title: Holding thermal receipt paper and eating food after using hand sanitizer results in high serum bioactive and urine total levels of bisphenol A (BPA).
abstract: Bisphenol A (BPA) is an endocrine disrupting environmental contaminant used in a wide variety of products, and BPA metabolites are found in almost everyone's urine, suggesting widespread exposure from multiple sources. Regulatory agencies estimate that virtually all BPA exposure is from food and beverage packaging. However, free BPA is applied to the outer layer of thermal receipt paper present in very high (∼20 mg BPA/g paper) quantities as a print developer. Not taken into account when considering thermal paper as a source of BPA exposure is that some commonly used hand sanitizers, as well as other skin care products, contain mixtures of dermal penetration enhancing chemicals that can increase by up to 100 fold the dermal absorption of lipophilic compounds such as BPA. We found that when men and women held thermal receipt paper immediately after using a hand sanitizer with penetration enhancing chemicals, significant free BPA was transferred to their hands and then to French fries that were eaten, and the combination of dermal and oral BPA absorption led to a rapid and dramatic average maximum increase (Cmax) in unconjugated (bioactive) BPA of ∼7 ng/mL in serum and ∼20 µg total BPA/g creatinine in urine within 90 min. The default method used by regulatory agencies to test for hazards posed by chemicals is intra-gastric gavage. For BPA this approach results in less than 1% of the administered dose being bioavailable in blood. It also ignores dermal absorption as well as sublingual absorption in the mouth that both bypass first-pass liver metabolism. The elevated levels of BPA that we observed due to holding thermal paper after using a product containing dermal penetration enhancing chemicals have been related to an increased risk for a wide range of developmental abnormalities as well as diseases in adults.
authors.affiliation: Division of Biological Sciences, University of Missouri, Columbia, Missouri, United States of America.
authors.forename: Annette M
authors.initials: AM
authors.lastname: Hormann
authors.affiliation: Division of Biological Sciences, University of Missouri, Columbia, Missouri, United States of America.
authors.forename: Frederick S
authors.initials: FS
authors.lastname: Vom Saal
authors.affiliation: Department of Obstetrics, Gynecology and Women's Health, University of Missouri, Columbia, Missouri, United States of America.
authors.forename: Susan C
authors.initials: SC
authors.lastname: Nagel
authors.affiliation: Division of Biological Sciences, University of Missouri, Columbia, Missouri, United States of America.
authors.forename: Richard W
authors.initials: RW
authors.lastname: Stahlhut
authors.affiliation: Division of Biological Sciences, University of Missouri, Columbia, Missouri, United States of America.
authors.forename: Carol L
authors.initials: CL
authors.lastname: Moyer
authors.affiliation: Department of Statistics, University of Missouri, Columbia, Missouri, United States of America.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Ellersieck
authors.affiliation: Department of Biomedical Sciences, University of Missouri, Columbia, Missouri, United States of America.
authors.forename: Wade V
authors.initials: WV
authors.lastname: Welshons
authors.affiliation: Université de Toulouse, INPT, ENVT, UPS, UMR1331, F- 31062 Toulouse, France; INRA, UMR1331, Toxalim, Research Centre in Food Toxicology, F-31027 Toulouse, France.
authors.forename: Pierre-Louis
authors.initials: PL
authors.lastname: Toutain
authors.affiliation: Division of Biological Sciences, University of Missouri, Columbia, Missouri, United States of America.
authors.forename: Julia A
authors.initials: JA
authors.lastname: Taylor
mesh_terms: D000328:Adult; D001559:Benzhydryl Compounds / Q000097:blood* / Q000652:urine; D004435:Eating; D052244:Endocrine Disruptors / Q000097:blood* / Q000652:urine; D004781:Environmental Exposure; D005260:Female; D006235:Hand Disinfection; D064548:Hand Sanitizers / Q000737:chemistry; D006801:Humans; D008297:Male; D010209:Paper; D010636:Phenols / Q000097:blood* / Q000652:urine; D012869:Skin Absorption; D055815:Young Adult; D000098826:Bisphenol A Compounds
chemical_list: D001559:Benzhydryl Compounds; D052244:Endocrine Disruptors; D064548:Hand Sanitizers; D010636:Phenols; C006780:bisphenol A; D000098826:Bisphenol A Compounds