Project
Risk Assessment
Distribution & Use

Distribution & Use

Hazard Identification

BPA: BPA can be absorbed through the skin, though exposure is especially concerning when it involves contact with the mouth and nasal passages1 2 3 4. This exposure raises health concerns because of BPA’s endocrine-disrupting properties, which can interfere with hormonal functions and increase the risk of various health issues, including reproductive problems and diseases2 3.

BPS: BPS is primarily used in “BPA-free” receipt paper5 6. Despite being considered a safer alternative to BPA, BPS also exhibits endocrine-disrupting properties, potentially affecting hormonal balance and health, similarly to BPA7 6.

Evaluation

Level of Risk to Workers

The primary concern for workers, particularly cashiers, as well as consumers, is exposure to BPS and BPA through skin contact7 2 6. Especially relevant to the COVID-19 pandemic, research has suggested that hand sanitizer increases the permeability of BPA and BPS from thermal receipt paper, introducing an extra hazard3 8.

Measurement of Risk

Biomonitoring: The most direct method is measuring BPA and BPS levels in urine or blood samples of workers7 6.

Workplace Sampling: While less common, it typically involves analyzing receipts themselves to determine BPA and BPS content7 9.

Exposure Limits

Bisphenol-A OELs

CountryAgencyTWA† Exposure LimitWorkplace Exposure Limit
United StatesOccupational Safety and Health Administration (OSHA)10––
CanadaCanadian Centre for Occupational Health and Safety (CCOHS)113–10 mg/m3-
European UnionEuropean Chemicals Agency (ECHA)120.36–10 mg/m3-

†Note. Time-weighted average (TWA) is the average exposure over eight hours.

Bisphenol-S OELs

CountryAgencyTWA† Exposure LimitWorkplace Exposure Limit
United StatesOccupational Safety and Health Administration (OSHA)10––
CanadaCanadian Centre for Occupational Health and Safety (CCOHS)113–10 mg/m3-
European UnionEuropean Chemicals Agency (ECHA)120.36–10 mg/m3-

†Note. Time-weighted average (TWA) is the average exposure over eight hours.

Types of Workers Most at Risk

  • Cashiers & Retail Workers: Workers handling numerous receipts throughout their shifts7 2.

  • Bank Tellers: Workers that process customer receipts7.

  • Service Industry Workers: Waitstaff workers handling customer receipts for payment7.

Potential Burden of Injury/Illness

Research examining the health effects of BPA and BPS exposure from receipt paper is still under review1 13. However, current evidence suggests the following may be correlated:

  • Endocrine Disruption: BPA and BPS pose potential impacts on reproductive health (especially for women), metabolism, and development2 3.

  • Increased Risk of Cancer: Some studies suggest links to breast cancer and prostate cancer, though further evidence is needed7 6.

  • Developmental Effects: Possible links to neurobehavioral problems in children have been discussed, particularly with exposure during pregnancy14.

Control

Substitution: Use digital receipts or BPA and BPS-free paper15.

Administrative Controls: Educating workers about proper hand hygiene and minimizing unnecessary contact with thermal papers6 3.

Personal Protective Equipment (PPE): Encouraging the use of gloves when handling receipts for prolonged periods6 3.

  1. Biedermann S, Tschudin P, Grob K. Transfer of bisphenol A from thermal printer paper to the skin. Anal Bioanal Chem. 2010 Sep 1;398(1):571–6. ↩︎ ↩︎

  2. Liao C, Kannan K. Widespread Occurrence of Bisphenol A in Paper and Paper Products: Implications for Human Exposure. Environ Sci Technol. 2011 Nov 1;45(21):9372–9. ↩︎ ↩︎ ↩︎ ↩︎ ↩︎

  3. Hormann AM, Saal FS vom, Nagel SC, Stahlhut RW, Moyer CL, Ellersieck MR, et al. Holding Thermal Receipt Paper and Eating Food after Using Hand Sanitizer Results in High Serum Bioactive and Urine Total Levels of Bisphenol A (BPA). PLoS One. 2014 Oct 22;9(10):e110509. ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎

  4. Hehn RS. NHANES Data Support Link between Handling of Thermal Paper Receipts and Increased Urinary Bisphenol A Excretion. Environ Sci Technol. 2016 Jan 5;50(1):397–404. ↩︎

  5. Pivnenko K, Pedersen GA, Eriksson E, Astrup TF. Bisphenol A and its structural analogues in household waste paper. Waste Manag. 2015 Oct 1;44:39–47. ↩︎

  6. Ndaw S, Remy A, Denis F, Marsan P, Jargot D, Robert A. Occupational exposure of cashiers to bisphenol S via thermal paper. Toxicol Lett. 2018 Dec 1;298:106–11. ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎

  7. Bousoumah R, Leso V, Iavicoli I, Huuskonen P, Viegas S, Porras SP, et al. Biomonitoring of occupational exposure to bisphenol A, bisphenol S and bisphenol F: A systematic review. Sci Total Environ. 2021 Aug 20;783:146905. ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎

  8. Hormann AM. Bisphenol A (BPA) in Human Serum and Urine: Exposure via Dermal Absorption from Thermal Paper Receipts and Oral Ingestion after Transfer from Hand to Food [Internet] [M.A.]. [Columbia, MO]: University of Missouri; 2013 [cited 2024 Mar 4]. Available from: University of Missouri ↩︎

  9. Molina-Molina JM, Jiménez-Díaz I, Fernández MF, Rodriguez-Carrillo A, Peinado FM, Mustieles V, et al. Determination of bisphenol A and bisphenol S concentrations and assessment of estrogen- and anti-androgen-like activities in thermal paper receipts from Brazil, France, and Spain. Environ Res. 2019 Mar 1;170:406–15. ↩︎

  10. Occupational Safety and Health Administration. Bisphenol A [Internet]. Occupational Chemical Database. 2020 [cited 2024 Feb 28]. Available from: OSHA ↩︎ ↩︎

  11. IMAP Group. Bisphenol S (BPS)-based polymers: Human health tier II assessment [Internet]. IMAP Group; 2020 [cited 2024 Feb 28]. Available from: IMAP Group ↩︎ ↩︎

  12. National Institute for Public Health and the Environment (NL). Overview of Occupational Exposure Limits within Europe. National Institute for Public Health and the Environment (NL); 2014. ↩︎ ↩︎

  13. Schwartz AW, Landrigan PJ. Bisphenol A in Thermal Paper Receipts: An Opportunity for Evidence-Based Prevention. Environ Health Perspect. 2012 Jan;120(1):a14–5. ↩︎

  14. Gogoi A, Neog B. The dark side of thermal printed paper. Curr Sci. 2016 Jan;110(1):11–2. ↩︎

  15. Moustafa K, García PJ, El Khoury F, Pierre S. From Seller Screens to Buyer Screens: Toward a Smart Digital Receipt Solution for Sustainability and Greenhouse Gas Mitigation by Million Tons. Digit Soc. 2023 Nov 30;2(3):53. ↩︎

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