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Bisphenol A (BPA) is a high-production-volume chemical associated with a wide range of health outcomes in animal and human studies. BPA is used as a developer in thermal paper products, including cash register receipt paper; however, little is known about exposure of cashiers to BPA and alternative compounds in receipt paper. We determined whether handling receipt paper results in measurable absorption of BPA or the BPA alternatives bisphenol S (BPS) and 4-hydroxyphenyl 4-isoprooxyphenylsulfone (BPSIP). Cashiers (n = 77) and non-cashiers (n = 25) were recruited from the Raleigh-Durham-Chapel Hill region of North Carolina during 2011-2013. Receipts were analyzed for the presence of BPA or alternatives considered for use in thermal paper. In cashiers, total urine and serum BPA, BPS, and BPSIP levels in post-shift samples (collected ≤ 2 hr after completing a shift) were compared with pre-shift samples. Levels of these compounds in urine from cashiers were compared to levels in urine from non-cashiers. Each receipt contained 1-2% by weight of the paper of BPA, BPS, or BPSIP. The post-shift geometric mean total urinary BPS concentration was significantly higher than the pre-shift mean in 33 cashiers who handled receipts containing BPS. The mean urine BPA concentrations in 31 cashiers who handled BPA receipts were as likely to decrease as to increase after a shift, but the mean post-shift concentrations were significantly higher than those in non-cashiers. BPSIP was detected more frequently in the urine of cashiers handling BPSIP receipts than in the urine of non-cashiers. Only a few cashiers had detectable levels of total BPA or BPS in serum, whereas BPSIP tended to be detected more frequently. Thermal receipt paper is a potential source of occupational exposure to BPA, BPS, and BPSIP. Thayer KA, Taylor KW, Garantziotis S, Schurman SH, Kissling GE, Hunt D, Herbert B, Church R, Jankowich R, Churchwell MI, Scheri RC, Birnbaum LS, Bucher JR. 2016. Bisphenol A, bisphenol S, and 4-hydro​xyphenyl 4-isopro​oxyphenyl​sulfone (BPSIP) in urine and blood of cashiers. Environ Health Perspect 124:437-444; http://dx.doi.org/10.1289/ehp.1409427.

Background: Bisphenol A (BPA) is a high-production-volume chemical associated with a wide range of health outcomes in animal and human studies. BPA is used as a developer in thermal paper products, including cash register receipt paper; however, little is known about exposure of cashiers to BPA and alternative compounds in receipt paper. OBJECTIVE: We determined whether handling receipt paper results in measurable absorption of BPA or the BPA alternatives bisphenol S (BPS) and 4-hydroxyphenyl 4-isoprooxyphenylsulfone (BPSIP). METHODS: Cashiers (n = 77) and non-cashiers (n = 25) were recruited from the Raleigh--Durham--Chapel Hill region of North Carolina during 2011-2013. Receipts were analyzed for the presence of BPA or alternatives considered for use in thermal paper. In cashiers, total urine and serum BPA, BPS, and BPSIP levels in post-shift samples (collected [less than or equal to] 2 hr after completing a shift) were compared with pre-shift samples. Levels of these compounds in urine from cashiers were compared to levels in urine from non-cashiers. RESULTS: Each receipt contained 1-2% by weight of the paper of BPA, BPS, or BPSIP. The postshift geometric mean total urinary BPS concentration was significantly higher than the pre-shift mean in 33 cashiers who handled receipts containing BPS. The mean urine BPA concentrations in 31 cashiers who handled BPA receipts were as likely to decrease as to increase after a shift, but the mean post-shift concentrations were significantly higher than those in non-cashiers. BPSIP was detected more frequently in the urine of cashiers handling BPSIP receipts than in the urine of noncashiers. Only a few cashiers had detectable levels of total BPA or BPS in serum, whereas BPSIP tended to be detected more frequently. CONCLUSIONS: Thermal receipt paper is a potential source of occupational exposure to BPA, BPS, and BPSIP.

Chlordecone belongs to the class of persistent organochlorine pesticides that are remarkably resistant to environmental degradation. Even though their use was banned in the United States in 1978, these compounds can still be detected in both humans and wildlife throughout the world. Previous work has shown that the pretreatment of male C57BL/6 mice with low doses of the persistent organochlorine (OC) pesticide, chlordecone (CD) stimulated biliary excretion of exogenous CH up to 3-fold, and further, that increased biliary excretion was not associated with changes in ATP-binding cassette transporter G8 (ABCG8) or scavenger receptor class B type I (SR-BI). In rodents, hepatic basolateral SR-BI is important in controlling plasma lipoprotein levels and cholesterol (CH) homeostasis, with major roles in reverse CH transport (RCT) and biliary excretion. The hepatic ABCG5/G8 heterodimer is a membrane transporter present on the apical surfaces of hepatocytes, and also plays a key role in biliary CH secretion. Scavenger receptor class B type II (SR-BII) was identified as a splice variant from the SR-BI gene and is expressed in a variety of tissues. Although the function of SR-BII is not clear it was proposed to play a role in CH homeostasis and trafficking that was distinctly different than SR-BI. In the present study, western blotting was used to show that a single dose of CD promotes subcellular distribution of SR-BII to murine hepatic microsomes while having no effect on liver crude membrane SR-BII. Western blotting also indicated CD pretreatment had no effect on the levels of liver fatty acid binding protein (L-FABP) in cytosol, but an increase in myosin-9 was observed with mass spectrometry. Myosin-9 may play a role in intracellular vesicular transport. This may at least partially explain the previously observed alterations in CH homeostasis produced by CD pretreatment. Changes in relative protein levels using a CH binding protein enriched fraction prepared from hepatic cytosol were detected with mass spectrometry using isobaric tagging for relative and absolute quantification (iTRAQ) methodology. Many factors can affect the accuracy of quantification with this technique. It has been observed that the low collision energies normally used in ESI QTOF can result in low iTRAQ reporter ion abundances. After evaluating protein changes in response to CD pretreatment, two-way ANOVA was used to compare the mean protein iTRAQ results from mass spectrometers using different collision energies in the same samples. It appears that iTRAQ analyses performed on an ESI QTOF without any special modifications in instrumental parameters produce essentially the same protein ratios as those obtained on a MALDI TOF/TOF.

Patients with melanoma and positive sentinel nodes were randomly assigned to completion lymph-node dissection or observation. Melanoma-specific survival did not differ significantly between the groups. Sentinel-lymph-node biopsy is a standard procedure in the care of appropriately selected patients with melanoma. The first Multicenter Selective Lymphadenectomy Trial (MSLT-I) confirmed the value of early nodal evaluation and treatment. 1 – 3 This prospective, international, randomized trial showed that the pathologic status of the sentinel node or nodes was the most important prognostic factor and that patients who underwent sentinel-node biopsy had fewer recurrences of melanoma than patients who underwent wide excision and nodal observation. Among patients with intermediate-thickness melanomas (defined as 1.2 to 3.5 mm) and nodal metastases, early surgical treatment, guided by sentinel-node biopsy, was associated with increased . . .