Thermal Receipt Paper Raises BPA Levels in Human Blood

Author: University of Missouri
Published: 10 May 2017 - Updated: 30 Sep 2026
Publication Type: Research, Study, Analysis

Table of Contents:
Synopsis - Definition - Overview - FAQs - Insights, Updates - Related Content

Synopsis

This research from the University of Missouri, led by biologist Frederick vom Saal and published in the peer-reviewed journal PLOS ONE, offers the first data showing that bisphenol A (BPA) coating thermal cash register receipts is a major source of the high BPA levels found in people. Volunteers cleaned their hands with hand sanitizer, held a receipt, and then ate French fries with their fingers, and their blood and urine BPA levels climbed within minutes as the chemical passed through the skin and onto the food they ate. The findings matter because BPA is a known endocrine disruptor that interferes with estrogen and other hormone signaling, and exposure happens during ordinary daily routines rather than in industrial settings. Cashiers and retail workers who handle receipts all day, pregnant women, children, seniors, and people with chronic conditions such as diabetes or immune disorders stand to benefit most from understanding how this everyday exposure works and how easily it can be reduced.*

At a Glance

• 1 - BPA was first developed by a biochemist and tested as an artificial estrogen supplement.
• 2 - Hand creams, soaps, and sunscreens can also change how quickly BPA moves from a receipt into the skin.
• 3 - Airline tickets, ATM slips, and fast food receipts also carry BPA on the paper surface as a print developer.
• 4 - Replacement chemicals now used in some BPA-free thermal paper may pose similar risks to human health, according to the researchers.

Topic Definition

Bisphenol A (BPA)

Bisphenol A (BPA) is an industrial chemical used primarily to make polycarbonate plastic and epoxy resins. It is a colorless solid that is soluble in organic solvents, but poorly soluble in water. It has been in commercial use since 1957 and used in countless applications such as water bottles, sports equipment, CDs, and DVDs. Epoxy resins containing BPA are used to line water pipes, as coatings on the inside of many food and beverage cans and in making thermal paper such as that used in sales receipts. In 2015, an estimated 4 million tonnes of BPA chemical were produced for manufacturing polycarbonate plastic, making it one of the highest volume of chemicals produced worldwide.

Overview

Research conducted at the University of Missouri is providing the first data that BPA from thermal paper used in cash register receipts accounts for high levels of BPA in humans. Subjects studied showed a rapid increase of BPA in their blood after using a skin care product and then touching a store receipt with BPA.

"BPA first was developed by a biochemist and tested as an artificial estrogen supplement," said Frederick vom Saal, Curators Professor of Biological Sciences in the College of Arts and Science at MU.

As an endocrine disrupting chemical, BPA has been demonstrated to alter signaling mechanisms involving estrogen and other hormones.

Massive Amounts of BPA

Store and fast food receipts, airline tickets, ATM receipts and other thermal papers all use massive amounts of BPA on the surface of the paper as a print developer.

The problem is, we as consumers have hand sanitizers, hand creams, soaps and sunscreens on our hands that drastically alter the absorption rate of the BPA found on these receipts."

In the study, researchers tested human subjects who cleaned their hands with hand sanitizer and then held thermal paper receipts.

As an added step, subjects who had handled the thermal paper then ate French fries with their hands. The result was that BPA was absorbed very rapidly, vom Saal said.

"Our research found that large amounts of BPA can be transferred to your hands and then to the food you hold and eat as well as be absorbed through your skin," vom Saal said.

BPA exhibits hormone-like properties and has been proven to cause reproductive defects in fetuses, infants, children and adults as well as cancer, metabolic and immune problems in rodents.

BPA from thermal papers will be absorbed into your blood rapidly; at those levels, many diseases such as diabetes and disorders such as obesity increase as well.

Use of BPA, or other similar chemicals that are being used to replace BPA in thermal paper, pose a threat to human health.

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

Frequently Asked Questions

NOTE: Researched FAQs by Disabled World (DW)

How can I tell if a receipt is printed on thermal paper?

Thermal paper usually feels smooth and slightly glossy, and the printed side darkens when scratched quickly with a fingernail or exposed to heat. Standard paper will not change color this way.

Are BPA-free receipts safe to handle?

Many BPA-free receipts use bisphenol S or similar compounds, which research suggests may have comparable hormone-disrupting effects. Paper using non-bisphenol developers or digital receipts are safer choices.

Does washing hands remove BPA from receipts?

Washing with plain soap and water after handling receipts can remove much of the BPA left on the skin surface. Alcohol-based sanitizers are not a substitute and may increase absorption.

Should cashiers wear gloves when handling receipts?

Nitrile gloves can reduce direct skin contact for workers who handle receipts throughout a shift. Avoiding lotion or sanitizer before handling receipts also lowers exposure.

Is BPA exposure from receipts a concern during pregnancy?

BPA can cross the placenta and has been linked to developmental effects in animal studies. Pregnant women may choose to decline paper receipts or ask for electronic copies to limit exposure.

How long does BPA stay in the body?

BPA is processed fairly quickly and much of it leaves the body in urine within a day. Repeated daily contact, however, can keep levels consistently elevated.

Can thermal receipts be recycled?

Thermal receipts are best kept out of paper recycling because BPA can spread into recycled paper products such as napkins and food packaging. Placing them in regular trash is generally recommended.

Which countries restrict BPA in thermal paper?

The European Union banned BPA in thermal paper above a set limit starting in 2020, and some U.S. states have introduced similar restrictions. Rules vary widely by region.

Insights, Analysis, and Developments

Editorial Note: What makes this study stand out is how ordinary the exposure is - a quick squirt of sanitizer, a receipt handed over at the checkout, a snack eaten on the way out the door. Animal research has tied BPA to reproductive defects, cancer, and metabolic and immune problems, while elevated human levels have been linked to higher rates of diabetes and obesity, so the rapid absorption seen here deserves attention from anyone managing a chronic health condition. The practical takeaways are simple: decline paper receipts when a digital copy is available, keep receipts away from food, avoid handling them right after applying lotion or sanitizer, and wash hands with soap and water afterward. Retail employers also have good reason to rethink receipt handling for staff who touch this paper hundreds of times a shift.*

Attribution/Source(s): This quality-reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally authored by University of Missouri and published on 10 May 2017, this content may have been edited for style, clarity, or brevity.

* Editorial additions by Ian C. Langtree.