Thermal receipt handling: an unrecognized source of dermal exposure to bisphenol A – a simulation crossover study

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Background: Human exposure to bisphenol A (BPA) is widespread and of high public health concern due to associations with adverse health outcomes. Exposure is primarily through diet and consumption of canned foods. A less well recognized source of exposure to BPA is thermal receipt handling. We hypothesized thermal receipt handling significantly increases BPA exposure via the dermal route. Methods:We recruited 24 volunteers for a simulation crossover study. Participants printed and handled receipts for 2 consecutive hours without the use of dermal protection (no gloves) in the first simulation. This was then repeated using nitrile gloves after a washout period of at least one week. Two urine samples were collected: one immediately prior to each simulation, another 2 hours after completing the simulation. The urine specific gravity (SG) was measured using a handheld refractometer; total urinary BPA concentration was measured at the Centers for Disease Control and Prevention using online solid-phase extraction coupled to isotope dilution high-performance liquid chromatography–tandem mass spectrometry.We used paired t-tests to examine mean change in log-transformed SG-adjusted urinary BPA concentrations between timepoints. Results: SG-adjusted geometric mean urine concentration of BPA increased from 2.0 ?g/L pre-simulation to 6.0 ?g/L (95% CI, 4.2-8.5 ?g/L) post-simulation (P =0.0012). There was no significant increase in urine BPA after handling receipts with gloves. Eleven participants provided sequential urine samples over 24 hours where SG-adjusted geometric mean urine BPA concentrations reached a peak of 11.1?g/L at 8h. Conclusion: Three and 5-fold increases in geometric mean urinary BPA concentrations were observed at 4 and 8 hours after receipt handling began. There was no significant increase in urinary BPA when the simulation was repeated with gloves. These findings suggest receipt handling is a significant source of exposure to BPA through the dermal route.