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In summary, the Food Directorate's position is that there is no conclusive scientific evidence that the food additive TiO₂ is a concern for human health. This is based on a review of the available scientific data relevant to food uses of TiO₂. However, we will continue to monitor the emerging science on the safety of TiO₂ as a food additive and may revisit our position if new scientific information becomes available.

The most significant uncertainty identified by the EU experts was the concern that TiO₂ particles may have genotoxic effects. Genotoxicity refers to the ability of a chemical to directly damage genetic material within a cell (DNA), which may lead to cancer in certain situations. Although the experts did not conclude that TiO₂ particles in E171 are genotoxic, they could not rule out the concern that they might be.

The compound in the Asia Pacific market experienced a mixed trends throughout the fourth quarter of 2021. These market attitudes were mostly related to lower operational loads at Chinese domestic manufacturing plants.

According to Procurement Resource, the price trends of Titanium Dioxide are estimated to follow a fluctuating trajectory in the upcoming quarters depending on the performance of the automotive industries.

How we’re exposed to an ingredient matters greatly in terms of our long-term health. 
  
Research shows that inhaling titanium dioxide particles in significant quantities over time can cause adverse health outcomes. Unless you work in an industrial setting, inhaling substantial amounts of titanium dioxide is highly unlikely. 

Most notably, a European Food Safety Authority safety assessment published in May 2021 pointed to genotoxicity concerns, as suggested by previous research. Genotoxicity is the ability of chemicals to damage genetic information such as DNA, which may lead to cancer.

Lithopone is used in water-based paints because of its excellent alkali resistance. It is also used as a whitener and reinforcing agent for rubber and as a filler and whitener for paper.

Recent analyses of food-grade TiO₂ samples have found that a significant portion of particles may be within the nanoscale. These particles (also known as nanoparticles) range in size from 1 to 100 nm, where 1 nm equals 1 billionth of a metre (the width of a typical human hair is 80,000 to 100,000 nm).

Suppliers of lithopone have recognized the growing need for high-quality, reliable products that meet both industry standards and consumer preferences. They have invested in advanced production techniques and stringent quality control measures to ensure that their lithopone products deliver consistent performance. This commitment to quality allows paint formulators to achieve the desired properties in their final products, such as enhanced durability, improved hiding power, and superior color stability over time.

It is expected that the implementation of rutile titanium dioxide market manufacturers will be stable this week, the new single quotation of the production link will be firm, the supply of low-cost goods will be reduced, and the reference range of the overall market transaction will rise slightly. It is expected that the market transaction reference is 15200-16200 yuan/ton, and the weekly average price may refer to 15600 yuan/ton. In addition, considering the difference of orders received by different manufacturers, some manufacturers may still have 300-500 yuan/ton of negotiation room. On the demand side, most buyers still have inventory to use, so the current new batch transaction intention is not strong; On the supply side, some producers are expected to increase the load next week, so the industry time output may be slightly increased. On the whole, it is expected that the overall trading range will rise slightly next week, but most producers will adjust the real single negotiation range according to their own orders, and the new single stable price of mainstream producers.

One of the key responsibilities of titanium dioxide manufacturers is to produce high-quality products that meet the stringent requirements of their customers. This involves carefully sourcing raw materials, employing efficient production processes, and conducting rigorous quality control measures to ensure that the final product meets the necessary specifications.

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On the other hand, Westerhoff said, there are hundreds of studies showing no adverse effects from the substance.

It's also worth noting that even prior to the EU decision, France had already outlawed titanium dioxide in food back in January 2020.

There's also evidence that inhaling titanium dioxide particles can be dangerous. That's mainly a concern for industrial workers. In places where it's produced, or where it's used to make other products, workers can breathe it in as a dust. The Occupational Health and Safety Administration has exposure standards manufacturers must meet.

No acute effects of nano-sized TiO₂ were observed in Danio rerio (zebrafish) embryos. Exposure of rainbow trout to TiO₂ NPs triggered lipid peroxidation, influence on the respiratory tract, disturbance in the metabolism of Cu and Zn, induction of intestinal erosion  and accumulation in kidney tissue. Linhua et al. exposed juvenile carp to 100 and 200 mg/ml of particles and TiO₂ observed no mortality. However, the fish suffered from oxidative stress and pathological changes in gill and liver. In the infaunal species Arenicola marina, exposure to TiO₂ NPs in sediment caused sub-lethal effects including decrease in casting rate and increase in cellular and DNA damage. Aggregated particles were visible in the lumen of the gut, but no uptake through the gut or the skin was observed.

In a 2020 study published in the Journal of Trace Elements in Medicine and Biology, researchers conducted an in vitro experiment to analyze the effects of TiO2 nanoparticles on a human neuroblastoma (SH-SY5Y) cell line. The scientists evaluated “reactive oxygen species (ROS) generation, apoptosis, cellular antioxidant response, endoplasmic reticulum stress and autophagy.” The results showed that exposure to the nanoparticles “induced ROS generation in a dose dependent manner, with values reaching up to 10 fold those of controls. Nrf2 nuclear localization and autophagy also increased in a dose dependent manner. Apoptosis increased by 4- to 10-fold compared to the control group, depending on the dose employed.” 

Health advocates urge US regulators to ban common food coloring additive, by Tom Perkins, The Guardian, June 2, 2023