The author thanks Marco Leona, Scientist-in-Charge of the Department of Scientific Research at the Metropolitan Museum of Art for conducting fluorescence spectrometry on Wheel of Fortune and a valuable discussion of the research, as well as Silvia Centeno, Research Scientist at the Metropolitan Museum of Art, who performed Raman analysis on the watercolors and also contributed her insight. The phenomenon of the phosphorescing lithopone was originally discovered during the author's fellowship in the Sherman Fairchild Center for the Conservation of Works on Paper, funded by the Andrew W. Mellon Foundation. The author thanks all her colleagues for their ideas and support during the research of this paper, and special thanks to Rachel Mustalish for her assistance in editing this work.

Australian researchers examined how titanium dioxide as a food additive affected gut microbiota in mice by orally administering it in drinking water. The study, published in the journal Frontiers in Nutrition in 2019, found the treatment could “alter the release of bacterial metabolites in vivo and affect the spatial distribution of commensal bacteria in vitro by promoting biofilm formation. We also found reduced expression of the colonic mucin 2 gene, a key component of the intestinal mucus layer, and increased expression of the beta defensin gene, indicating that titanium dioxide significantly impacts gut homeostasis.” The changes were then linked to colonic inflammation, along with a higher expression of inflammatory cytokines, which are signal proteins that help with regulation. The researchers concluded that titanium dioxide “impairs gut homeostasis which may in turn prime the host for disease development.”

There are many uses of titanium dioxide that we don't know about because they were made exempt from being on the package in 1977, said Faber, who added that nothing much has changed since – other than the FDA approving some other uses of the color additive, such as expanding the use of mica-based pearlescent pigments (prepared from titanium dioxide) as color additives in distilled spirits over recent years.

Titanium dioxide as used in sunscreens is commonly modified with other ingredients to ensure efficacy and stability. Examples of what are known as surface modifier ingredients used for titanium dioxide include stearic acid, isostearic acid, polyhydroxystearic acid, and dimethicone/methicone copolymer.