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Understanding the Health Risks of Thermal Paper in Receipts: A Medical Perspective by Dr. Renuka RamasamySpecialist Family Medicine – International Modern Hospital

Understanding the Health Risks of Thermal Paper in Receipts:

A Medical Perspective by Dr. Renuka Ramasamy
Specialist Family Medicine – International Modern Hospital**

In recent years, growing attention has been directed toward the health risks associated with thermal paper—especially the type used for printing invoices, receipts, and point-of-sale transactions. While most people handle receipts daily, few are aware of the chemicals embedded in this type of paper or their potential impact on long-term health.

In this article, Dr. Renuka Ramasamy, Specialist Family Medicine at International Modern Hospital, explains how thermal paper works, the chemicals involved, how exposure occurs, and why transitioning to digital receipts may be an important public-health step.


What Is Thermal Paper and How Does It Differ from Regular Paper?

Thermal paper is a specialized, heat-sensitive paper used extensively in retail shops, supermarkets, restaurants, fuel stations, and ATMs. Unlike ordinary paper, which requires ink or toner, thermal paper contains chemically coated layers that react to heat, producing text and images instantly.

Key Differences Between Thermal Paper and Regular Paper

FeatureThermal PaperRegular Paper
Printing MethodChanges color with heat (no ink)Requires ink, toner, or ribbons
Surface TextureSmooth, glossy, sometimes waxyMatte, fibrous
Chemical CoatingContains leuco dyes + developersNo chemical coating
Reaction to HeatTurns black when heatedNo response to heat
DurabilityPrint may fade with heat, sunlight or oilsGenerally stable
Environmental ImpactMay contain BPA/BPSMore recyclable

The glossy surface and the ability to darken under friction or heat are distinguishing features that indicate a piece of thermal paper.


What Chemicals Are Used in Thermal Paper and Why?

One of the major concerns about thermal paper lies in the chemical developers used to activate printing.

Bisphenol A (BPA)

Traditionally, BPA has been the most common color-developer used in thermal paper.
Its role:
When heat is applied by the thermal print head, BPA chemically reacts with leuco dyes to produce the familiar black print on receipts.

Bisphenol S (BPS)

With increasing regulatory pressure against BPA, manufacturers began substituting it with BPS.
Its role:
BPS performs the same function—developing color upon heat activation—making it an effective alternative, though with similar health concerns.

Both substances belong to a family of endocrine-disrupting chemicals, raising questions about their long-term effects.


How Do These Chemicals Transfer to the Human Body?

According to Dr. Renuka Ramasamy, BPA and BPS can transfer from thermal paper to the skin during normal handling. Several important points explain how this happens:

  • The chemicals sit loosely on the surface of thermal paper and can rub off easily.
  • Skin absorption is possible, though the rate is relatively low.
  • Frequent or prolonged contact increases exposure—important for cashiers, retail workers, and people who handle receipts repeatedly.
  • Hand sanitizers or lotions significantly increase absorption, as they break down the skin barrier and dissolve BPA/BPS, enhancing transfer.

While diet remains the primary source of BPA exposure for most people, repeated contact with receipts can measurably contribute to chemical levels in the body.


What Are the Proven Long-Term Health Effects?

Scientific research has linked BPA—and increasingly BPS—to several biological and hormonal disruptions.

Long-Term Health Risks of BPA

  • Hormonal imbalance (endocrine disruption)
  • Reduced fertility and reproductive health effects
  • Metabolic changes linked to obesity and diabetes
  • Cardiovascular abnormalities
  • Developmental effects in unborn babies and children
  • Potential association with breast and prostate cancer
  • Neurobehavioral changes

Long-Term Health Risks of BPS

Though less studied, BPS shows similar endocrine-disrupting behavior, with evidence suggesting:

  • Hormonal disruption
  • Fertility-related effects
  • Thyroid hormone interference
  • Increased metabolic disorders
  • Cardiovascular and neurodevelopmental concerns

“These chemicals can interfere with hormone function even at very low concentrations,” explains Dr. Renuka.


Is the Link to Hormonal Imbalances, Fertility Problems, and Cancer Medically Accurate?

Dr. Renuka emphasizes three key points:

  1. The link to hormone disruption is well-established.
    BPA and BPS both mimic estrogen, interfering with natural hormonal pathways.
  2. There is credible evidence associating chronic exposure with fertility problems.
    This includes effects on sperm quality, ovulation, and reproductive hormones.
  3. Cancer links remain under investigation.
    Laboratory studies suggest a possible relationship, but current human data are not conclusive.

Thus, concerns are medically valid, but the risk depends on frequency, duration, and combined exposure sources.


Should BPA and BPS Thermal Papers Be Banned? Dr. Renuka’s Perspective

As a Family Medicine Specialist, Dr. Renuka supports transitioning away from BPA/BPS thermal papers, especially in environments with high exposure.

Why a Phase-Out Is Necessary

  • Reduces exposure to endocrine-disrupting chemicals
  • Protects retail workers and high-contact professionals
  • Supports environmental safety
  • Encourages modern, sustainable alternatives

Why Digital Invoices Are Preferable

Digital receipts:

  • Reduce chemical exposure
  • Decrease paper waste
  • Improve record-keeping
  • Allow safer consumer interactions

While implementation challenges exist—such as customer preferences and data privacy—Dr. Renuka believes they are manageable through hybrid systems and gradual adoption.


Final Thoughts from Dr. Renuka Ramasamy

“Thermal paper may appear harmless, but the chemicals embedded in it have well-documented biological effects. While occasional contact is unlikely to cause harm, repeated exposure—especially in workplaces—deserves attention. Transitioning to safer alternatives, including digital receipts, is a practical and effective step toward protecting both individual and public health.”

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Health

Before, with or after meals? Why medications timing matters

Many medications can be taken before, after or during a meal with little to no side effects—but for some, timing is everything.

This is because having a full stomach can interfere with how well medications are absorbed and processed by the body. 

Some studies have even found that certain medications, like blood pressure drugs, are most effective earlier in the day if you are a morning person, and vice-versa for night owls. 

More than 30 million of us take some form of medication every day and with instructions often as long as your arm, it can be confusing to know exactly what time each should be taken. 

But, an intriguing area of scientific research alongside long-proven effects of food-drug interactions, may provide the answer. 

Chronotherapy—the study of how the body clock impacts drug efficiency—is said to be the key to ensuring we get the best out of our pills, especially once we’ve worked out whether its best to take them before, with or after a meal.

One study found that patients who are ‘morning people’ could reduce their risk of heart attack by around 26 per cent by taking their blood pressure medication in the morning. 

Significantly, they increased their risk of heart attack if they took the drug in the evening—the opposite end of the day to their chronotype. 

So when is the best time to take your pills? 

Always on empty  

Food significantly alters the environment of the digestive tract, changing pH levels, delaying gastric emptying and ultimately reducing the bioavailability of certain medications.

For this reason, a lot of drugs should be taken on an empty stomach, at least 30 minutes to an hour before a meal, or two to three hours after eating

As prescribing pharmacist Ayesha Bashir explains: ‘Some medications need an empty stomach so nothing gets in the way. Food can slow them down, bind to them, or stop them from being absorbed at all, which means they may not work properly.’

One example of this is bisphosphonates, a widely prescribed drug used to treat osteoporosis, which works by slowing the rate that bone is broken down in the body. 

This helps to maintain bone density and reduce the risk of a broken bone—if taken on an empty stomach. 

According to the NHS, bisphosphonates should always be taken on an empty stomach with a full glass of water. GPs also recommend standing or sitting upright for at least half an hour after taking them to avoid indigestion.

The reason for this is because bisphosphonates, like alendronate or risedronate, have extremely low oral bioavailability meaning that even small amounts of calcium from food can almost completely block drug absorption. 

But if indigestion does strike, the most commonly prescribed anti-indigestion drug, omeprazole should also be taken on an empty stomach ideally 30 mins before eating. 

But, Dr Jarvis added: ‘If you’ve got heartburn rather than indigestion, that tends to be worse late at night when you lie down, you could take it half an hour before dinner or an empty stomach, so you have peak levels in your system when you go to bed and the acid will be most suppressed.’

Thyroid medications, like levothyroxine, should also always be taken on an empty stomach, around the same time each day if possible. 

Studies show that the body can absorb the drug far more efficiently when taken before any food has entered the digestive tract, whereas taking the pill with food can reduce bioavailability by up to 60 per cent.

With a meal 

Whilst some drugs are best taken on an empty stomach to help boost absorption, others can do serious harm to the stomach lining if taken on empty, increasing the risk of stomach ulcers, liver failure and kidney damage. 

Ibuprofen—taken by millions daily to treat everything from headache to fevers—is safe when taken correctly. 

But routinely taking the painkiller on an empty stomach can cause permanent liver and kidney damage. 

The danger with the ibuprofen and other non-steroidal anti-inflammatory drugs (NAIDs) comes from how they are processed by the body, irritating the stomach lining and increasing the risk of stomach ulcers. 

‘In some cases, this can lead to peritonitis,’ warned Dr Dean Eggitt, GP and CEO at Doncaster Local Medical Committee. 

Peritonitis occurs when the lining of the stomach becomes infected, which can be caused by routinely taking painkillers on an empty stomach. 

Left untreated, the condition can be life threatening.  

Taking certain medications with food can also help reduce side effects like nausea, dizziness, stomach upset and ulcers. 

This can also protect medications from being broken down in the stomach, before they reach the intestines where most absorption occurs.  

After dinner or before bed 

Some studies suggest that certain short-acting statins, like lovastatin, taken to combat high cholesterol, are best taken in the evening. 

High cholesterol causes fat to build up in the arteries, restricting blood flow. left untreated, it can raise the risk of heart attack, stroke, and even dementia. 

But taking potentially life-saving medication at the wrong time can render the drug almost ineffective.  

This is because statins tend to have a fairly short half-life. 

Most cholesterol in the blood comes from dietary fats, which are then converted into cholesterol by the liver. 

Therefore, taking statins at night can help supercharge the medication as this is when there is the most cholesterol in the bloodstream. 

However longer acing statins, like atorvastatin, sold under the brand name Lipitor, can have a half-life of up to 19 hours, meaning that patients can choose which time of day suits them best. 

Blood pressure drugs are the most commonly prescribed medication in the UK, with as many as non million people receiving prescriptions for drugs including beta blockers, and ACE inhibitors. 

And recently, researchers from the University of Dundee found for the first time that a person’s chronotype—determined by the time they wake up and go to sleep—impacts the efficacy of their blood pressure medication. 

However, some patients may experience dizziness after taking their first dose, as drugs like ACE inhibitors work by relaxing the blood vessels, so it’s usually recommended take the first dose at bedtime. 

Betablockers similarly can make users feel dizzy, as they work by slowing down the heart, so again GPs may recommend starting by taking the drug in the evenings.

Daily Mail

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Food

3 immunity boosting soups can protect against winter viruses

Feel a sniffle coming on? Don’t reach for the Lemsip, grab a hand blender and whip up a soup which can help your body fight off winter nasties from the inside out. 

It’s the advice of nutritionist Robbie Puddick, who told the Daily Mail that regular servings of hearty soups could be the secret to warding off colds and flu. 

While he said the occasional soup isn’t likely to stop you from reaching for the tissues, having them regularly can ‘support the immune system’ as it’s ‘inherently a very healthy thing to consume’.

He explained: ‘It’s really easy to digest, and obviously, we’re in a generation where gut health and digestive issues are quite common. A lot of people suffer with IBS-like symptoms and poor gut health.

‘But consuming things like soup is a great way of providing really bioavailable nutrition—the proteins from meat will be easier to break down and digest by your gut and the plant-based compounds are beneficial.’

However, while it may be tempting to pick up a tin of soup that takes just minutes to prepare, he warned that ‘they’re often packed full of sugar’ so it’s better if ‘you’re making them from fresh’ which allows you to ‘know exactly what’s in them’. 

There’s something distinctly comforting about a bowl of soup on a cold day—regardless of if you’re ill or not—and there could be a scientific reason for it.

After the coronavirus pandemic, a 2022 study looked at the healing properties of traditional Iranian folk medicine—including both chicken and barley soups—when taken by people recovering from covid.

A steaming bowl of chicken soup has long been seen as the perfect tonic for a streaming cold or flu, and the study confirmed it does offer some sort of healing properties. 

The researchers found that people who ate soup recovered up to 2.5 days faster than those who didn’t. 

Furthermore, they reported milder symptoms of nasal congestion, sore throat and fatigue, and in some people, reduced levels of inflammation-related markers. 

Often, soups are made with a base of immunity-boosting herbs, spices and vegetables including garlic, onion, and ginger, all of which are packed with antioxidants and have natural bacteria-beating qualities. 

They are also natural sources of vitamins A and C which power the immune system. 

A warm mug or bowl of soup also has the potential to loosen mucus and soothe sore throats—plus it’s easy to swallow and digest. 

Mr Puddick, who is one of the experts from the NHS’ weight loss programme Second Nature, has shared three soups with ingredients that will help support your immune system in the colder months.

From a hearty, meaty soup to a traditional tomato, find out why you need to add these delicious and cheap to make meals to your weekly menu. 

Goulash Soup

The first recipe that he recommended was Goulash Soup, a traditional Hungarian dish

This traditional Hungarian dish is a watery version of a beef stew that includes a multitude of immune system boosting ingredients.

The soup’s origins lie in the ninth century, when it was eaten by shepherds who moved large herds of livestock and sheep through the Hungarian mountains. 

In those days it would be made in a cauldron, known as a bogrács, hung from a chain over an open fire.

However, the recipe has evolved throughout history, with the addition of paprika added after the invading Ottomans introduced the spice to Hungary in the 15th century.

Overall, goulash is packed with lots of ingredients that are good for you including garlic, which Mr Puddick says is ‘a big win’ because it contains allicin.

He said: ‘Allicin has been shown in clinical trials to stimulate immune cell activity, which is great for just an individual ingredient.

‘If we’re having garlic regularly across the week, and we put a large amount in our soups, it is definitely a big win.’

Meanwhile, probiotics—good bacteria—found in the Greek yoghurt in this soup, can also help the immune system.

‘There is a good connection between, consuming probiotics and our immune function,’ said Mr Puddick.

A 2011 study showed probiotics, also known as ‘good bacteria’, can help stave off the common cold by stimulating the immune system.

Other research has shown that the ‘good bacteria’ in probiotics support a healthy gut microbiome. 

A healthy gut microbiome has the right types of bacteria thriving together to support digestion, the immune system and even mental health. 

Ingredients

  • 2 tbsp olive oil 1 onion, diced
  • 2 garlic cloves, finely diced or minced
  • 1 tsp ground paprika
  • 400g diced beef
  • 400g mushrooms, sliced
  • 1 carrot, diced
  • 1L beef stock
  • 1 x 400g tin chopped tomatoes
  • 200g potatoes, cut into 1cm cubes
  • 100g plain natural or Greek yoghurt
  • 50g fresh flat leaf parsley, roughly chopped

Method

  1. Heat 2 tbsp of oil in a large saucepan, over medium heat. Fry the onion, garlic, and paprika, until softened.
  2. Add the beef and stir until evenly browned. Add the mushrooms and carrots, and cook until softened.
  3. Pour in the stock and tomatoes, and season with salt and pepper. Stir to combine and bring to a boil. Reduce to a simmer, cover and cook for up to 1 hour.
  4. Add the potatoes and cook uncovered for 20 – 30mins, or until the potatoes are tender.
  5. Ladle into bowls, and top with a spoonful of yoghurt and chopped parsley.

Tomato soup

When you are not feeling well you may be craving a tin of tomato soup and a cheese toastie.

But a tin of Heinz’s tomato soup, while delicious, is packed with 20g of sugar—which is two thirds of the NHS adult daily recommended intake.

So, keeping in line with the advice of Mr Puddick, it’s always better to whizz up a steaming bowl of red soup using fresh ingredients at home. 

This soup has a smooth texture is a brilliant source of vitamin C, which previous studies have found contributes to immune defence.

However, he said it’s better to get it from food rather than supplements because foods have the right balance of vitamin C and zinc.

‘When we consume these ingredients from whole foods, they come in the right balance, so this doesn’t tend to be an issue.’ 

Typically, he added that tomato soups can be lacking in protein which can leave people still hungry. 

‘A lot of people have tomato soup with a bit of bread on the side and that’s their lunch, and they might feel hungry an hour or two after,’ he said.

‘It’s probably because they haven’t provided their body with enough protein alongside it.

‘So, it may be better to have it as a side, or with eggs or some smoked salmon on the side if a main.’

Luckily, this tomato soup recipe includes cannellini beans, giving it some additional protein.

If you’re vegan, you can also skip the cream, which is added for smoothness, and use coconut milk instead. 

Ingredients

  • 1.5 tbsp extra virgin olive oil
  • 2 large carrots, chopped
  • 1 medium onion, diced
  • 2 cloves garlic, minced
  • 2 x 400g tins whole or chopped tomatoes
  • 2 x 400g tins cannellini beans
  • 700ml water or vegetable stock
  • 300 ml single cream
  • Handful fresh basil, to serve

 Method

  1. Add the oil to a large saucepan, over medium heat.
  2. Add the carrots and onions, and cook until softened.
  3. Add the garlic and cook for an additional 3-4 minutes.
  4. Add the tomatoes and lower the heat to low/medium. Cook for 25 minutes to reduce the acidity of the tomatoes.
  5. Add the beans and stock, season with salt and pepper, and bring to a simmer for an additional 10 minutes.
  6. Turn off the heat and add the cream, transfer to a blender or use an immersion blender until smooth.
  7. Top with the fresh basil and serve

Roasted cauliflower and fennel soup

Cauliflower is a cruciferous superfood that’s low in carbs which supports digestion, heart health and the immune system.

It is rich in vitamin C and vitamin K both of which can help support your immune response.

Studies have shown that fennel is rich in antioxidants that protect against cell damage and support the immune system.

This soup contains basil, which is rich in antioxidants, and anti-inflammatory properties like vitamin K that are great for your immune system.

‘A lot of herbs and spices have anti-inflammatory properties,’ said Mr Puddick.

Interestingly, he explained a lot of people think all inflammation is unhealthy, when it is integral to the immune system.

In the right amounts, he said: ‘Inflammation is healing, and our immune system, our immune response, is an inflammatory response.

‘It’s our body sending out these killer cells and all of these immune-supporting cells that can fight pathogens and infection.’ 

Adding walnuts to this soup, he added, ensure that you feel satiated for longer, preventing unnecessary snacking. 

Walnuts are rich in omega-3s, protein, fibre and antioxidants which are great for your heart and brain. 

A recent study found that eating walnuts can boost your brain power, improving memory in young adults 

Meanwhile, another found a fistful of walnuts a day can lower bad cholesterol which has been linked to increased risk of heart disease.

Ingredients

  • 1 large head of cauliflower, cut into small florets
  • 3 tbsp extra virgin olive oil
  • 1 small fennel bulb, roughly chopped
  • 1 shallot, chopped
  • 2 garlic cloves, finely diced or minced
  • 150mL water
  • 800mL chicken stock
  • 300mL single cream
  • 2 bay leaves
  • 60g hazelnuts
  • 1 small handful of chives, sliced

Method

  1. Preheat the oven to 200°C/180°C fan.
  2. Toss cauliflower in 2 tbsp oil on a baking sheet. Season with salt and pepper.
  3. Roast the cauliflower for 30–35 minutes (tossing halfway) or until florets are browned all over and tender.
  4. While the cauliflower is roasting, add 1 tbsp olive oil to a large saucepan, over medium heat. 
  5. Fry the shallot, fennel and garlic until softened (5-8mins). Add 150ml water and cook until mostly evaporated (around 5mins).
  6. Add roasted cauliflower, stock, cream, and bay leaves; season lightly with salt and pepper. 
  7. Bring to a boil, reduce heat, and simmer until cauliflower is very tender, 20 minutes.
  8. While the soup is simmering, fry the bacon in a small non-stick frying pan and set aside once golden brown. No need to add any oil as the bacon will release oils.
  9. In the same pan fry the hazelnuts until golden and roasted. Set aside to cool and then roughly chop. Remove the bay leaves from the soup and discard.
  10. Allow the cauliflower mixture to cool slightly before using a blender or stick/immersion blender until a smooth consistency is formed.
  11. Serve topped with hazelnuts

Daily Mail

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COMMUNITY

Saudi German Hospital Dubai Celebrates the UAE’s 54th Union Day with a Staff-Centered Community Gathering

Dubai, UAE — 28 November 2025

Saudi German Hospital Dubai celebrated the UAE’s 54th Union Day with a special community event held in the hospital garden, bringing together medical leadership, nursing teams, administrative staff, and employees from all departments. The gathering reflected the spirit of unity, pride, and Emirati heritage.

The celebration began at 3:00 PM in a beautifully prepared garden setting, where staff enjoyed a vibrant cultural program featuring Emirati horse shows, traditional dance performances, authentic Emirati cuisine, henna painting, and a variety of interactive activities that highlighted the richness of the UAE’s identity. The event provided employees with a joyful and meaningful opportunity to celebrate the nation’s remarkable journey.

Honoring Team Spirit and the Emirati Identity

Hospital leadership expressed deep appreciation to the SGH Dubai workforce for their continuous dedication, resilience, and commitment to patient care. They emphasized that the strength of the hospital lies in its people and in the unity that connects them.

Dr. Ahmed Eissa, Group CEO of Saudi German Hospital UAE, shared:

 “Union Day is a celebration of a nation that continues to lead with vision, compassion, and determination. Today, we also celebrate the incredible people who bring these values to life within our hospitals. Every doctor, nurse, technician, and employee plays a vital role in caring for our patients and supporting the UAE’s healthcare mission. We also extend our heartfelt appreciation to the UAE’s wise leadership, whose continuous efforts have made this country one of the best places in the world to live, work, and thrive. Their vision is the foundation of the stability, opportunity, and progress we all enjoy. As we gather here, we honor the UAE’s journey and renew our promise to serve its people with integrity, innovation, and dedication.”

A Celebration of Culture and Connection

The event showcased the essence of Emirati culture and strengthened the sense of belonging among staff. The shared experiences and cultural activities enhanced team spirit and reflected the UAE’s values of unity, respect, and community.

Saudi German Hospital Dubai continues to stand alongside its employees and the wider community in advancing healthcare excellence and contributing to a healthier and brighter future for the UAE.

For more information please visit our website: https://saudigerman.com/dubai/

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