Hormann · PloS one 2014 · Human experimental exposure study · n=?

Holding thermal receipt paper and eating food after using hand sanitizer results in high serum bioactive and urine total levels of bisphenol A (BPA).

Cited 203 times in the scientific literature.

Level 3 - non-randomized controlled study

Non-randomized human experimental challenge study assessing before-and-after biomarker levels.

PubMed 25337790 · doi:10.1371/journal.pone.0110509 · record verified 2026-08-26

What was done

Men and women applied a hand sanitizer containing dermal penetration enhancers, held thermal receipt paper containing free bisphenol A (BPA; ~20 mg BPA/g paper), and then handled and ate French fries. Investigators measured transfer of BPA to hands and food, as well as resulting concentrations of unconjugated (bioactive) BPA in serum and total BPA in urine over time.

What was found

Free BPA transferred from thermal receipt paper to sanitized hands and subsequently to food. The combination of dermal and oral exposure led to a rapid average maximum increase (Cmax) of ~7 ng/mL unconjugated BPA in serum and ~20 µg total BPA/g creatinine in urine within 90 minutes.

Why it matters

Regulatory risk assessments often assume BPA exposure occurs primarily via diet through ingestion, where first-pass hepatic metabolism rapidly clears it. This study demonstrates that dermal penetration enhancers and mucosal/dermal uptake from routine receipt handling can bypass first-pass metabolism and cause substantial spikes in circulating bioactive BPA.

Limits

The abstract does not state the sample size (n), participant demographics, or whether a control condition (e.g., handling receipts without hand sanitizer or without eating) was evaluated simultaneously. Long-term clearance kinetics and clinical health outcomes were not measured.

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