If You Are Scared Of BPA, JAMA Will Make You Happy
    By Hank Campbell | February 26th 2014 05:30 AM | 1 comment | Print | E-mail | Track Comments
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    Human exposure to bisphenol A (BPA) has recently been linked to negative health claims, like a decline in reproductive function in adults and stunted neurodevelopment in children, and so people consumed with the 'natural' fallacy have been up in arms about it.  It hasn't quite become 'BPA causes autism' hysteria, like they did with vaccines, but it is getting close. 

    Naturally, companies have listened to the nocebo worries of the natural-obsessed and dutifully created BPA-free products and charged more money for them.

    The methodology of those claims has been suspect, though that is an article for another time (and respected chemists like Steve Hentges have dealt with it extensively) but despite the fact that the evidence isn't there, we still get a lot of 'you can't prove it is safe' assertions. And  researchers aren't dumb, they want to tackle issues that concern the public, so there are efforts to see if BPA does cause harm. I want to know too. I have been using BPA plastic all of my life and if I suffered reproductive harm from it you can bet I am writing a letter to Congress. The world needs more little versions of me running around a lot more than it needs expensive new kinds of plastic.

    A small study in JAMA regarding BPA and cash register receipts wouldn't ordinarily garner much attention on a science site (well, a science site that isn't in the Scare Journalism/Whoring For Pageviews/Corporate Media world) because the BPA issue seems to be more of a political one than a health one, and because this same claim gets regurgitated every year. Here is the New York Times doing its part for Scare Journalism about BPA again (that was 2011, they have since moved on to sugar and gluten as the things most likely to kill us all now) while Science News turned the Fear and Doubt amplifier up to 11 in 2010 and told pregnant cashiers they were putting their children at risk by having jobs.  But because it is still such a hot-button issue I am linking yet another paper about an essentially meaningless finding that nonetheless implies scary chemicals are going to doom us all. 

    The JAMA article is not the kind of shrill claim you will read in Natural News or some other equally goofy place ("devasting metabolic changes!" they yell, due to a common chemical they never even heard of before six years ago) but will get some mainstream media attention, because it's in JAMA and because people have been trained to be afraid of chemicals and repeating the same claim over and over again seems to work.

    You have handled thousands of receipts. We all have. So why anyone did another study on those receipts that use thermal imaging paper, which is most of them these days.

    Dr. Shelley Ehrlich, an epidemiologist at Cincinnati Children's Hospital Medical Center, and co-authors recruited 24 students and employees from the Harvard School of Public Health who provided urine samples before and after handling (with or without gloves) receipts printed on thermal paper for two hours. BPA was detected in 83.3% (n = 20) of the urine samples before handling any receipts at all and after handlng them, 100 percent of samples of the people without gloves had them. BPA exits the body pretty quickly, that is why it is harmless in realistic use. There was also an increase in urinary BPA concentrations after handling the receipts for 2 hours without gloves but no significant increase when the participants used gloves.

    Credit: doi:10.1001/jama.2013.283735

    An increase? It was 1.8 micrograms per liter to 5.8 micrograms per liter! Over 300 percent!!!! That's a lot, right? 

    Ummm, no. And are those levels dangerous? Not even remotely, but in a chemophobia culture, they don't have to be dangerous, they just have to be talked about. It's why people buy gluten-free labels too - they don't know if gluten is bad for them, they assume it must be bad or its lack thereof would not be printed on a label. It's why the $29 billion Big Organic conglomerates claim they have no GMOs. And why did 83 percent of people have BPA in their urine and not be ill if BPA is bad? Ehrlich does the public no favors by conspiratorially asserting in Health Day that "There's quite a huge body of literature that shows that it has adverse health effects even at low doses."

    Noooo, there are epidemiological correlations. I recently showed that epidemiologists can also blame the riots in Kiev on the price of steel if we just find any two curves going the same way and imply causation. In modern times, much of epidemiology has become sociology, but without having to he stuck in the Humanities buildings on campus.

    This also highlights the flaw in really small studies, though that will get lost in the mainstream media desire to sell advertising, especially with an eager researcher willing to provide scary sound bites. We have seen it all before. This tiny study could be worse - it had twice the participants of Andrew Wakefield's vaccine-autism paper and look at how many progressives have stopped giving their kids vaccines because they are now convinced science is out to ruin their children. The FDA has already banned BPA in sippy cups and maybe if this gets enough media outcry, they will ban cash registers too.

    Literally millions of people have handled these receipts, so you'd think at least some increase in reproductive problems would be evident, especially since BPA has been common since the 1950s and existed long before that. But that hasn't happened, despite that fact that we actually have a giant pool of test subjects - all of America. Instead, we keep seeing animal model studies and iffy epidemiological correlations foisted off on us over and over again. As I have noted in the past, 100 percent of a completely organic Thanksgiving dinner is stuffed full of carcinogens that cause cancer in animal model studies. Yet we are not dying from Thanksgiving dinner because the dose still makes the poison (and in some cases the dopes make the poison) and BPA in high enough doses to harm humans is bordering on impossible unless you eat old sippy cups for a year - even then the digestive problems would kill you before the BPA had any effect.

    The paper concedes that it has no clinical implications, but they imply there is some risk because levels of a chemical that hasn't been found to be harmful is slightly more prevalent in people who handle receipts.And then we get the scary quotes from the epidemiologist who really should know better.

    "A larger study is needed to confirm our findings and evaluate the clinical implications," they write.

    Then shouldn't they have just waited until they did that larger study? Why duplicate the exact same small study finding that gets done every year? Was the clock ticking on the Publish Or Perish-o-meter and this data was in a drawer from Ehrlich's days at Harvard? We may never know.

    Formerly popular scare journalism standards don't like being one-upped by upstarts like BPA so perfluorinated chemicals also got a story out yesterday saying they were the reason why kids are fat. Trans fats and sodas and McDonald's Happy Meals are relieved by that revelation but mainstream media has moved on to a new fad because childhood obesity isn't going up any more, so I bet they won't notice the PFC thing.

    Citation: Shelley Ehrlich, MD, ScD, MPH, Antonia M. Calafat, PhD, Olivier Humblet, ScD, Thomas Smith, PhD, Russ Hauser, MD, ScD, MPH, 'Handling of Thermal Receipts as a Source of Exposure to Bisphenol A', JAMA. 2014;311(8):859-860, 26 February 2014, doi:10.1001/jama.2013.283735.


    While it's always dicey to overinterpret such a small-scale study that is only briefly reported in letter format, the paper provides 3 pieces of useful contextual information that help to assess whether the increased exposure might be significant. First, the figure from the JAMA paper shows mean and 95th %ile values from the NHANES 2009-2010 database. NHANES is a large CDC database that collects, among other things, extensive biomonitoring data on chemicals including BPA. The data provides a snapshot of chemical exposure across the US population. Since all of the samples from the JAMA study were below the 95th %ile values for the US population, it appears that handling receipts for 2 hours does not increase BPA exposure beyond the range of background values in the US population.

    The authors also note that 1 participant was excluded because their preexposure BPA level was 49.3 micrograms/L, which was attributed to consuming 4 cans of beverage prior to handling receipts. From this data it appears BPA exposure from handling receipts for 2 hours is less than from drinking canned beverages.

    The authors also refer to a previous study that reported BPA levels of 20.8 micrograms/L after consuming canned soup. It appears that BPA exposure from handling receipts is also less than from eating soup.

    These are all simplistic comparisons with limitations of their own, but they suggest that the value of a larger study is questionable. Of much more value is the definitive research that is underway in FDA's laboratory. It may not get the media attention so commonly given to scare stories, but is of far more scientific value. I'll post an article summarizing the research to date in the near future.