Occupational exposure of cashiers to Bisphenol A via thermal paper: urinary biomonitoring study.
Level 4 - case-series / case-control
Cross-sectional comparative biomonitoring study
PubMed 27126703 · doi:10.1007/s00420-016-1132-8
What was done
Researchers evaluated BPA exposure among 90 cashiers and 44 non-occupationally exposed control workers across several workplaces. Urinary BPA was measured in free (unconjugated) and total (unconjugated plus conjugated) forms from 24-hour and spot urine samples using LC-MS/MS. BPA concentrations in workplace thermal paper were determined, and questionnaires collected data on diet, tobacco use, handwashing frequency, and job characteristics.
What was found
Free and total BPA were detected in all urine samples. Median total urinary BPA concentration was 8.92 µg/L (6.76 µg/g creatinine) in cashiers compared with 3.54 µg/L (2.89 µg/g creatinine) in controls, reflecting a significant increase. Median free urinary BPA was 0.28 µg/L (0.22 µg/g creatinine) in cashiers versus 0.20 µg/L (0.21 µg/g creatinine) in controls, which was not significantly different. No correlation was found between urinary BPA concentrations and the number of receipts handled, handwashing frequency, age, job length of service, or tobacco use.
Why it matters
This study provides real-world human biomonitoring data showing that occupational handling of thermal receipts contributes to elevated total BPA excretion, moving beyond simulated or modelled exposure estimates.
Limits
The study is limited by a modest sample size (134 total participants) and a cross-sectional design that cannot confirm causation. Dietary and other non-occupational BPA sources were tracked by questionnaire rather than strict control, no dose-response relationship was detected with the number of receipts handled, and clinical health endpoints were not assessed.
Cited by
- supports Studies show that retail checkout workers who handle receipts, particularly pregnant checkout workers, have some of the highest measured levels of bisphenol A (BPA).