title: Bisphenol A, Bisphenol S, and 4-Hydro​xyphenyl 4-Isopro​oxyphenyl​sulfone (BPSIP) in Urine and Blood of Cashiers.
abstract: BACKGROUND
  Bisphenol A (BPA) is a high-production-volume chemical associated with a wide range of health outcomes in animal and human studies. BPA is used as a developer in thermal paper products, including cash register receipt paper; however, little is known about exposure of cashiers to BPA and alternative compounds in receipt paper.
  
  
  OBJECTIVE
  We determined whether handling receipt paper results in measurable absorption of BPA or the BPA alternatives bisphenol S (BPS) and 4-hydroxyphenyl 4-isoprooxyphenylsulfone (BPSIP).
  
  
  METHODS
  Cashiers (n = 77) and non-cashiers (n = 25) were recruited from the Raleigh-Durham-Chapel Hill region of North Carolina during 2011-2013. Receipts were analyzed for the presence of BPA or alternatives considered for use in thermal paper. In cashiers, total urine and serum BPA, BPS, and BPSIP levels in post-shift samples (collected ≤ 2 hr after completing a shift) were compared with pre-shift samples. Levels of these compounds in urine from cashiers were compared to levels in urine from non-cashiers.
  
  
  RESULTS
  Each receipt contained 1-2% by weight of the paper of BPA, BPS, or BPSIP. The post-shift geometric mean total urinary BPS concentration was significantly higher than the pre-shift mean in 33 cashiers who handled receipts containing BPS. The mean urine BPA concentrations in 31 cashiers who handled BPA receipts were as likely to decrease as to increase after a shift, but the mean post-shift concentrations were significantly higher than those in non-cashiers. BPSIP was detected more frequently in the urine of cashiers handling BPSIP receipts than in the urine of non-cashiers. Only a few cashiers had detectable levels of total BPA or BPS in serum, whereas BPSIP tended to be detected more frequently.
  
  
  CONCLUSIONS
  Thermal receipt paper is a potential source of occupational exposure to BPA, BPS, and BPSIP.
  
  
  BACKGROUND
  Thayer KA, Taylor KW, Garantziotis S, Schurman SH, Kissling GE, Hunt D, Herbert B, Church R, Jankowich R, Churchwell MI, Scheri RC, Birnbaum LS, Bucher JR. 2016. Bisphenol A, bisphenol S, and 4-hydro​xyphenyl 4-isopro​oxyphenyl​sulfone (BPSIP) in urine and blood of cashiers. Environ Health Perspect 124:437-444; http://dx.doi.org/10.1289/ehp.1409427.
authors: Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Research Triangle Park, North Carolina, USA.
authors: Kristina A
authors: KA
authors: Thayer
authors: Kyla W
authors: KW
authors: Taylor
authors: Stavros
authors: S
authors: Garantziotis
authors: Shepherd H
authors: SH
authors: Schurman
authors: Grace E
authors: GE
authors: Kissling
authors: Dawn
authors: D
authors: Hunt
authors: Brenda
authors: B
authors: Herbert
authors: Rebecca
authors: R
authors: Church
authors: Rachael
authors: R
authors: Jankowich
authors: Mona I
authors: MI
authors: Churchwell
authors: Richard C
authors: RC
authors: Scheri
authors: Linda S
authors: LS
authors: Birnbaum
authors: John R
authors: JR
authors: Bucher
mesh_terms: D000328:Adult; D000368:Aged; D001559:Benzhydryl Compounds / Q000097:blood* / Q000652:urine*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D016273:Occupational Exposure / Q000032:analysis*; D010209:Paper; D010636:Phenols / Q000097:blood* / Q000652:urine*; D013450:Sulfones / Q000097:blood* / Q000652:urine*; D000098831:Bisphenol S Compounds; D000098826:Bisphenol A Compounds
chemical_list: D001559:Benzhydryl Compounds; D010636:Phenols; D013450:Sulfones; C000613560:4-hydroxyphenyl 4-isopropoxyphenylsulfone; C543008:bisphenol S; D000098831:Bisphenol S Compounds; C006780:bisphenol A; D000098826:Bisphenol A Compounds