 effective alternatives to BPA, but found that none met their criteria as safer alternatives, including BPS, which is also hormone active like BPA. So more research and innovation are needed to solve this problem!
Many companies are searching for safer alternatives to BPA and BPS, including Minnesota-based Best Buy Company, which has found a replacement thermal paper that is BPA and BPS free.
In the meantime…
If you work as a cashier, your exposure to BPA in receipts is likely much higher than average, so it’s wise to take steps to reduce your exposure. The Minnesota Pollution Control Agency is working on this issue and they have some helpful tips to reduce exposure for cashiers.
For everyone else, take precautionary action to avoid unnecessary contact with thermal receipts to help protect your family’s health. See Top Tips for Healthy Kids – Thermal Receipt Paper.
Kathleen Schuler, MPH, Healthy Kids and Families Program Director, Co-Director Healthy Legacy
 Liao C. and Kannan K. Widespread occurence of bisphenol a in paper and paper products: implications for human exposure. Environ. Sci. Technol. 2011;45:9372-79.
 Hormann AM, vom Saal FS, Nagel SC, Stahlhut RW et al. Holding thermal receipt paper and eating food after using hand sanitizer results in high serum bioactive and urine total levels of bisphenol A (BPA). PLOSone. 2014;9(10):e110509:1-12.
 Liao C. and Kannan K. High levels of bisphenol A in paper currencies from several countries, and implications for dermal exposure. Environ. Sci. Technol. 2011;45:6761-68.
 Liao, 2011.
 Rancière F, Lyons JG, Loh VH, Botton J et al. Bisphenol A and the risk of cardiometabolic disorders: a systematic review with meta-analysis of the epidemiological evidence. Environ Health. 2015;14:46.
 Braun JM, Kalkbrenner AE, Calafat AM, Bernert JT et al. Variability and Predictors of Urinary Bisphenol A Concentrations during Pregnancy Environ Health Perspect. 2011;119(1):131-37.
 Hormann et al, 2014.