For most of us, they’re just bits of paper that we tuck away in our pockets after paying for our shopping. For others, however, they have become a source of concern due to their potential health risks.
In recent months, social media feeds have been flooded with videos making claims such as: ‘Touching receipts could damage your ability to have children in the future’ or ‘These things can seriously harm your body’.
Around 2,500 posts on TikTok feature a popular audio clip with the phrase: ‘I never touch cheques.’ A guest on the ‘Diary of a CEO’ podcast, which is listened to by millions of people worldwide every month, also spoke about these concerns.
Such posts often claim that contact with cheques can lead to infertility, hormonal imbalances and a drop in testosterone levels.
So why are these pieces of paper treated with such caution?
The reason is that they are usually printed on thermal paper coated with a chemical layer that often contains bisphenol A (or BPA).
According to the World Health Organisation (WHO), BPA is an endocrine-disrupting chemical; it is linked to hormonal imbalances and reduced fertility.
However, scientists have told the BBC World Service that the evidence does not warrant panic amongst consumers.
What is BPA and how might it affect your fertility?
Since the 1960s, shop receipts have been treated with bisphenol A (BPA) – a chemical compound also used in plastic water bottles and food tins.
Modern receipt printers use heat instead of ink. The BPA coating reacts to the printer’s high temperature, turning the paper black and instantly printing letters and numbers.
However, laboratory studies using human testicular tissue have shown that BPA reduces testosterone production.
Other studies have found a link between exposure to these compounds during the prenatal period and reproductive system disorders in boys.
According to Professor Channa Jayaseni, a consultant in reproductive endocrinology at St Mary’s and Hammersmith Hospitals in London, an increasing number of patients at fertility clinics are expressing concerns about BPA.
“Couples are often very concerned about all aspects of their health. They are keen to detoxify their bodies and rid themselves of toxins, and this may involve avoiding the use of plastic,” he notes.
He agrees that there is a growing body of evidence pointing to the potential impact on fertility of endocrine-disrupting chemicals such as BPA.
At the same time, he points out that these studies still leave important questions unanswered — for example, what dose of BPA is required for such effects to occur.
“In my view, they certainly pose a potential health risk,” he says.
Photo credit: Getty Images
What do studies on the levels of bisphenol A (BPA) in shop receipts reveal?
According to the findings of a 2014 study, bisphenol A (BPA) can be absorbed through the skin, and contact with a receipt after using hand sanitiser appears to enhance this process.
However, it is not so much the chemical itself that is decisive, but rather the level of exposure, notes Professor Oliver Jones, a chemistry professor at RMIT University in Melbourne, Australia.
He compares it to alcohol. “If you drink a glass of wine, it’s unlikely to have any serious consequences. But if you drink a whole bottle every evening for a year, that will have an effect on your body,” he says.
Based on this, the scientist believes it is unlikely that a negligible amount of BPA from a single receipt could be harmful to health.
“To be honest, I think that even if you were to eat the receipt, the concentration of the substance wouldn’t reach a level capable of causing problems,” he adds.
But what about cashiers, who have to handle receipts much more frequently?
“I haven’t seen hordes of cashiers rushing to fertility clinics,” notes endocrinologist Jayasena.
At the same time, he emphasises that more data is needed to understand how the long-term exposure to chemicals that disrupt the endocrine system (through occupational exposure or environmental factors) affects fertility.
Despite this, the use of BPA-containing receipts is already banned in the European Union and the UK. They are also being phased out in Japan and South Korea.
In these regions, many manufacturers have replaced BPA with bisphenol S (BPS) — a chemical compound which, according to Jones, is ‘almost identical’ in its properties.
“Technically, it (BPS) poses a greater risk, as we do not have the same body of evidence as we do for BPA. However, overall, I believe the risk remains fairly low,” he adds.
Photo credit: Imperial College London
Should you avoid paper receipts as a precaution?
If you’re still concerned, it’s worth minimising your exposure to this substance, for example by wearing gloves or opting to receive receipts by email.
“If it puts your mind at rest and reduces your stress levels – why not?” says Jones.
According to Jayasena, if you’re concerned about the effects of bisphenol A (BPA), there are other, more scientifically sound steps you can take.
You should start by avoiding reusing or reheating food in plastic takeaway containers, which are often not suitable for the microwave.
“If you want to improve or maintain your fertility, the most important thing is to stop smoking, drink alcohol in moderation, exercise and maintain a healthy body mass index,” he adds.
“There are things we can control, and there are factors that have been proven to affect reproductive health, but cheques are not one of them.”