The Hidden Dangers of Everyday Receipts

From forever chemicals in cosmetics to harmful food additives, health hazards seem to lurk at every turn. Is receipt paper another cause of concern? We asked the experts.

Thermal paper used in register receipts is a hot topic in the wellness world. Social media users share how they avoid skin contact with receipts by using clothes or refusing to take them altogether.

Some healthcare professionals also turned to social networks to warn about the potential risks of bisphenols, toxic chemicals found in thermal paper. They cite a study conducted in 2022 by the Ecology Center, the non-profit organization, which tested 571 cash register receipts collected from stores, restaurants, and other establishments in the United States.

They identified color developer on each receipt, a chemical layer on the paper that allows for fast printing at the point of sale.

Bisphenol S (BPS) was the most common color developer, detected in 85% of receipts. The authors said that although BPS has been marketed as an alternative to the well-known hormone-disrupting chemical bisphenol A (BPA), emerging evidence suggests its hazards can be as concerning.

The follow-up study, published in 2023, tested another 245 receipts from businesses in eight cities across the U.S. Of those, 80% were coated with BPS and 2% with BPA.

Health risks of bisphenol exposure

Dr. Katie Pelch, a senior scientist at the Natural Resources Defense Council, says the levels of bisphenols found in receipts can contribute to the daily body burden of these chemicals and could cause harm.

Once in the bloodstream, Pelch says, they can mimic the body’s hormone system, which regulates important functions like growth, stress responses, blood pressure, metabolism, reproduction, behavior, and even sleep.

Pelch says that while much is known about the health harms associated with exposure to BPA, a growing body of evidence indicates that other bisphenols used in thermal papers share similar concerns.

“Though some studies suggest that BPS is less likely to be absorbed through the skin compared to BPA, as a consumer, it is not possible to know whether you are being handed a receipt coated with BPA or one coated with BPS or another alternative chemical,” she tells Healthnews.

BPA is classified as a hazardous chemical in the European Union due to its ability to damage fertility and cause serious eye damage, allergic skin reactions, and respiratory irritation. Moreover, research indicates that BPA may raise the risk of breast and prostate cancer, hypertension, type 2 diabetes, and cardiovascular disease.

California’s Environmental Health Hazard Assessment has classified BPS as a reproductive toxicant. As many as 81% of Americans have detectable BPS levels in their systems, and most of the exposure comes from thermal receipt papers, research suggests.

Bisphenol manufacturers have repeatedly disputed the toxicity claims, saying the levels of typical human exposure are safe. However, many of the studies they cite, including the CLARITY study conducted by the U.S. federal government research program, analyzed bisphenol effects in rats, making it difficult to generalize the findings to humans.

What influences bisphenol absorption?

Pelch says daily habits like washing hands or using lotions or hand sanitizers can impact how readily bisphenols are absorbed by the skin.

Some people have higher levels of exposure due to their jobs or shopping habits. For example, cashiers are likely to handle a lot of receipts during a shift and, therefore, may have higher exposures than other consumers.

Scientists have also observed that consumers handle thermal paper receipts in surprising ways, many of which could increase their exposure to bisphenols. These included rolling a receipt to be used as a straw, blotting pizza, and using the receipt as a napkin.

Pelch

How to protect yourself from chemicals on receipts

The use of non-bisphenol alternatives in the U.S. increased from 2% in 2017 to 20% in 2022, according to the Ecology Center. Nevertheless, the organization calls on businesses to reduce the use of printing receipts by offering digital receipt alternatives.

Some states have also taken action to reduce bisphenol exposure. Washington state has prohibited the sale, manufacture, and distribution of bisphenol-containing thermal paper, although the ban will not take effect until Jan. 1, 2026.

Last year, California’s State Assembly approved the bill, encouraging the greater adoption of electronic receipts to minimize the health risks that paper versions pose.

Genoa Warner, Ph.D., an assistant professor at the Department of Chemistry and Environmental Science at New Jersey Institute of Technology, says consumers can protect themselves from bisphenol exposure by avoiding handling receipts, especially with greasy fingers or after using hand sanitizer.

Pelch says consumers can always decline a receipt or opt for a digital one. They should also aim to handle receipts and other thermal papers as little as possible and wash their hands afterward.

Thermal papers should not be put in recycling bins to avoid contaminating other paper-based products with bisphenols.

Pelch

Workers who occupationally handle receipts can wear gloves or request their employers use receipts with safer alternatives, according to Warner.

Even though BPA is now rarely found in receipt paper, its alternative, BPS, may not be much better. Therefore, avoid taking receipts, wash your hands after handling them, and don't put them in recycling bins.