EFSA's evaluation is related to the risks of TiO₂ used as a food additive, not to other uses.

Genotoxicity Assessment 

Lithopone B301, Lithopone B311 powder is also called C.I. 77115; Pigment White 5; Barium zinc sulfate sulfide and belongs to Product Categories of Inorganic & organic chemicals; uvcbs-inorganic. Lithopone B301, Lithopone B311 powder is used in water-based paints because of its excellent alkali resistance. It is widely utilized as a whitener and reinforcing agent for rubber and as a filler and whitener for paper. Lithopone B301, Lithopone B311 powder is considered to be poisonous because it is able to liberate hydrogen sulfide upon decomposition by heat, moisture, and acids. When heated to decomposition Lithopone B301, Lithopone B311 powder emits highly toxic fumes of SOx, ZnO, and H2S.

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.