Bisphenol A, Bisphenol S, and 4-Hydro​xyphenyl 4-Isopro​oxyphenyl​sulfone (BPSIP) in Urine and Blood of Cashiers.
Level 3 - non-randomized controlled study
Prospective observational occupational study with pre- and post-shift sampling and a control group.
PubMed 26309242 · doi:10.1289/ehp.1409427
What was done
Researchers measured bisphenol A (BPA), bisphenol S (BPS), and 4-hydroxyphenyl 4-isoprooxyphenylsulfone (BPSIP) in thermal receipt paper, urine, and blood samples from 77 cashiers and 25 non-cashiers in North Carolina between 2011 and 2013. Urine and serum samples were collected pre-shift and within 2 hours post-shift from cashiers, and concentrations were compared between pre- and post-shift periods as well as between cashiers and non-cashiers.
What was found
Receipts contained 1% to 2% by weight of BPA, BPS, or BPSIP. Among 33 cashiers handling BPS receipts, post-shift geometric mean urinary BPS was significantly higher than pre-shift levels. In 31 cashiers handling BPA receipts, urine BPA was as likely to decrease as increase post-shift, but mean post-shift concentrations were significantly higher than those in non-cashiers. BPSIP was detected more frequently in the urine of cashiers handling BPSIP receipts than in non-cashiers. Total BPA and BPS were detected in the serum of only a few cashiers, whereas BPSIP was detected more frequently in serum. Exact numerical concentrations, p-values, and confidence intervals were not reported in the abstract.
Why it matters
This study demonstrates that handling thermal cash register receipts is a viable occupational route of exposure not only to BPA but also to replacement compounds like BPS and BPSIP. It highlights that substitute chemicals in consumer paper products can lead to direct systemic human absorption.
Limits
The sample size was relatively small (77 cashiers across different chemical exposure groups and 25 controls) and geographically limited to one region. Non-occupational sources of exposure (such as diet) were not controlled for in the abstract, and serum detection rates for BPA and BPS were low.
Cited by
- supports Handling thermal receipts with hand sanitizers or creams increases dermal absorption of BPA into the bloodstream about a hundredfold compared to dry hands.