Is mixing BPA and Hand Sanitizer a Toxic Combination for Health?
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BPA and Hand Sanitizer: A Toxic Mix with Serious Health Risks?

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A new study shows that using hand sanitizer (and other skin products) before handling receipts increases BPA absorption by as much as 185 times and leads to BPA levels associated with obesity, diabetes, CVD, infertility, and cancer.

hand sanitizer dangers
One of the dangers of using hand sanitizer prior to handling a receipt like this one is increased risk of BPA absorption. iStock.com/nullplus

Imagine the following scenarios:

  • You go to the gas station and fill up your tank. You use the hand sanitizer next to the pump to clean your hands, then grab the receipt from the payment terminal before getting back into your car.
  • You go for lunch at a fast-food or take-out restaurant. Just before ordering, you use the hand sanitizer positioned near the counter. The cashier hands your order to you with the receipt stapled on top of your bag, which you carry out with you.
  • You work as a cashier at a retail store. You keep a bottle of hand sanitizer next to the register, and use it frequently throughout the day as you ring customers up.

These scenarios aren’t uncommon; they happen millions of times each day all over the industrialized world. Recent estimates suggest that 50 million people in the USA alone eat in a fast-food restaurant each day.

That’s why I was so alarmed by a new study, published in the journal PLOS One, suggesting that using hand sanitizer prior to handling receipts can dramatically increase exposure to a chemical called BPA. (1)

What Is BPA (And Why Should You Care?)

Bisphenol-A (BPA) is a chemical that has been used in consumer goods since the 1950s. It’s found in plastic containers, food cans, DVDs, cell phones, eyeglass lenses, automobile parts, sports equipment, and in the thermal paper used for airline ticket, gas, ATM, cash register, and other types of receipts.

New study shows holding receipts for as little as 2 seconds after using hand sanitizer dramatically increases BPA exposure.

BPA is incredibly prevalent in our environment. Over 15 billion pounds of it are produced each year, and nearly all of us are exposed: according to a 2008 study, 93% of Americans have detectable levels of BPA in their urine. (2)

Why is this a problem?

We’ve known for decades that BPA can mimic the effects of estrogen. The best way to think of chemicals with estrogenic activity is as a counterfeit key fitting into a loose lock. When these chemicals activate the estrogen receptor, they produce an increase in circulating estrogen, which in turn can wreak havoc on both male and female reproductive and endocrine systems.

Over 60 studies have linked BPA to a wide range of diseases, including:

  • PCOS, infertility, premature delivery, miscarriage, and other reproductive effects in women
  • Reduced libido and sperm quality, and altered sex hormone concentrations in men
  • Altered thyroid function
  • Obesity and diabetes
  • Cardiovascular disease
  • Impaired liver and kidney function
  • Impaired immune function
  • Inflammation
  • Neurobehavioral deficits such as aggressiveness, hyperactivity, and impaired learning (3)

Though it’s difficult to prove causation with epidemiological research, and there is still significant controversy regarding the health effects of BPA, I believe both the volume of evidence and the magnitude of our exposure warrant caution. This is yet another situation where the precautionary principle applies. We have no biological need for BPA, and there’s considerable evidence that it may cause serious harm, so the most prudent approach would be to limit our exposure as much as possible.

How Does Using Hand Sanitizer (And Other Personal Care Products) Increase Your Exposure to BPA?

BPA, and a related compound called BPS that also has significant estrogenic activity, are used in thermal receipts as a heat-activated print developer. Virtually all thermal receipts contain either BPA or BPS, and it has been shown that BPA is readily transferred to other materials that come into contact with receipts. (4)

Although it’s well-known that BPA can pass through the skin, regulatory agencies like the EPA have typically downplayed the risk of BPA exposure from handling receipts. However, they haven’t considered the important role that hand sanitizers and personal skin care products might play in increasing the absorption of BPA through the skin.

Hand sanitizers and other skin products (e.g. soaps, sunscreens, lotions) contain “dermal penetration enhancers” that are designed to enhance the delivery of the active ingredients they contain. Previous studies have found that dermal penetration enhancers can increase the absorption of estradiol, a chemical very similar to BPA, by as much as 100-fold. (5)

If BPA can be transferred from receipts to human skin, and hand sanitizer and other personal care products dramatically increase the absorption of BPA, then might using these products prior to handling receipts lead to potentially toxic levels of BPA exposure? That’s exactly the question the authors of the PLOS One study set out to answer.

They observed people in fast-food restaurants, food courts, and shopping malls in Columbia, Missouri. They also performed experiments in their own lab with volunteers. And what they found was, frankly, quite disturbing:

  • If hand sanitizer is used prior to holding a receipt for even a few seconds, a large amount of BPA is transferred to the skin. (Holding a receipt for 45 seconds led to maximum BPA transfer, but holding it for only 2 seconds led to absorption of 40 percent of the maximum amount.)
  • Absorption of BPA from the skin happens rapidly due to the dermal penetration enhancers in the hand sanitizer (and other skin care products). In fact, the data showed that there was 185-times more BPA transferred to a wet hand after using hand sanitizer than to a dry hand.
  • There was a “dramatic” increase in serum BPA levels after using hand sanitizer, holding a receipt, and then eating with the BPA-contaminated hand. The primary route of exposure was the thin skin in the mouth, not the GI tract.)
  • The levels of BPA measured in the urine 90 minutes after using hand sanitizer and holding a receipt were consistent with levels that have been associated with a significant increase in cardiovascular disease and diabetes (along with numerous other diseases) in humans.

Previous studies have shown that handling receipts for long periods (i.e. continuously for 2 hours, as a cashier at a retail establishment might do) leads to increased levels of BPA in urine, and studies of actual cashiers have shown that they have higher levels of BPA in their urine than the general public. (6, 7)

This is the first study, however, to highlight the dramatic impact that hand sanitizer and skin products with dermal penetration enhancers can have on BPA absorption from receipts. And it may help to explain the high levels of bioactive BPA observed in the serum and urine of humans—especially those suffering from “diseases of civilization” like obesity, diabetes, and cardiovascular disease.

Unfortunately, the solution to this problem is unlikely to come from industry or government anytime soon. A recent EPA report examined 19 alternative chemicals that could potentially replace BPA as a developer in thermal paper, and concluded that “No clearly safer alternatives to BPA were identified in this report; most alternatives have Moderate or High hazard designations for human health or aquatic toxicity endpoints.” (8) The report mentioned that “decision makers may wish to consider alternative printing systems.” Hmmm. Forgive me for not holding my breath until that happens.

Conclusions and Recommendations

Perhaps someday we will live in a society that requires industry to thoroughly test a new chemical before introducing it into our environment. At the moment, that is not required. So what we’re left with is doing our best to determine the toxicity of chemicals after they are already present—and, in the case of BPA, ubiquitous—in our food supply and commercial products.

In other words, all of us (as well as our children, grandchildren, etc.) are unwitting participants in a gigantic, uncontrolled, society-wide experiment. And so far, the results of this experiment are not encouraging.

Yes, there is still disagreement in the scientific community about just how much BPA exposure is safe, and just how harmful BPA is to human health. But why should we gamble our own health and that of future generations on the hope that a chemical already known to be toxic may turn out to be a little less toxic than we feared? Given that more than 90% of us have detectable BPA levels in our urine, and that BPA is associated with chronic diseases increasing at alarming rates, shouldn’t we be doing everything in our power to better understand BPA’s effects—and protect ourselves from them if necessary?

If your answer to that question is “yes”, here are a few things you can do to reduce your exposure to BPA in receipts, and elsewhere:

  • Avoid using hand sanitizer and other skin products like sunscreen or lotion prior to handling receipts.
  • Avoid handling receipts even with dry hands for long periods of time. If you are a cashier, make sure to wear gloves.
  • Use glass and stainless steel containers at home for food storage. Be aware that the lids of Mason and Kerr brand canning jars contain BPA. There are BPA-free lids, but they still may contain chemicals with estrogenic activity, and I’ve been told they’re made with formaldehyde. Weck makes 100% glass jars that are a good alternative. Crate and Barrel sells them here. My favorite stainless steel containers are from Lunch Bots.
  • Use glass, stainless steel, or silicone instead of plastic for freezer storage. See this article for recommendations.
  • Use a stainless steel water bottle (like the Klean Kanteen) instead of plastic bottles.
  • Don’t drink bottled water from plastic bottles, especially when they’ve been exposed to sunlight.
  • Parents: use glass baby bottles instead of plastic. Evenflo is a commonly available brand you can buy at Target, Wal-Mart, Walgreens, Rite-Aid, etc. and online at Amazon and other retailers.

If you’d like to read more about BPA in plastics and other food containers, check out my previous article and podcast on this topic.

  1. you would not believe how many gallons of water bottles consumed by our deployed troops- and they are sitting in plastic bottles in pallets in the hot sun for weeks if not months prior to consumption ….uggh

  2. Hi Chris! Thanks for the great article. I, for one, was not aware of the receipts-BPA connections but I’m relatively new to living a healthy lifestyle.

    Question: Do you know if laser copiers and printers use BPA?

    Thanks in advance!

  3. I repair electronics, and I have to hand out thermal paper receipts to customers. Do you think lathering isopropyl alcohol on my hands would reduce BPA levels?

    I have never once used hand sanitizers on my hands, and I really don’t wash my hands. Hospitals, gyms, schools, grocery stores, and large retailers come to mind. I think hospitals and gyms would be the worse. Some gyms enforce wiping down the equipment you’ve used. Imagine placing your crotch all over that equipment and absorbing it that way.

  4. We have always been a part of an uncontrolled experiment. Our species are experimenters, we try new things all the time. A lot of those new things have devastating effects on us, but I don’t see the alternative. We have maximized evolutionary success through experimentation, stopping it is not the answer.

  5. The mason jars I use are sold as BPA free as are the plastic bags I get from Target. So does this mean they might have something worse for us than BPA?

    • Thats my exact question. If getting BPA free is worse than BPA, then Im worried about those jars. Maybe Chris can guide us on this one?
      Thank you Chris!

  6. Did anyone notice the linked article regarding the freezing of foods recommends to wrap in Aluminium foil. Chris surely you do not recommend aluminium touching any food for human consumption?

  7. Does anyone know of an accurate way to test for BPA?

    Ideally, I’d like to find a panel that tests for a variety of endocrine disrupting chemicals.

    I’ll ask my doctor if she has any recommendations, as she’s well versed in paleo and functional medicine. If I find anything I’ll try to provide an update.

  8. Chris,

    I am pregnant with two small children. What is your personal routine when it comes to outings with Sophie to places like the park, grocery stores/carts, public transportation, restaurants, etc? Or noticing that she has played with a kid who doesn’t look well? With a four year old and an almost two year old, I feel like we go through periods of virus after virus after virus, sometimes for weeks and weeks, and I start getting paranoid about germs and infection. We live in an urban environment, as opposed to the country. I don’t mind the colds as much and truly see the benefit of the immune system building, but it is the secondary infections like stubborn ear or sinus infections that get complicated, or bugs like stomach flu (not fun when EVERYONE in the house is throwing up), or even more serious flu strains or (we avoid the flu shot), or diseases like whooping cough or the measles, especially as we are expecting a newborn soon. I find myself avoiding the park and places like it, or being paranoid at the zoo, etc., not letting my kids touch ANYTHING at a Dr’s office (especially the kid’s toys), eyeing restaurant high-chairs suspiciously, noticing if any kid sniffles or coughs in 30 foot radius, etc., all because of wanting to avoid illnesses, and I know that is not the answer. I was not always like this–it has been borne out of frustration. So how do you handle that? Do you let Sophie get exposed to anything and everything so that her immune system can build, come what may, or do you have some sort of routine for hygiene after being in public places? What is a reasonable approach? I have several years of mothering ahead of me. I need a sane strategy!
    Thanks,
    N. Boyd

  9. Thank you for an informative article. We no longer need to have receipts printed out; they can be emailed or txted. I rarely have a customer complain. I’m concerned about an overabundance of receipts in landfills. The BPA plus all the other contaminants are contaminating the planet.

  10. Another thing to consider is the use of pacifiers and plastic teethers. Some babies suck on plastic daily for the large part of their day. Like Chris said we are a part of a giant, uncontrolled experiment. And it begins way too young.

  11. Hmm. “Don’t drink bottled water from plastic bottles, especially when they’ve been exposed to sunlight.” Can you expand on this? I was under the impression that bottled water was preferred to getting it out of the tap. Are you saying that we should look at water bottled in glass? The brands out there are quite expensive and considering that everyone in my family drinks water pretty often it could really add up.

    • re: I was under the impression that bottled water was preferred to getting it out of the tap.

      That depends on the sources of each form. Bottled water can easily be sourced from municipal water, including treatment residues. Tap water might perfectly OK, such as from your own well.

    • Bottled water contains all kinds of things that leach from the plastics used–not to mention the amount of garbage bottled water generates. A better alternative is to get a carbon block water filter and refill your own stainless steel water bottles to bring with you where ever you go. That plastic taste in the bottled water is definitely not good for your body!

    • Home filtered water is best. A reverse osmosis system is best. It has an upfront cost and annual filter replacement… But cheaper than years of bottled water in both cost of bottled water, and in your health. And buying glass bottles of water regularly would be quite expensive.

      Bottled water companies are exempt from tap water standards for maximum levels of plastic chemicals that leach into the bottled water!

      I threw out all my Kleen Kanteen stainless steel water bottles because if the water sits in there for a few hours it smells like chemicals (possibly from something in the seam of the metal which goes down the inside). Now I use glass bottles with the rubber coating, and also a thermos brand stainless steel bottle with no inner seam and it never smells.

      • Reverse osmosis systems are only “best” if the system is set up to return grey water to the household, which is not standard installation. Reverse osmosis systems discard three times the water they yield.

  12. Important stuff – I’d just dispute your recommendation to can in 100% glass jars or stainless steel. Glass against glass doesn’t provide enough of a seal to protect against spoilage, including botulism. Steel cans have a plasticized lining, that typically contains BPA or BPS, not to mention that canning in actual cans requires quite a bit more equipment than canning in jars. I’m aware that canning lids contain BPA, but I still think it’s a reasonable alternative since food is not actually in contact with the lids.

    • The glass jars seem to come with rubber seals, vs. being glass on glass. We’ve already converted to all glass in our storage, and reusable cloth produce bags, so I am not going to get too persnickety about the jar lids.

      • The rubber gaskets that come with hermetic jars are not “seals.” Plus, I don’t think they will even withstand the high heat needed for canning. Preferring something old-fashioned like botulism to BPA, is not a good solution AFAIC.

  13. Thanks for contributing to the gross mis-information about BPA and plastics out there. You contribute to confusion and panic.

    The only plastic that contains BPA is polycarbonate. Polycarbonate has been removed from infant care and many other food contact markets, for years.

    Tritan plastic is BPA free, BPS free, and has been proven free of estrogenic activity. SAN plastic is also BPA free.

    Instead of causing panic, educate the people with detailed, truthful, and practical information. What are you going to do when your baby throws her glass bottle on the counter, shatters it, and cuts her hand? Clean the blood with a BPA-free rag? This article reminds me of Mother Jones. Shame on you!

    • Ah, an industry shill. I was wondering when one would show up.

      If you believe everything the industry says about plastic (including the idea that Tritan is free of estrogenic activity), I’ve got some studies the tobacco industry did proving that it’s not carcinogenic to show you.

      I prefer to draw conclusions from peer-reviewed research that isn’t industry-sponsored, myself.

  14. Hi Chris,
    Do all plastics contain BPS and/or BPA? I am just wondering about water filter pitchers and even water filter systems you might have installed in your home. The pitchers are plastic and the installed units have plastic housing and other parts. I prefer to filter all my water for myself and my pets and never thought of the actual containers possibly having these in them.
    Any insight would be greatly appreciated.

      • So better to not buy BPA free Chris? Just got a BPA free 5 gallon container for my water. I don’t think they sale glass containers in that size.
        Thank you for all the information.

        • It’s really tricky, unfortunately. Often you have to contact the company and ask if their BPA containers have BPS or any other chemical with estrogenic activity. Some are more aware than others. If they don’t know, or they obfuscate, then the answer is probably “yes”.

          • calling them for sure! I have high estrogen issues, misbalanced hormones….I cut off food containing estrogen, no way Im putting more of this unwanted estrogen in my body.
            Thank you so much Chriss

          • I called the company and they have no idea what BPS is. I assume they aren’t BPS free at all. Going to change to glass containers.

        • Actually glass bottles in 3, 5 and 6 gallon sizes are easily available. Use the term “carboy” and shop your local homebrew store. They typically do not have screw-top closures though, so you’ll need to use cork.

  15. Is there any research on BPA or other chemicals in plastic gloves? And is the BPA in the paper or in the ink? I sometimes work with a machine that produces print outs. Luckily (I thought!) it doesn’t have the glossy receipt paper, but the more normal old fashioned paper. Would that be better?

  16. I just bought a box of Mason jars, now that I know the lids aren’t BPA free, would it help if I put a coffee filter ( unbleached and no chlorine) around the mouth of the jar and then the lid on?
    Thank you for your help and valuable information.

    • You can buy BPA-free lids for Mason jars. But if the food isn’t coming into contact with the lids, the exposure would be minimal.

      • thank you!
        And for 5 gallon wAter containers is there a brand/ type that is ” safe” besides glass? I re-fill my BPA free container twice a week but after reading your article about BPA free products I don’t want to use it no more. I have hormone disbalance and I’ve read quimicals in plastic contribute to hormone issues.

        • This doesn’t answer your question but I wanted to mention that glass 5-gallon containers are available, in case you weren’t aware of that. You can find them online and also in home-brew shops. The best search term would probably be glass carboys. I think they also make a 6-gallon container, plus handles and carts to make maneuvering them easier (they’re heavy).

  17. I used to work for a large corporate where select investors would come in and ask us, “What’s the best replacement for wood?” And, our head sustainability person would answer, “The best replacement for wood is wood. It’s renewable, produces oxygen, and is completely biodegradable.” This investor would argue time and again that plastic is a better replacement. Then our team developed a cost benefit analysis to show the actual results, which were astounding.

    The second best natural product to natural fibers and wood is GLASS. We’ve been hard-core glass converts since our kids were young. The amount of plastic of all types being thrown at children is down-right frightening. We eat off of china and ceramic, drink from glass or ceramic, and use metal utensils or bamboo (bought in bulk and some stored in the car). It can be done. Totally done. And, I don’t accept bpa-receipts… most companies let you return product even without a receipt nowadays if it’s needed.

    Good luck to all. Take control of your and your family’s plastic exposure yourself.. the government will be way too late and a generation of infertile youth are awaiting our future.

  18. The study looked at BPA absorption immediately after using the hand sanitizer, while the hands were still wet. For the sake of all grocery store customers who sanitizing wipes to clean cart handles and their own hands before doing their shopping, it’d be good to know if BPA absorption is still increased once the hands have dried.

    • That is one thing the researchers mentioned needs more investigation in their conclusion. But in their study dry hands absorbed 185-times less BPA than hands that were wet after using hand sanitizer. Studies have shown that continual handling of receipts with dry hands can elevate BPA levels in urine, but I don’t think touching a receipt briefly with dry hands is likely to be a major concern. The question, as you say, is how long lasting is the effect of the dermal penetration enhancers?

  19. Is there a list of known “dermal penetration enhancers” so we can avoid them in all products? Does anyone know what the specific ingredients are? I don’t use HS but use lotions and regular soaps sometimes especially in the office.

    • Hi Grace and Chris,
      Some of the ingredients that I do know of are the Glycols, such as Butylene Glycol, Pentylene Glycol and Propylene Glycol. They are in a lot of products for skin use because they perform other functions. They are humectants that draw moisture to our skin to keep it hydrated (which isn’t a great thing if you live in a dry desert climate with hardly any moisture in the air to draw from), they are solvents that help to dissolve other ingredients in formulation and they also improve freeze/thaw abilities.
      MSM is a form of sulfur that is present in all living things, without which we wouldn’t be able to live. You can take it as a supplement and it can also be put into cosmetic products.
      Unfortunately a lot of preservatives can be penetration enhancers also, but I would have to say, in my opinion, that to use a product without a broad spectrum preservative is inherently more dangerous than using products with the small amounts they contain. There can be upwards of 100,000 microbes in 1 ml of water and to the naked eye you would not be able tell. So if a product contains water or water soluble ingredients (i.e. plant extracts, aloe vera, hydrosols or distillates), along with oils or oil soluble ingredients they need to be well preserved.
      I do disagree with the use of antibacterial cleaners in general, such as Triclosan. It is normal for our skin to have certain microbes and bacteria present. It’s a far better bet to just use soap and water or products without antibacterial ingredients.
      There are other ingredients that enhance penetration but those are some that immediately come to mind that are common in products.

      • A possible antibacterial solution sourced entirely from a natural source is Propolis. Combined with beeswax it is used by the bees to protect aganst contaminants in the hive, as well as a preservative. It also is a pretty good glue.
        I have used my own bees propolis & wax in a cream (adding Olive Oil or Coconut oil to soften. Seems to provide good protection.
        Any thoughts?
        I wish you could test these in your lab. Make sure you source your samples from Beekeepers who primarily practice natural/ chemical free beekeeping.