Q: I’ve seen claims online that paper receipts contain toxic chemicals. Should I avoid touching them?
In a video on TikTok, Dr. Tania Elliot, a social media influencer with a medical background, grasps a Whole Foods receipt with a large pair of wooden tongs. “Don’t touch this,” she says, explaining that most paper receipts contain a “toxic” chemical called bisphenol A, or BPA, which is easily absorbed through the skin and linked to health issues like infertility, hormone imbalances and certain cancers.
Such claims are made all over the internet. And many of them are not totally wrong, experts say. Until recently, most paper receipts in the United States did contain BPA, a known hormone disruptor, and skin exposures have been linked to fertility issues, insulin resistance and more.
But over the past decade, BPA has largely been phased out and replaced with a different chemical, bisphenol S, or BPS.
We know much less about BPS, such as how it might affect the body and what exposure levels may be safe, said Nancy Hopf, an industrial toxicologist at the University of Lausanne in Switzerland.
The risk associated with handling paper receipts quite likely depends on many factors, including how often and for how long you touch them. Here’s what we know.
What chemicals are used?
Most paper receipts are printed on a type of paper called thermal paper, which is coated in dyes and chemical developers that react with heat to create a printed image. “Sometimes, the thermal coating feels like powder on the backside of the receipt,” Dr. Hopf said. That thermal coating used to contain BPA.
BPA mimics estrogen, a hormone that interacts with many cells throughout the body, including those in the reproductive system and the brain, said Andrea Gore, a professor of pharmacology and toxicology at the University of Texas at Austin. “It can trick the cell into thinking that it’s bound to an estrogen when in fact it’s bound to this artificial chemical,” Dr. Gore said.
That could, at least in part, lead to a range of downstream effects, including insulin resistance, Type 2 diabetes, obesity and infertility. Most major U.S. retailers began replacing BPA with BPS about a decade ago. One 2023 study of 571 paper receipts collected from 24 states concluded that just one percent of those receipts contained BPA — whereas 85 percent contained BPS.
We don’t know if BPS is safer than BPA, but there is mounting evidence that BPS also mimics estrogen, in ways that could cause similar health effects, particularly those related to reproduction, Dr. Gore said.
When pregnant mice are fed BPS at levels comparable to what humans are typically exposed to each day, researchers have found that their female offspring have a harder time getting pregnant and have fewer babies compared with pregnant mice not fed BPS. In a 2019 study of 1,841 pregnant women in China, scientists found that those with the highest levels of BPS in their urine were 68 percent more likely to develop gestational diabetes than those with the lowest levels. California health officials recently listed BPS as a reproductive toxicant for both men and women.
Other mouse studies have linked BPS ingestion to obesity, and studies in children have found that those with more BPS in their urine tend to have higher markers of insulin resistance and issues with their blood vessels.
“There is very strong evidence and also strong confidence that both these chemicals are contributing to health disorders,” Dr. Gore said.
Should you worry about your exposure?
We know that both BPA and BPS are absorbed through the skin and are associated with higher risks of health problems, Dr. Hopf said.
And while it would be difficult to prove that handling paper receipts directly causes those issues, there is enough evidence to recommend avoiding them and other products containing those chemicals, Jonathan Martin, a toxicologist and professor at Stockholm University, wrote via email.
Neither BPS nor BPA are absorbed instantly, so you shouldn’t worry too much about touching a receipt for a few seconds or even a few minutes. “It takes a good couple of hours before it gets in,” Dr. Hopf said.
If you work in a retail business, wearing nitrile gloves can minimize your exposure. And when shopping, know that the dust from thermal receipts can linger on your hands for hours, Dr. Hopf said, so wash them as soon as you can. But don’t use hand sanitizer, Dr. Martin said — “this will only enhance the absorption of BPA or BPS across the skin.”
We also know that the amount of skin that’s exposed matters, so hold the receipt with the tips of your fingers, and don’t leave it lying around where its dust might shed onto your clothes or purse, or where small children might find it. Throw the receipt away as soon as you’re done with it.
Alternatively, Dr. Gore said, you can opt out of paper receipts altogether and get an electronic receipt when offered. “I figure I’m protecting myself,” she said, “but I’m also thinking about the cashier who’s handling thousands of receipts each day.”
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