What Not to Do When You Handle Receipts

The plastics chemical bisphenol A, commonly known as BPA, was banned for use in baby bottles in Canada in 2008, in France in 2010, in the European Union in 2011, and in the United States in 2012. Then, in 2015, France forbade the use of BPA in any food or beverage packaging, something the U.S. Food and Drug Administration had decided was not warranted. But, what about the more than 90 studies “reporting relationships between total BPA in [people’s] urine and a wide array of adverse health outcomes, including a significant increase in the likelihood of developing cardiovascular disease and type 2 diabetes, obesity, impaired liver function, impaired immune and kidney function, inflammation, reproductive effects in women…[and] in men…, altered thyroid hormone concentrations, and neurobehavioral deficits such as aggressiveness, hyperactivity, and impaired learning”?

Only a very small minority of studies appear to support the U.S. government’s assertions that there were no effects of BPA at low doses. Where is the disconnect? Governmental regulatory agencies determine safety levels of chemicals by sticking tubes down into the stomachs of lab animals. In these types of tests, BPA is released directly into the stomach, where it goes to the liver to be detoxified into an inactive form called BPA-glucuronide. So, very little active BPA gets into the bloodstream. But, that’s not what studies on humans show. People have active BPA in their blood. How did the FDA respond? By rejecting all such human studies as implausible.

The problem with a “blanket rejection” of human data is that there may be sources of BPA exposure that are not modeled by stomach tube exposure in rats. After all, “[t]his isn’t how food actually enters our bodies. We chew it, move it around in our mouths…before it enters the stomach.” It turns out “that BPA can be completely absorbed directly into the bloodstream from the mouth,” thus bypassing instant liver detoxification. The same would be the case for BPA absorbed through the skin, which you can see at 2:08 in my video BPA on Receipts: Getting Under Our Skin.

Thermal paper, often used for cash register receipts, luggage tags, and many bus, train, and lottery tickets, is 1 to 2 percent BPA by weight. Taking hold of a receipt can transfer BPA to our fingers, especially if they’re wet or greasy. Does the BPA then get absorbed into our system through the skin? Cashiers were found to have more BPA flowing through their bodies “[c]ompared with other occupations,” but that was based on only 17 people. “Strict vegetarians had lower urinary BPA concentrations compared with nonvegetarians,” but, once again, the sample size was too small to really make a conclusion. It’s been estimated that even cashiers handling receipts all day may not exceed the “tolerable daily intake” of BPA—however, that could change if they were using something like hand cream.

Indeed, “many skin-care products, including hand sanitizers, lotions, soaps and sunscreens,” contain chemicals that enhance skin penetration. So, using a hand sanitizer, for example, before touching a receipt could cause a breakdown of the skin barrier.

What’s more, we now know that “using hand sanitizer and handling a thermal receipt…prior to picking up and eating food with [our] hands” results in high blood levels of active BPA. Researchers at the University of Missouri, conducting a study to mimic aspects of the behavior of people in a fast-food restaurant found that when people handled a receipt right after using the hand sanitizer Purell, BPA was transferred to their fingers. Then, BPA was transferred from their fingers to their fries, and the combination of absorption through the skin and mouth led to significant levels of active BPA in their blood, as you can see at 3:45 in my video.

We can hold a receipt in our hand for 60 seconds and only come away with 3 micrograms of BPA in our body. In contrast, if we pre-wet our hands with hand sanitizer, we can get 300 micrograms in just a few seconds—a hundred times more BPA, as you can see at 4:05 in my video. “These findings show that a very large amount of BPA is transferred from thermal paper to a hand as a result of holding a thermal receipt for only a few seconds immediately after using a product with dermal penetration enhancing chemicals,” like hand lotion. This could explain why dozens of human studies show active BPA in people’s systems, contrary to the assumptions based on stomach tube studies in rodents.

When actual evidence contradicts your assumptions, you reject your assumptions. The FDA, however, rejected the evidence instead.


Watch my video to learn Why BPA Hasn’t Been Banned.

For more on BPA, see:

Interested in other examples of Food and Drug Administration failings? Check out:

Phthalates are another class of concerning plastics compounds. For more, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

The Food Safety Risk of Organic versus Conventional

The stated principles of organic agriculture are “health, ecology, fairness, and care,” but if you ask people why they buy organic, the strongest predictor is concern for their own health. People appear to spend more for organic foods for selfish reasons, rather than altruistic motives. Although organic foods may not have more nutrients per dollar (see my video Are Organic Foods More Nutritious?), consumption of organic foods may reduce exposure to pesticide residues and antibiotic-resistant bacteria.

Food safety-wise, researchers found no difference in the risk for contamination with food poisoning bacteria in general. Both organic and conventional animal products have been found to be commonly contaminated with Salmonella and Campylobacter, for example. Most chicken samples (organic and inorganic), were found to be contaminated with Campylobacter, and about a third with Salmonella, but the risk of exposure to multidrug-resistant bacteria was lower with the organic meat. They both may carry the same risk of making us sick, but food poisoning from organic meat may be easier for doctors to treat.

What about the pesticides? There is a large body of evidence on the relation between exposure to pesticides and elevated rate of chronic diseases such as different types of cancers, diabetes, neurodegenerative disorders like Parkinson’s, Alzheimer’s, and ALS, as well as birth defects and reproductive disorders—but these studies were largely on people who live or work around pesticides.

Take Salinas Valley California, for example, where they spray a half million pounds of the stuff. Daring to be pregnant in an agricultural community like that may impair childhood brain development, such that pregnant women with the highest levels running through their bodies (as measured in their urine) gave birth to children with an average deficit of about seven IQ points. Twenty-six out of 27 studies showed negative effects of pesticides on brain development in children. These included attention problems, developmental disorders, and short-term memory difficulties.

Even in urban areas, if you compare kids born with higher levels of a common insecticide in their umbilical cord blood, those who were exposed to higher levels are born with brain anomalies. And these were city kids; so, presumably this was from residential pesticide use.

Using insecticides inside your house may also be a contributing risk factor for childhood leukemia. Pregnant farmworkers may be doubling the odds of their child getting leukemia and increase their risk of getting a brain tumor. This has led to authorities advocating that awareness of the potentially negative health outcome for children be increased among populations occupationally exposed to pesticides, though I don’t imagine most farmworkers have much of a choice.

Conventional produce may be bad for the pregnant women who pick them, but what about our own family when we eat them?

Just because we spray pesticides on our food in the fields doesn’t necessarily mean it ends up in our bodies when we eat it, or at least we didn’t know that until a study was published in 2006. Researchers measured the levels of two pesticides running through children’s bodies by measuring specific pesticide breakdown products in their urine. In my video, Are Organic Foods Safer?, you can see the levels of pesticides flowing through the bodies of three to 11-year-olds during a few days on a conventional diet. The kids then went on an organic diet for five days and then back to the conventional diet. As you can see, eating organic provides a dramatic and immediate protective effect against exposures to pesticides commonly used in agricultural production. The study was subsequently extended. It’s clear by looking at the subsequent graph in the video when the kids were eating organic versus conventional. What about adults, though? We didn’t know… until now.

Thirteen men and women consumed a diet of at least 80% organic or conventional food for seven days and then switched. No surprise, during the mostly organic week, pesticide exposure was significantly reduced by a nearly 90% drop.

If it can be concluded that consumption of organic foods provides protection against pesticides, does that also mean protection against disease? We don’t know. The studies just haven’t been done. Nevertheless, in the meantime, the consumption of organic food provides a logical precautionary approach.

For more on organic foods:

For more on the infectious disease implications of organic versus conventional, see Superbugs in Conventional vs. Organic Chicken. Organic produce may be safer too. See Norovirus Food Poisoning from Pesticides. Organic eggs may also have lower Salmonella risk, which is an egg-borne epidemic every year in the US. See my video Who Says Eggs Aren’t Healthy or Safe?

More on Parkinson’s and pesticides in Preventing Parkinson’s Disease With Diet.

Those surprised by the California data might have missed my video California Children Are Contaminated.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

What Are the Benefits of Organic?

The medical literature has been historically hostile to organic foods, blaming in part erroneous information supplied by the health food movement for our ignorance of nutrition. But until just a few generations ago, all food was organic. It’s kind of ironic that what we now call conventional food really isn’t very conventional for our species.

By eating organic, we can reduce our exposure to pesticides, but it remains unclear whether such a reduction in exposure is clinically relevant. In my video, Are Organic Foods Safer?, I talked about some of the test tube studies comparing health-related properties of organic versus conventional foods. Organic produce was found to have higher antioxidant and antimutagenic activity combined with better inhibition of cancer cell proliferation, but in terms of studies on actual people rather than petri dishes, there isn’t much science either way.

Why can’t you just compare the health of those who buy organic to those who don’t? Organic consumers do report being significantly healthier than conventional consumers, but they also tend to eat more plant foods in general and less soda and alcohol, processed meat, or milk, and just eat healthier in general. No wonder they feel so much better!

Therefore, there is an urgent need for interventional trials, or studies following cohorts of people eating organic over time like the Million Women Study in the UK, which was the first to examine the association between the consumption of organic food and subsequent risk of cancer. The only significant risk reduction they found, though, was for non-Hodgkin’s lymphoma. This is consistent with data showing a higher risk of developing lymphoma in those who have higher levels of pesticides stored in their butt fat, a study undertaken because farmworkers have been found to have higher rates of lymphoma.

Parental farmworker exposure is also associated with a birth defect of the penis called hypospadias; and so, researchers decided to see if moms who failed to choose organic were at increased risk. Indeed, they found that frequent consumption of conventional high-fat dairy products was associated with about double the odds of the birth defect. This could just be because those that choose organic have other related healthy behaviors, or it could be that high-fat foods, like dairy products, bioamplify the fat-soluble toxins in our environment.

In my video, Are Organic Foods Healthier?, you can see two other general population pesticide studies that have raised concerns. One study found about a 50 to 70% increase in the odds of ADHD among children with pesticide levels in their urine, and another that found triple the odds of testicular cancer among men with higher levels of organochlorine pesticides in their blood. 90% of such pollutants come from fish, meat, and dairy, which may help explain rising testicular cancer rates in many Western countries since World War II. 

What about interventional trials? All we have in the medical literature so far are studies showing organically grown food provides health benefits to fruit flies raised on diets of conventional versus organic produce when subjected to a variety of tests designed to assess overall fly health. And what do you know—flies raised on diets made from organically grown produce lived longer. Hmm, insects eating insecticides don’t do as well. Not exactly much of a breakthrough!


For how to best get pesticides off of conventional produce, see my video How to Make Your Own Fruit and Vegetable Wash.                                                                                                  

Pesticides are one thing, but Are Organic Foods More Nutritious?

Overall, Are the Benefits of Organic Food Underrated or Overrated?

For more on the impact of food contaminants during pregnancy, see:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: