“Would you like your receipt?” Maybe not.
Your exchange with the grocery store checkout clerk may seem like an odd time to worry about potentially harmful chemicals, but for decades, receipts printed on thermal paper have been treated with the potent endocrine-disrupting chemical bisphenol A.
Considerable progress has been made to remove this toxic chemical from food cans and reusable food and drink containers, but manufacturers still rely heavily on it as a color developer in inkless thermal paper. In response to public and regulatory pressure to remove BPA from the market, they have turned to bisphenol S, a closely related, structurally and toxicologically similar alternative.
A rapidly growing body of scientific evidence strongly indicates that BPS disrupts hormones and harms reproductive, developmental, metabolic and cardiovascular health, just like its predecessor, BPA. Other preliminary evidence suggests BPS may play a role in altering immune function or in the development of certain cancers and asthma.
Scientists and public health advocates call this regrettable substitution – replacing one harmful chemical in consumer products with another that may be just as bad. In this case, we’ve known about this ongoing regrettable substitution since 2012, when BPS was detected in all thermal receipt paper samples tested by researchers at the New York State Department of Health.
In 2010, EWG-commissioned tests of thermal paper found the amount of BPA on a receipt is 250 to 1,000 times greater than that found in a BPA-based food can lining. And in 2014, the Minnesota Pollution Control Agency reported similar levels of BPA and BPS in samples of thermal paper. In food cans, BPA is bound into resins that line the cans. But the BPA or BPS in thermal paper is “free,” making it likely more prone to migrate out of the coating.
Besides sales receipts, thermal paper is widely used for printed tickets, boarding passes and luggage tags. BPA and its alternatives are components of a heat-reactive mixture that coats the paper surface, causing it to change color when the paper is exposed to heat, revealing printed text and images.
Exposure to BPA and BPS in the U.S. is widespread and pervasive. A 2018 study of more than 1,800 American adults detected BPA and BPS in 95 and 89 percent of participants, respectively. Cashiers who handle BPS-containing receipts at work have significantly higher BPS levels in their urine after clocking out, meaning BPS exposure from thermal paper is a real concern.
In Europe, BPA-coated thermal paper was banned at the beginning of this year. The European Chemicals Agency, or ECHA, estimates that 61 percent of thermal paper in Europe will be BPS-based by 2022, and the remaining 39 percent will use other non-BPA alternatives. But in the U.S., there is no federal regulation banning BPA in receipts. Without a ban, thermal paper remains a likely source of exposure to both BPA and BPS for Americans.
Bisphenol chemicals like BPA and BPS are now considered ubiquitous in the environment, and urgent action is needed to limit their damaging effects on people and the environment. Whereas the Food and Drug Administration has failed to ban or restrict most uses of BPA, other countries are already moving to regulate BPS.
Belgium is evaluating the risks posed to people and the environment by BPS and has proposed to the ECHA Committee for Risk Assessment, or RAC, to classify it as “toxic to reproduction.” These assessments by Belgium and RAC should conclude early next year. As BPA, BPS and other bisphenols tend to be linked to similar health harms, EWG advocates for evaluating and regulating them as an entire class to avoid regrettable substitution.
Manufacturers must embrace the safest alternatives to bisphenols in thermal paper, and should be open in reporting what alternative coatings they’ve selected. As of yet, there is no perfect phenol-free solution.
In 2015, the Environmental Protection Agency rated an alternative chemical called Pergafast 201 as a low to moderate human health hazard but high to very high environmental hazard. Another option, Alpha Free, might have a preferable toxicological profile but could create print that fades quickly. Manufacturers must assess the safety of current alternatives and develop new materials that are safer by design.
Businesses that use thermal paper must implement best practices to reduce paper handling for both employees and customers. Although it may not be possible to avoid all exposure to bisphenols in thermal paper, to limit those encounters, try following these tips:
- When possible, say “no” to paper receipts. Take advantage of email or text receipts.
- If you do accept a paper receipt, store it separately in an envelope (BPA and BPS can contaminate currency and other items stored next to receipts) and then wash your hands, especially before preparing food or eating.
- Prevent children from touching receipts.
- Avoid using lotions, hand sanitizers or anything else wet or greasy on your hands immediately before touching receipts. Wetness or greasiness may increase the amount of chemicals transferred onto the skin and its capacity to absorb BPA or BPS.
- Since bisphenol residues from receipts contaminate the recycled paper stream, put receipts and other thermal paper into the trash rather than the recycle bin.
Regrettable Substitution: BPA vs. BPS
Health Concerns |
Strength of Evidence |
|
BPA |
BPS |
|
Endocrine disruption |
Definitive1-4 (government classification) |
Strong3-5 |
Reproductive and developmental toxicity |
Definitive1, 2, 6-10 (government classification) |
Strong9-16 |
Metabolic and cardiovascular harm |
Strong2, 17-20 |
Strong16-22 |
Cancer Breast, ovarian and prostate cancer |
Strong2, 23 |
Preliminary16 |
Other harms Asthma, childhood wheezing, impaired immune function |
Strong2, 24 |
Preliminary16, 24, 25 |
References:
- European Chemicals Agency. https://echa.europa.eu/substance-information/-/substanceinfo/100.00133
- Rochester JR. Bisphenol A and human health: a review of the literature. Reprod Toxicol. 2013 Dec;42:132-55. doi: 10.1016/j.reprotox.2013.08.008. Epub 2013 Aug 30. PMID: 23994667.
- Rochester JR, Bolden AL. Bisphenol S and F: A Systematic Review and Comparison of the Hormonal Activity of Bisphenol A Substitutes. Environ Health Perspect. 2015 Jul;123(7):643-50. doi: 10.1289/ehp.1408989. Epub 2015 Mar 16. PMID: 25775505; PMCID: PMC4492270.
- Gorini F, Bustaffa E, Coi A, Iervasi G, Bianchi F. Bisphenols as Environmental Triggers of Thyroid Dysfunction: Clues and Evidence. Int J Environ Res Public Health. 2020 Apr 13;17(8):265 doi: 10.3390/ijerph17082654. PMID: 32294918; PMCID: PMC7216215.
- Amar S, Binet A, Téteau O, Desmarchais A, Papillier P, Lacroix MZ, Maillard V, Guérif F, Elis S. Bisphenol S Impaired Human Granulosa Cell Steroidogenesis in Vitro. Int J Mol Sci. 2020 Mar 6;21(5):1821. doi: 10.3390/ijms21051821. PMID: 32155818; PMCID: PMC7084356.
- California Proposition 65. https://oehha.ca.gov/proposition-65/chemicals/bisphenol-bpa.
- Peretz J, Vrooman L, Ricke WA, Hunt PA, Ehrlich S, Hauser R, Padmanabhan V, Taylor HS, Swan SH, VandeVoort CA, Flaws JA. Bisphenol a and reproductive health: update of experimental and human evidence, 2007-2013. Environ Health Perspect. 2014 Aug;122(8):775-86. doi: 10.1289/ehp.1307728. Epub 2014 Jun 4. PMID: 24896072; PMCID: PMC4123031.
- Cantonwine DE, Ferguson KK, Mukherjee B, McElrath TF, Meeker JD. Urinary Bisphenol A Levels during Pregnancy and Risk of Preterm Birth. Environ Health Perspect. 2015 Sep;123(9):895-901. doi: 10.1289/ehp.1408126. Epub 2015 Mar 27. PMID: 25815860; PMCID: PMC4559950.
- Siracusa JS, Yin L, Measel E, Liang S, Yu X. Effects of bisphenol A and its analogs on reproductive health: A mini review. Reprod Toxicol. 2018 Aug;79:96-123. doi: 10.1016/j.reprotox.2018.06.005. Epub 2018 Jun 18. PMID: 29925041; PMCID: PMC6689411.
- Mustieles V, Zhang Y, Yland J, Braun JM, Williams PL, Wylie BJ, Attaman JA, Ford JB, Azevedo A, Calafat AM, Hauser R, Messerlian C. Maternal and paternal preconception exposure to phenols and preterm birth. Environ Int. 2020 Apr;137:105523. doi: 1016/j.envint.2020.105523. Epub 2020 Feb 29. PMID: 32120140; PMCID: PMC7169435.
- Horan TS, Pulcastro H, Lawson C, Gerona R, Martin S, Gieske MC, Sartain CV, Hunt PA. Replacement Bisphenols Adversely Affect Mouse Gametogenesis with Consequences for Subsequent Generations. Curr Biol. 2018 Sep 24;28(18):2948-2954.e3. doi: 10.1016/j.cub.2018.06.070. Epub 2018 Sep 13. PMID: 30220498; PMCID: PMC6156992.
- Kolla S, Morcos M, Martin B, Vandenberg LN. Low dose bisphenol S or ethinyl estradiol exposures during the perinatal period alter female mouse mammary gland development. Reprod Toxicol. 2018 Jun;78:50-59. doi: 10.1016/j.reprotox.2018.03.003. Epub 2018 Mar 8. PMID: 29526645; PMCID: PMC6736525.
- Kolla S, McSweeney DB, Pokharel A, Vandenberg LN. Bisphenol S alters development of the male mouse mammary gland and sensitizes it to a peripubertal estrogen challenge. Toxicology. 2019 Aug 1;424:152234. doi: 10.1016/j.tox.2019.06.005. Epub 2019 Jun 12. PMID: 31201878; PMCID: PMC6736534.
- Aung MT, Ferguson KK, Cantonwine DE, McElrath TF, Meeker JD. Preterm birth in relation to the bisphenol A replacement, bisphenol S, and other phenols and parabens. Environ Res. 2019 Feb;169:131-138. doi: 10.1016/j.envres.2018.10.037. Epub 2018 Nov 1. PMID: 30448626; PMCID: PMC6347500.
- Hu J, Zhao H, Braun JM, Zheng T, Zhang B, Xia W, Zhang W, Li J, Zhou Y, Li H, Li J, Zhou A, Zhang Y, Buka SL, Liu S, Peng Y, Wu C, Jiang M, Huo W, Zhu Y, Shi K, Li Y, Cai Z, Xu S. Associations of Trimester-Specific Exposure to Bisphenols with Size at Birth: A Chinese Prenatal Cohort Study. Environ Health Perspect. 2019 Oct;127(10):107001. doi: 10.1289/EHP4664. Epub 2019 Oct 1. PMID: 31573832; PMCID: PMC6867404.
- Thoene M, Dzika E, Gonkowski S, Wojtkiewicz J. Bisphenol S in Food Causes Hormonal and Obesogenic Effects Comparable to or Worse than Bisphenol A: A Literature Review. Nutrients. 2020 Feb 19;12(2):532. doi: 10.3390/nu12020532. PMID: 32092919; PMCID: PMC7071457.
- Rancière F, Botton J, Slama R, Lacroix MZ, Debrauwer L, Charles MA, Roussel R, Balkau B, Magliano DJ; D.E.S.I.R. Study Group. Exposure to Bisphenol A and Bisphenol S and Incident Type 2 Diabetes: A Case-Cohort Study in the French Cohort D.E.S.I.R. Environ Health Perspect. 2019 Oct;127(10):107013. doi: 10.1289/EHP5159. Epub 2019 Oct 30. PMID: 31663775; PMCID: PMC6867193.
- Drobna Z, Talarovicova A, Schrader HE, Fennell TR, Snyder RW, Rissman EF. Bisphenol F has different effects on preadipocytes differentiation and weight gain in adult mice as compared with Bisphenol A and S. Toxicology. 2019 May 15;420:66-72. doi: 10.1016/j.tox.2019.03.016. Epub 2019 Apr 5. PMID: 30959087; PMCID: PMC6574128.
- Liu B, Lehmler HJ, Sun Y, Xu G, Sun Q, Snetselaar LG, Wallace RB, Bao W. Association of Bisphenol A and Its Substitutes, Bisphenol F and Bisphenol S, with Obesity in United States Children and Adolescents. Diabetes Metab J. 2019 Feb;43(1):59-75. doi: 10.4093/dmj.2018.0045. PMID: 30793552; PMCID: PMC6387872.
- Zhang YF, Shan C, Wang Y, Qian LL, Jia DD, Zhang YF, Hao XD, Xu HM. Cardiovascular toxicity and mechanism of bisphenol A and emerging risk of bisphenol S. Sci Total Environ. 2020 Jun 25;723:137952. doi: 10.1016/j.scitotenv.20137952. Epub 2020 Mar 18. PMID: 32213405.
- Rezg R, Abot A, Mornagui B, Knauf C. Bisphenol S exposure affects gene expression related to intestinal glucose absorption and glucose metabolism in mice. Environ Sci Pollut Res Int. 2019 Feb;26(4):3636-3642. doi: 10.1007/s11356-018-3823-z. Epub 2018 Dec 7. PMID: 30523531.
- Jacobson MH, Woodward M, Bao W, Liu B, Trasande L. Urinary Bisphenols and Obesity Prevalence Among U.S. Children and Adolescents. J Endocr Soc. 2019 Jul 25;3(9):1715-1726. doi: 10.1210/js.2019-00201. PMID: 31528831; PMCID: PMC6735733.
- Seachrist DD, Bonk KW, Ho SM, Prins GS, Soto AM, Keri RA. A review of the carcinogenic potential of bisphenol A. Reprod Toxicol. 2016 Jan;59:167-82. doi: 10.1016/j.reprotox.2015.09.006. Epub 2015 Oct 19. PMID: 26493093; PMCID: PMC4783235.
- Malaisé Y, Lencina C, Cartier C, Olier M, Ménard S, Guzylack-Piriou L. Perinatal oral exposure to low doses of bisphenol A, S or F impairs immune functions at intestinal and systemic levels in female offspring mice. Environ Health. 2020 Aug 31;19(1):93. doi: 10.1186/s12940-020-00614-w. PMID: 32867778; PMCID: PMC7457519.
- Mendy A, Salo PM, Wilkerson J, Feinstein L, Ferguson KK, Fessler MB, Thorne PS, Zeldin DC. Association of urinary levels of bisphenols F and S used as bisphenol A substitutes with asthma and hay fever outcomes. Environ Res. 2020 Apr;183:108944. doi: 10.1016/j.envres.2019.108944. Epub 2019 Nov 22. PMID: 31911000; PMCID: PMC7167336.