FEBRUARY 20--A Florida teacher was arrested yesterday and charged with battery for allegedly ordering a 10-year-old student to unclog a urinal in the bathroom of a Coral Springs elementary school. 
 
 According to cops, Jennifer King Forshey, 58, ordered the child to use his bare hands to remove a wad of soggy paper towels from the urinal. The boy, who attends Broward Community Charter School, told cops that the paper towels were soaked with someone else’s urine. 
 
 As detailed in a Coral Springs Police Department report, the child told investigators that Forshey, a third grade teacher, had accused him earlier this month of clogging the urinal. She then allegedly ordered him to “use his hands to remove all the paper towel product in the drain of the urinal.” 
 
 The boy said that he held a dry paper towel in his hand as he sought to remove the soggy paper towels, but “the paper and urinal were wet enough to seep through the paper towel,” leaving his hands “saturated in what smelled like urine,” according to the report. The bathroom, the child reported, “had no soap in it.” 
 
 A teacher interviewed by police said that he saw Forshey (seen above) instruct the boy to remove the paper towels from the urinal. The school’s principal said that the child “came to his office looking for soap because his hands smelled of urine.” 
 
 Following her arrest yesterday for felony battery of a child, Forshey reportedly acknowledged directing the boy to unclog the urinal. “She only thinks what she did was wrong because she is in trouble for it,” cops reported. “Otherwise, she does not see anything wrong with exposing a child to urine.” 
 
 After being booked into the Broward County jail, Forshey was released on $1000 bond. (2 pages) ||||| A Broward Community Charter School teacher was arrested after police say she made a student clean a urinal with his bare hands. NBC 6's Justin Finch spoke with parents dropping their children off at the school. 
 
 A South Florida teacher has been arrested after police said she forced a 10-year-old to unclog a urinal with his bare hands. 
 
 Jennifer Forshey, 58, was charged with battery of a child by exposure to urine, according to a Coral Springs arrest report. 
 
 Forshey was booked into jail Wednesday and later released on $1,000 bond. 
 
 "I did not do anything illegal," Forshey said as she left the jail. 
 
 Police said Forshey, a teacher at Broward Community Charter School, accused the boy of clogging the urinal with paper towels. She then ordered him to use his hands and a paper towel to remove all the paper from the drain, the report said. 
 
 Officials noted the boy's hands were saturated in "what smelled like urine" from the urinal and that the bathroom had no soap in it. 
 
 Forshey did not give the child safety equipment to clean the urinal, police said. 
 
 The boy told police the urine was not his and that he did not know who had clogged the urinal. 
 
 Forshey admitted to making the boy clean the urine, but she only thought what she did was wrong because she got in trouble, authorities said in the report. 
 
 Broward Community Charter School issued a statement saying it acknowledges what occurred and that Forshey was reprimanded. 
 
 The victim's mother, Jenay Roberts, did not want to provide a statement Thursday, but attorney Joshua Hertz released the following statement on her behalf: 
 
 "The only reason we are bringing this story to the public is to find out if any other child has been treated in this way before. We want to protect this child and possibly any other children that may have been subjected to this form or corporal and unmoral punishment. My client wants to find out why a teacher would allow this to happen. She also asks for her and her son's privacy to be respected and wants her son to retain a normal life back at the school." 
 
 Word of Forshey's release did not set well with some parents dropping their children off at the school Thursday morning. 
 
 "That teacher should go back to jail. That's not cool," said parent Mark Henrice. 
 
 Others believe it was a bad call made by an otherwise good teacher. 
 
 "She used really bad judgement, but it's a really good school. I hope it doesn't reflect on the school," parent George Vitieri said. 
 
 At Forshey's home Wednesday night, a close family friend and co-worker said Forshey was like a mentor to her. 
 
 The woman, who only wanted to be identified as Debbie, said she loved walking into Forshey's classroom because it was so cozy. She also talked about her dedication to teaching. 
 
 "She would literally spends nights at the library finding things to do, you know, fun things to do to interact, not just your boring way of teaching," she said. 
 
 What Debbie heard on the news came as a shock. She said it's out of character for a woman who does so much for her students, including spend her own money. 
 
 "She buys curriculum, she buys games. I mean, I've been with her when she buys all these incentives for the children," she said. "She was actually the main one to get us to like, you know, more positive reinforcement things like that." ||||| Abstract Bisphenol A (BPA) is an endocrine disrupting environmental contaminant used in a wide variety of products, and BPA metabolites are found in almost everyone’s urine, suggesting widespread exposure from multiple sources. Regulatory agencies estimate that virtually all BPA exposure is from food and beverage packaging. However, free BPA is applied to the outer layer of thermal receipt paper present in very high (~20 mg BPA/g paper) quantities as a print developer. Not taken into account when considering thermal paper as a source of BPA exposure is that some commonly used hand sanitizers, as well as other skin care products, contain mixtures of dermal penetration enhancing chemicals that can increase by up to 100 fold the dermal absorption of lipophilic compounds such as BPA. We found that when men and women held thermal receipt paper immediately after using a hand sanitizer with penetration enhancing chemicals, significant free BPA was transferred to their hands and then to French fries that were eaten, and the combination of dermal and oral BPA absorption led to a rapid and dramatic average maximum increase (Cmax) in unconjugated (bioactive) BPA of ~7 ng/mL in serum and ~20 µg total BPA/g creatinine in urine within 90 min. The default method used by regulatory agencies to test for hazards posed by chemicals is intra-gastric gavage. For BPA this approach results in less than 1% of the administered dose being bioavailable in blood. It also ignores dermal absorption as well as sublingual absorption in the mouth that both bypass first-pass liver metabolism. The elevated levels of BPA that we observed due to holding thermal paper after using a product containing dermal penetration enhancing chemicals have been related to an increased risk for a wide range of developmental abnormalities as well as diseases in adults. 
 
 Citation: Hormann AM, vom Saal FS, Nagel SC, Stahlhut RW, Moyer CL, et al. (2014) Holding Thermal Receipt Paper and Eating Food after Using Hand Sanitizer Results in High Serum Bioactive and Urine Total Levels of Bisphenol A (BPA). PLoS ONE 9(10): e110509. doi:10.1371/journal.pone.0110509 Editor: David O. Carpenter, Institute for Health & the Environment, United States of America Received: August 13, 2014; Accepted: September 23, 2014; Published: October 22, 2014 Copyright: © 2014 Hormann et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability: The authors confirm that all data underlying the findings are fully available without restriction. All relevant data are within the paper and its Supporting Information files. Funding: This work was supported by a grant from The Passport Foundation (no URL available) and by NIEHS grant ES018764 to FvS (NIEHS website http://www.niehs.nih.gov). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist. 
 
 Introduction Bisphenol A [BPA; bis(4-hydroxyphenyl)propane; CAS #80-05-7] is one of the highest volume chemicals in commerce with 15-billion pounds produced per year [1], and based on the presence of BPA metabolites in urine, it can be concluded that virtually everyone is exposed [2], [3]. BPA has estrogenic and other endocrine disrupting activities [4], [5]. BPA molecules are polymerized to make polycarbonate plastic used for food and beverage containers, epoxy resins used to line cans, and dental composites and sealants, but free (unpolymerized) BPA is also used as an additive (plasticizer), such as in polyvinyl chloride (PVC) products. Our interest is in the use of BPA in thermal paper, which is used for airline ticket, gas, ATM, cash register and other types of receipts (Figure 1). The print surface of thermal paper is coated with milligrams of free BPA per gram paper as a heat-activated print developer [6], and it appears that free BPA is readily transferred to other materials that the thermal paper contacts [7]. PPT PowerPoint slide 
 
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 larger image ( ) TIFF original image ( ) Download: Figure 1. Schematic diagram of thermal receipt paper identifying the thermal reactive layer that contains BPA as a developer and a leuco dye, as well as stabilizers and binders (not shown). doi:10.1371/journal.pone.0110509.g001 While small lipophilic compounds such as BPA (logP = 3.4; molecular weight 228 Da) can pass through skin [8], [9], regulatory agencies have assumed that this route of human BPA exposure should not be significant in spite of the lack of data and acknowledged “significant uncertainties” around the issue of human exposure to BPA from thermal paper [10]. However, a factor that has not been considered in estimating transdermal exposure to BPA from thermal paper is that hand sanitizers are now commonly used, particularly in fast-food restaurants where people may handle thermal receipts before eating or ordering food. Hand sanitizer and other skin care products may also be used by cashiers while working. Exposure to BPA from thermal paper goes beyond just transdermal exposure and consumption of food that is picked up and eaten with a BPA-contaminated hand. The transfer of a chemical directly from hand-to-mouth (mouthing behavior) has been proposed to be an important variable for estimating total chemical exposure in humans [11], particularly in young children [12]. The use of hand sanitizers and other skin-care products, including soaps, lotions and sunscreens, is significant because some contain mixtures of chemicals that are also used as dermal penetration enhancers to increase the transdermal delivery of drugs. Drugs and chemicals that are suitable for transdermal delivery and are impacted by dermal penetration enhancers have a LogP>1.5 and a molecular weight <500 Da [9]. There are many factors that impact the ability of compounds to pass through skin in addition to molecular weight and lipophilicity, including differences arising from the location of skin on the body, gender and age [13]. Mixtures of dermal penetration enhancing chemicals can act synergistically to increase by up to 100 fold the dermal penetration of small lipophilic molecules such as estradiol [8], [9], with which BPA shares physical-chemical and biological properties [4]. For example, Purell hand sanitizer (Gojo Industries), which we used in the current study, contains a number of dermal penetration enhancers, such as isopropyl myristate and propylene glycol, and is (63% w/w) ethanol. The use of hand sanitizers has increased in recent years and is now about a 200 million dollar a year industry just in the USA [14]. The impact of the use of personal care products such as moisturizing lotions that contain dermal penetration enhancing chemicals on exposure to environmental chemicals has been identified as a concern [15]. To assess the relevance of this research to real-world behavior, we conducted a preliminary observational study in fast-food restaurants, food courts and shopping malls in Columbia Missouri. Receipt contact time varied widely, but was sometimes substantial. In one restaurant, we found that receipt contact time ranged up to 65 sec for people purchasing food that was eaten in the restaurant; the 75th percentile for time holding the receipt was >12 sec, and the 90th percentile >32 sec. In a fast-food restaurant that is part of an international chain, take-out food was placed into a bag and the top of the bag was folded, then the thermal receipt was stapled to the top of the bag; the result was that the print surface of the receipt (coated with BPA) was grabbed when the bag was picked up. The contact time between the hand and thermal receipt was thus considerably longer than would be the case for food eaten in the restaurant. In a food court we observed that some fast-food restaurants had hand sanitizer dispensers available for use by customers next to the cash register, and customers were observed using the hand sanitizer before handling the thermal receipt. The estimate is that 50 million people eat in a fast-food establishment every day in the USA [16]. Finally, our experiments here are also relevant to occupational exposures, because we observed in a national chain big-box store that all cash registers had a hand sanitizer dispenser next to them for use by the cashiers. Our objectives were to examine the impact of having dry hands vs. wet hands due to using a popular hand sanitizer that contains dermal penetration enhancing chemicals on extraction of BPA from the surface of thermal receipt paper coated with BPA. We also measured (using a LC/MSMS assay) unconjugated, bioactive BPA (uBPA) and its conjugated metabolites, BPA-glucuronide (BPA-G) and BPA-monosulfate (BPA-S), in serum and urine in adult male and female subjects after holding a thermal receipt. To determine the proportion of thermal receipts that contained BPA, we examined receipt papers for the presence and amount of BPA. We also examined receipts for the most commonly used BPA replacement chemical, bisphenol S [bis(4-hydroxyphenyl)sulfone; BPS; CAS #80-09-1]. 
 
 Methods Ethics statement The University of Missouri School of Medicine Institutional Review Board approved all procedures involving human subjects, and sample collection was conducted by licensed personnel in the Clinical Research Center (CRC) within the University of Missouri School of Medicine. Subjects were informed of the procedures, and provided written consent. The signed consent forms were retained. The University IRB approved the consent procedure. Subjects Participants for the different experiments in this study were recruited through a weekly University of Missouri campus-wide email newsletter. Candidates (men and women) were pre-screened by age, height, weight, and health status. Participants selected were 20–40 years old (average 27.0 yrs), and an attempt was made to select those with average height, weight and normal-range body-mass index. Participants selected were not taking any prescription or non-prescription medication other than oral contraceptives; the type of oral contraceptive used was recorded. To ensure that pregnant women were excluded from the study, all women were administered a pregnancy test when they arrived at the CRC. For all studies participants were asked to refrain from touching thermal paper receipts, consuming food or beverages stored in polycarbonate or other types of plastic containers as well as canned food and beverages during the 48 hr prior to participating in the study, in order to reduce background BPA levels in body fluids as much as possible. The participants also filled out a questionnaire concerning their activities during the prior 48 hr (see Section S3 in File S1 for questionnaire). For experiments in which there was hand contact with thermal receipt paper, subjects were required to wash their hands with soap and water, rinse thoroughly, and then dry using Kimwipes (Kimberly-Clark, Irving, TX). A number of soaps were screened for BPA content and/or chromatographic interference prior to the start of the study, and the soap chosen was Softsoap “Aquarium series” (Colgate Palmolive Company, Manhattan, NY), which showed no detectable BPA or chromatographic interference with the assay of BPA. Standard brown laboratory paper towels were tested and found to contain BPA at around 6 µg/towel. Because of this, Kimwipes, which tested negative for BPA, were used throughout for drying hands. Water from faucets used in the CRC was tested and found to be below the limit of detection (LOD) for BPA content (detection limit was 10 pg/mL by HPLC with CoulArray detection based on C-18 extraction of 250 ml of water). Sample analysis Analysis of BPA in extracted samples occurred within an accredited facility (Veterinary Medicine Diagnostic Laboratory) within the College of Veterinary Medicine at the University of Missouri. Reagents. Solvents (methanol, acetonitrile) and water were HPLC grade, and were obtained from Fisher Scientific. BPA, bisphenol S (BPS), and BPA monosulfate (BPA-S) were obtained from Sigma-Aldrich (St. Louis MO; purity >99%, 98% and 95% respectively). C13-BPA was obtained from Cambridge Isotope Laboratories Inc. (Andover, MA; purity 99%), and both BPA-G (purity 98%) and BPA D-glucuronide (BPA-DG; purity >99%) were provided by the National Institute of Environmental Health Sciences (NIEHS), Research Triangle Park, NC. Ethanol (200 proof) used for hand swipes was obtained from Decon Labs, Inc. (King of Prussia, PA). Total receipt BPA and BPS content. Weighed samples of each receipt (3×3 cm) were incubated overnight in methanol at room temperature. The methanol extracts were diluted in methanol, typically to a final dilution of 1/10,000, and BPA content was analyzed by HPLC with CoulArray detection (see Section S1 in File S1 for details). We also analyzed the same receipt sample extracts for BPS using LC/MSMS (see Section S1 in File S1 for details). BPA levels in Kimwipe hand swipes. Kimwipe swipes were incubated in methanol at room temperature overnight, and aliquots were taken from the methanol extract for analysis. BPA in the methanol extract was determined by HPLC with CoulArray detection. BPA levels in French fries. French fries were incubated individually in methanol overnight. The fries were then removed, and the samples centrifuged briefly to separate any solid and/or oily matter, and a sample of the clear methanol extract was assayed. Equal volumes from the 10 extracts from the 10 French fries touched by each participant were pooled, and a single measurement was made for each participant. Quantitation was made by HPLC with CoulArray detection. Serum sample collection and extraction. Multiple-point blood samples were collected via IV catheter into 10 mL syringes, and the syringes were emptied into the same uncoated vacutainer tubes (for details and catalog numbers of collection materials Section S1 in File S1). Single point blood samples were collected by venipuncture into uncoated glass vacutainer tubes (Becton Dickinson, Franklin Lakes, NJ). All blood samples were allowed to clot at room temperature for 15–30 min and then refrigerated until centrifugation at 4°C for 15 min. The serum was transferred with glass Pasteur pipets into 15 mL centrifuge tubes and then frozen at −20°C. Samples were extracted using C18 SPE as previously described [17]; see Section S1 in File S1. Procedural blanks were also run alongside the samples to monitor for reagent contamination or interference. Serum extracts were analyzed by LC/MSMS. Urine sample collection and extraction. All urine samples were collected directly into Samco polypropylene specimen cups (Fisher Scientific, Waltham, MA) and were immediately refrigerated (4°C for 2–5 hours) until they could be transferred to the research laboratory, at which point they were frozen at −20°C. The total BPA concentration (representing a combined measure of unconjugated and conjugated BPA) was measured by LC/MSMS (see Section S1 in File S1). Assay of creatinine in urine. To calculate creatinine-corrected urine BPA concentrations, urine creatinine was measured using an ELISA kit (R&D Systems Inc., Minneapolis, MN), according to manufacturer’s instructions. Sensitivity of this assay is 0.02 mg/dL. Field blanks. The possibility of BPA leaching from each piece of equipment used in the collection or processing of samples identified above was determined by passing BPA-free water through all collection equipment, which was then handled and assayed for BPA as described below for the actual samples. All equipment and sample handling was determined to not leach detectable BPA before any sample collections occurred. Statistical methods and calculation of pharmacokinetic parameters For both uBPA and BPA-G, the area under the concentration-time curve (AUC) up to the last measured serum concentration above the LOQ, i.e. AUC (0–90 min), was calculated by using the linear trapezoidal rule. The average AUC (0–90 min) (ng/mL) was calculated by dividing AUC (0–90 min ng/mL)/90 min. Time (Tmax) of maximal plasma BPA concentration (Cmax) was directly obtained from the raw data. Comparisons of men and women were conducted using the Mann-Whitney U test or ANOVA. Statistical significance was set a P<0.05, two-tailed test. All data are presented as mean±SEM. Experiment 1: Measurement of BPA and BPS in 50 used thermal receipt papers The objective of this experiment was to determine the amount of BPA and BPS in thermal receipt paper and to determine the proportion of receipts that contained BPA or BPS, which is the most commonly used BPA replacement chemical. Thermal paper sales receipts were obtained by purchasing items from 41 different vendors in Columbia, MO and from a further 9 vendors in Southern Missouri (50 receipts total). Weighed portions of each paper were extracted and assayed for BPA by HPLC with CoulArray detection and for BPS by LC/MSMS. After screening, an unused roll was obtained from a vendor from which a BPA-positive receipt had been identified. The BPA content of paper from this roll was confirmed prior to being used for testing with human subjects in Experiments 2, 3 and 4. Experiment 2: BPA transferred to a hand with and without using hand sanitizer due to holding a thermal receipt for different lengths of time The objective of this experiment was to determine the amount of BPA extracted by a hand from a standard piece of thermal receipt paper immediately after using Purell hand sanitizer (Experiment 2-A) or with dry hands (Experiment 2-B). Subjects in both experiments cleaned and dried their hands prior to the experiment and between each trial. For Experiment 2-A the subjects (2 men and one woman) each held the thermal paper for different lengths of time: 2, 15, 30, 45, 60 or 240 sec (in 6 separate trials for each subject). Both hands were wetted by applying three “squirts” of Purell to each hand, and the hands were then briefly rubbed together to distribute the hand sanitizer evenly across both palms and fingers, but the sanitizer was not allowed to dry prior to holding the receipt paper. In experiment 2-B the subjects (2 men and 2 women) held the receipt with dry hands for 60 or 240 sec (2 separate trials for each subject). In both experiments an 8×12 cm portion of thermal paper cut from an unused receipt roll that was obtained from a local merchant (previously identified as containing 27.2 mg BPA/g paper) was placed BPA-coated (print surface) side down into the right hand. The hand was swiped 3 times each with 3 ethanol-soaked Kimwipes, and BPA was extracted from the Kimwipes with methanol and measured by HPLC with CoulArray detection. Experiment 3: Serum and urine BPA in men and women before and after transdermal and oral exposure to BPA from thermal receipt paper after using hand sanitizer The objective of this experiment was to measure the transfer of BPA from thermal paper receipts to hands, and the amount of BPA remaining on the surface of a hand 90-min later, after using Purell hand sanitizer (as described in the prior experiment) in 5 male and 5 female subjects. In addition, we measured the amount of BPA transferred from a BPA-contaminated hand to 10 French fries, and measured blood and urine concentrations of uBPA, BPA-G and BPA-S before and after ingestion of the French fries and BPA absorption through skin. The design of the study is shown in Figure 2. PPT PowerPoint slide 
 
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 larger image ( ) TIFF original image ( ) Download: Figure 2. Schematic diagram of the protocol for Experiment 3 in which thermal receipt paper containing BPA was held with a hand wet from using Purell hand sanitizer, after which the subjects picked up 10 French fries and ate them, resulting in both oral and transdermal routes of exposure. Of the 5 male and 5 female subjects, 7 subjects had serum collected from the cubital vein in the arm with a contaminated hand that contained the BPA from holding thermal paper. Three subjects had blood collected from the cubital vein in the unexposed arm that did not have BPA on the hand throughout the 90-min test period during which blood was collected. Urine samples were obtained before and at the end of the test period. doi:10.1371/journal.pone.0110509.g002 The background level of BPA on the dominant hand was determined when the subjects first arrived at the CRC. The dominant hand was swiped 3 times with 3 separate Kimwipes soaked with ethanol, from which we extracted BPA for analysis by HPLC with CoulArray detection, and the hands were then cleaned. The subjects’ weight and height were determined, after which they provided a baseline urine specimen, an IV port was inserted into the cubital vein, and a baseline blood sample was collected. Purell hand sanitizer was applied to the hands as described in Experiment 2. An 8×12 cm piece of thermal paper cut from an unused receipt roll (used in Experiment 2) was then placed BPA-coated side down into each hand with the hands still wet. The subjects held the receipt papers for 4 min in each hand. The dominant arm of each subject was determined based on whether the person was right or left handed, and in this experiment the non-dominant hand remained contaminated with BPA for the duration of the experiment. Blood was collected from the cubital vein in the contaminated arm of one set of subjects (N = 7) and from the cubital vein in the non-contaminated arm of other subjects (N = 3). We note that the phlebotomist did not handle the thermal paper for either Experiment 3 or Experiment 4. The study coordinator who did handle the paper wore gloves to do so and did not touch the blood tubes of other equipment. A separate person swiped the subjects’ hands after thermal paper exposure and wore fresh gloves for each swipe session and discarded them immediately afterwards. French fries that had been purchased from a local fast food restaurant and had been found to not contain detectable BPA were briefly warmed in a toaster oven. Immediately after holding the thermal receipts in each hand, the subjects picked up a French fry in each hand, and held both fries for 10 sec. The fry held in the dominant hand was placed into a labeled glass tube, and the fry that was held in the non-dominant hand was eaten. A total of 10 French fries was handled by each hand and either placed in a test tube or eaten using this same procedure. Approximately 4 min elapsed between removal of the receipt paper from the hand and consumption of the last French fry. Thus, it took about 8 min from the time that the thermal receipt paper was first touched and consumption of the last French fry. After the last French fry was consumed, the subject’s dominant hand was swiped with 3 ethanol-soaked Kimwipes to clean BPA off the hand and for determination (by extracting BPA from the Kimwipes) of the amount of BPA remaining on the hand immediately after holding the 10 French fries that were placed into test tubes. The non-dominant hand was not cleaned after holding the receipt paper and eating French fries, and thus was a continuing source of transdermal BPA exposure over the following 90-min period of blood collection. Blood samples were collected from the cubital vein from the still contaminated arm of 7 subjects, 4 males and 3 females, and from the uncontaminated arm of 3 subjects, one male and 2 females. The blood collected from the BPA-contaminated arm provided direct information about BPA absorbed from the hand on which BPA remained for 90 min, since the cubital vein is one of the major veins draining the hand; this blood is not subject to first-pass liver metabolism prior to going to the heart and being transported in the arterial circulation to tissues. The blood collected from the uncontaminated arm provided information about BPA in the systemic (mixed) circulation. Blood was collected from the IV port before holding the thermal paper (baseline) and at 15, 30, 60 and 90 min after consumption of the last French fry. The non-dominant contaminated hand (from which the French fries were eaten) was not allowed to touch anything during the 90-min after holding the receipt paper and then picking up the 10 French fries; this hand was swiped with 3 ethanol-soaked Kimwipes after the final 90-min blood collection at the end of the study. After these swipes were obtained, both hands were thoroughly cleaned and a second urine sample was collected. Experiment 4: Serum and urine BPA in men and women before and after transdermal exposure to BPA from thermal receipt paper with dry hands The objective of this study was to examine the amount of BPA transferred to a clean dry hand and then present in serum and urine without using hand sanitizer. In this study we examined 12 adult men and 12 adult women subjects. The subjects washed and dried their hands and provided a baseline blood and urine sample as described in Experiment 3. The non-dominant hand was swiped 3 times each with 3 ethanol-soaked Kimwipes to obtain a baseline measure of BPA on the hand prior to holding a thermal receipt. After the hand was dry, subjects held an 8×12 cm piece of thermal receipt paper (from the roll used in Experiment 1) with the non-dominant dry hand for 4 min. Thirty minutes later a second blood sample was collected from the contaminated arm, after which the BPA was swiped from the contaminated hand with ethanol-soaked Kimwipes as described previously. As above, the contaminated hand was not allowed to touch anything during the 30-min period prior to the second blood collection. The hands were washed, and a second urine sample was collected 60 min after holding the receipt paper. 
 
 Conclusions Thermal paper requires a chemical in the surface coating as a print developer. The current preferred developers, BPA and BPS, have both been shown to have estrogenic activity [45], [46]. This is leading to widespread exposure to both of these endocrine-disrupting chemicals [7], [47], and BPS is more persistent in the environment relative to BPA and is thus an unacceptable replacement for BPA [18], [48]. A recent EPA report examined 19 alternative chemicals, including BPS, 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” [18]. The report identified that “decision makers may wish to consider alternative printing systems”. Two of the papers screened for our current study employed a developer other than BPA or BPS that was not estrogenic in a MCF-7 human breast cancer cell proliferation assay (data not shown), but lack of estrogenic activity does not imply safety, as indicated in the EPA report. Thermal paper is a major source of BPA contamination in recycled paper, and its use results in the widespread contamination of other products and the environment [49] due to the presence of large amounts of free, unpolymerized BPA in the surface coating of thermal paper (Figure 1). Further, our findings are consistent with other data reporting that BPA can be transferred from the surface of thermal paper to items it contacts. Because no safe alternatives to the use of BPA or its primary replacement chemical BPS in thermal paper have been identified, our findings provide support for the EPA’s recommendation that thermal paper should be replaced with other safer technologies [18]. Our study provides the first data that thermal paper may be a significant factor in accounting for high levels of bioactive BPA in human serum and total BPA in urine that have been associated with diseases that are increasing in frequency in human populations [21], [34]. Our findings also suggest that the impact of the use of dermal penetration enhancing chemicals in skin care products on transdermal absorption of environmental contaminants should be taken into consideration in risk assessments and should be a priority for future research. 
 
 Supporting Information File S1. Section S1: Sample handling, extraction and assay methods. Section S2: Table of individual BPA and BPS values for 50 thermal receipt papers. Section S3: List of questions asked each subject. doi:10.1371/journal.pone.0110509.s001 (DOCX)
– A veteran teacher in Florida faces felony charges of battery of a child for meting out an unusual punishment. Police say 58-year-old Jennifer Forshey accused a 10-year-old boy of deliberately clogging a urinal with paper towels, and ordered him to get them out of the drain, reports NBC Miami. She didn't give him any tools or guidance, however, so he used his bare hands and a dry paper towel, and his hands soon reeked of urine—not his own, say police. To make matters worse, that particular bathroom had no soap, which led the kid to go to the principal's office looking for some, which led to the charges being filed. Forshey willingly caused the boy "to project his hands into a urinal with unknown persons (sic) urine expelled in it, causing his hands to absorb the urine," says the police report cited by the Smoking Gun. In other urinal news, a Pizza Hut worker lost his job after using his restaurant's kitchen sink as a substitute.