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:

Why Hasn’t Bisphenol A (BPA) Been Banned Completely?

“The number of new chemicals is increasing exponentially, with approximately 12,000 new substances added daily…”—yet data aren’t available on the hazards of even some of the high-volume chemicals. Bisphenol A (BPA) is one of the highest volume chemicals, with billions of pounds produced each year. Studies have raised concerns about its possible implication in the cause of certain chronic diseases, such as diabetes, obesity, reproductive disorders, cardiovascular diseases, birth defects, chronic respiratory diseases, kidney diseases, and breast cancer. Given this, BPA is the topic of my video Why BPA Hasn’t Been Banned.

A new study on the health implications of BPA comes out nearly every week. BPA was first developed over a hundred years ago as a synthetic estrogen, but it wasn’t until the 1950s that industry realized it could be used to make polycarbonate plastic, and “BPA rapidly became one of the most produced and used chemicals worldwide, even though it was a recognized synthetic estrogen” with hormonal effects. About a billion pounds are also used to line food and beverage cans, especially for tuna and condensed soups.

Today, nearly all of us, including our children, have BPA in our bodies, but not to worry: The government says up to 50 µg/kg per day is safe. Even those working in Chinese BPA factories don’t get exposed to more than 70 times lower than that so-called safety limit. Why then did exposure seem to affect male workers’ sperm counts? In the United States, the general population gets less than a thousand times lower than the safety limit, yet, even at those incredibly low doses, we still seem to be seeing adverse effects on thyroid function, weight control, blood sugar control, cardiovascular disease, liver function, and immune function. Indeed, “[t]he fact that there are significant adverse effects in populations exposed to BPA at concentrations [thousands of] times lower than the TDI [tolerable daily limit]…indicates that the safe exposure to BPA may be much lower than previously thought in humans.” Despite this, the limit hasn’t been changed. BPA has been banned from “baby bottles and sippy cups,” but nearly unlimited doses are still apparently okay for everyone else. What’s the disconnect?

It has to do with the fascinating world of low-dose effects of hormone-disrupting chemicals. “For decades, studies of endocrine-disrupting chemicals (EDCs) have challenged traditional concepts in toxicology, in particular the dogma of ‘the dose makes the poison’”—that is, the concept “that lower exposures to a hazardous compound will therefore always generate lower risks.” Indeed, that is the core assumption underlying our system of chemical safety testing. Researchers start giving animals in laboratories a super-high dose and then keep lowering the dosage until whatever adverse effects that had occurred disappear. Then, they add a safety buffer and assume everything below that dose should be okay, assuming a straight line showing the higher the dose, the higher the effect. However, hormone-disrupting chemicals can have all sorts of curious curves. How is it possible that something could have more of an effect at a lower dose?

A study was done to see whether BPA suppressed an obesity-protective hormone in fat samples taken from breast reduction and tummy tuck patients. At 100 nanomoles of BPA, hormone levels were no lower than they were at 0nM of BPA. And, since most people have levels between 1 and 20, BPA was considered to be safe. But, although there was no suppression at 0 and no suppression at 100, at the levels actually found in people’s bodies, BPA appeared to cut hormone release nearly in half.

As the world’s oldest, largest, and most active organization devoted to research on hormones concluded, “even infinitesimally low levels of exposure—indeed, any level of exposure at all—may cause [problems].” In fact, it may come to nearly $3 billion in problems every year, counting the estimated effects of BPA on childhood obesity and heart disease alone. There are alternatives the industry can use. The problem, though, is that they may cost companies two cents more.


Related videos about BPA include BPA on Receipts: Getting Under Our Skin and Are the BPA-Free Alternatives Safe?

 BPA isn’t the only problem with canned tuna. Check out:

What can we do to avoid endocrine-disrupting chemicals? See, for example, Avoiding Adult Exposure to Phthalates and How to Avoid the Obesity-Related Plastic Chemical BPA.

Alkylphenols are another group of endocrine-disrupting chemicals. To learn more about them, 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:

Estrogenic Growth Promoters in Meat

In 1979, an epidemic of breast enlargement was noted in Italian children. Poultry or veal was suspected, given that estrogens “may be fed to farm animals to accelerate their weight gain.” “After this episode, the European Union banned the application/use of anabolic growth promoters in agriculture,” as well as the importation of American meat from animals injected with drugs like Zeranol, sold as “Ralgro Magnum.”

Zeranol, one of the most potent known endocrine disrupters, is 100,000 times more estrogenic than the plastics chemical, BPA, for example, and is the subject of my video Zeranol Use in Meat and Breast Cancer. “Zeranol constitutes a special case among potential endocrine disrupters, because Zeranol, in contrast to all other oestrogenic ‘endocrine disrupting’ chemicals, is present in human food because it is deliberately used in the production of consumer products. Furthermore, Zeranol is designed to be a potent, fairly persistent, [estrogen] whereas the [estrogenic] properties of the chemicals that are considered potential endocrine disrupters is accidental.”

If you drip blood from a cow implanted with the drug onto human breast cancer cells in a petri dish, you can double the cancer growth rate. We don’t drink blood, though, but preliminary data showed that muscle extracts—that is, meat extracts—also stimulated breast cancer cell proliferation.

Furthermore, Zeranol may cause the transformation of normal breast cells into cancer cells in the first place. Zeranol-containing blood from implanted cattle “was capable of transforming the human normal breast epithelial cell line” into breast cancer cells within 21 days.

“[O]bese individuals may be at greater risk of developing zeranol-induced breast cancer,” since they already have high levels of leptin, which is a hormone produced by fat cells that can itself promote breast cancer growth. And, Zeranol exposure can greatly enhance this growth-promoting action. “This result also suggests that Z[eranol] may be more harmful to obese breast cancer patients than to normal weight breast cancer patients in terms of breast cancer development.”

“In conclusion, because the synthetic and the natural hormones, used as anabolic growth promoters in meat production, are by far the most potent hormones found in human food,” we should really be testing people, especially children, before and after eating this meat. It amazes me this hasn’t been done, and, until it has, we have no idea what kind of threat they may pose, though the fact that Zeranol is as potent as estradiol (the primary sex steroid in women) and DES should concern us. DES is another synthetic estrogen that was marketed to pregnant women until 1971 when it was shown to cause vaginal cancers in the daughters. But few know it was also used in meat.

“In the absence of effective federal regulation, the meat industry uses hundreds of animal feed additives…with little or no concern about the carcinogenic and other toxic effects of dietary residues of these additives. Illustratively, after decades of misleading assurances of the safety of diethylstilbestrol (DES) and its use as a growth-promoting animal-feed additive, the United States finally banned its use in 1979 some 40 years after it was first shown to be carcinogenic. The meat industry then promptly switched to other [potentially] carcinogenic additives,” such as Zeranol.

When girls started dying from vaginal cancer, DES-treated meat was banned in Europe. However, “misleading assurances…including the deliberate suppression of residue data, managed to delay a U.S. ban on DES” in the meat supply for eight years.

Today, “[v]irtually the entire U.S. population consumes, without any warning, labeling, or information, unknown and unpredictable amounts of hormonal residues in meat products over a lifetime.” If all hormonal and other carcinogenic feed additives aren’t banned immediately, the least we should have is “explicit labeling requirements of use and of [hormone] residue levels in all meat products, including milk and eggs.”


Isn’t the DES story amazing? I had no idea it was used in meat production. Check out Illegal Drugs in Chicken Feathers for more on Big Pharma on Big Farms.

The most dangerous additive used in the meat industry is antibiotics, though. See, for example:

For more on what may be bad for the breast, check out:

And, for what may be protective, 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: