The sneaky thing you handle every day that could be bad for your health

If you’ve been to a big-box pharmacy or grocery store lately, you’re likely familiar with the three-foot-long receipt epidemic that seems to have struck many chains. What a waste of paper, you might think. Why is this a thing?

Turns out, you should be more than annoyed by the persistence of paper receipts, regardless of their length. They are, according to researchers, coated in Bisphenol A, or BPA, a hazardous environmental toxin. “Bisphenols are endocrine-disrupting chemicals that mimic hormones such as estrogen and thyroid hormone,” explains Nancy L. Wayne, PhD, professor at the UCLA School of Medicine’s Department of Physiology.

The health risks of this exposure are not insignificant. “Studies have shown that there is an association between elevated levels of BPA detected in human urine and a number of health problems, including increased risk of miscarriages and premature birth and prostate cancer,” says Dr. Wayne. Exposure has also been linked to altered brain and nervous system development, behavioral changes in children, stunting tooth enamel development, obesity, and heart disease.

“There’s more BPA in a single thermal paper receipt than the total amount that would leach out from a polycarbonate water bottle used for many years.” —Robin Berzin, MD

If BPA sounds familiar, that’s likely because it’s found in many commonly-used products. Plastic bottles are its most infamous source, but the Environmental Working group (EWG) disturbingly found BPA lurking in the packing of 16,000 grocery store items, with canned goods being the worst culprit. Even plastic straws aren’t safe. So, that aforementioned urine testing? It’s positive for almost everybody. “Nearly every man, woman, and child that has been tested—and thousands have been tested—have detectable levels of BPA and BPS in their urine,” says Wayne. “Given that both chemicals are rapidly metabolized by our bodies, this indicates that we are constantly being exposed to these toxins.”

If BPA is everywhere, then, you may be wondering how worried you should be about your exposure via receipts, specifically. To answer that question, Parsley Health’s Robin Berzin, MD, quotes John Warner, PhD and president of the Warner Babcock Institute for Green Chemistry, saying, “There’s more BPA in a single thermal paper receipt than the total amount that would leach out from a polycarbonate water bottle used for many years.” She also cites research that showed that skin absorption of BPA led to prolonged exposure when compared to dietary absorption (meaning, your body continues absorbing the chemical long after you’ve thrown away the receipt).

Laura N. Vandenberg, PhD, a graduate program director at the University of Massachusetts, Amherst, School of Public Health & Health Sciences who specializes in endocrine disruptors, likewise asserts that BPA exposure from receipts is greater than exposure via other sources (e.g. canned goods). She further explains that when it comes to BPA, no dosage is a “safe” dosage. “The standard toxicological approach of ‘the dose makes the poison,’ is not true of chemicals that act like hormones in our bodies,” she says, explaining that there are hundreds of studies that show negative effects at low doses. “This isn’t fringe science, it’s information that’s been acknowledged by groups as conservative as the National Academy of Sciences,” Dr. Vandenberg adds.

“This isn’t fringe science.” —Laura N. Vandenberg, PhD

Vandenberg also stresses that it’s not just BPA that’s an issue when it comes to the health risks of handling receipt paper. “The EPA evaluated the chemicals used in receipts and found 17 present in addition to BPA and its sometimes-replacement, BPS,” she explains, noting that BPS has also been found to be estrogenic. “It determined that none of these chemicals are without hazard, either to people or to the environment.”

A buzzy 2014 study also showed that BPA is more quickly absorbed into the skin after hand sanitizer is applied, which is of particular note when it comes to receipts. “This scenario of handling receipts then eating with your hands after using hand sanitizer was pointed out by the authors to be very common at fast food restaurants and food courts,” says Dr. Wayne. This enhancement effect isn’t limited to hand sanitizer, either. Dr. Vandenberg explains that any product that utilizes a dermal penetrant—like hand sanitizer, but also some soaps and lotions—enhances absorption of BPA (and other such hormonal disruptors) into the skin.

Though embryos, fetuses, and pre-pubescent adolescents are at the greatest risk with respect to BPA (and other endocrine disruptors) exposure, says Dr. Vandenberg, the toxins are too ubiquitous for these demographics (e.g. expectant mothers) to specifically evade exposure. (BPA is also found on money, thanks to receipts!) It’s therefore up to the general population to help eliminate the threat by requesting digital receipts whenever possible, she says, a thought that echoes the EPA’s official recommendation that society move away from thermal paper receipts altogether. However, BPA has also been found on the thermal paper used for movie tickets, airline boarding passes, prescription medication labels, and deli meat and cheese labels, says Dr. Berzin, so it’s not just receipts that need to be avoided. “Use apps for concert tickets, boarding passes, etc.,” she advises.

“By recycling our receipt paper, we’ve now dumped BPA into products like toilet paper and tissues.”

It’s not always possible to evade paper, however, and when it’s handed to you, you may be tempted to recycle it so as to help ease its environmental burden. According to Dr. Vandenberg, however, this instinct is wrong. “By recycling our receipt paper, we’ve now dumped BPA into products like toilet paper and tissues, thereby introducing it to sensitive parts of our bodies,” she says. “They’ve done studies that compared paper towels made with virgin fibers to those made with recycled paper, and the recycled towels had BPA in them.”

Fortunately, some big box stores are beginning to offer digital alternatives to their mile-long receipts upon request. Don’t be afraid to ask and, if you’re feeling brave, take the extra measure of alerting your cashier to the fact that he or she is over-exposed and should bring the issue up with their employer. These small steps can help to push paper out, which is the only way to eliminate the risk altogether. “Do I think BPA is killing people? No,” adds Dr. Vandenberg. “Do I think that it’s acting like an estrogen in their bodies and affecting their normal physiology in some way? Yes, I do.”

Dr. Wayne says BPA is just one of many toxins in our environment negatively affecting our health. For this reason, pollution-protecting skin care is going to be big in 2018. Plus, this is how to detoxify your home, stat.