The supply in North America remained adequate, as companies were seen constantly altering their production rates in response to the volatility in the demand pattern. In the final week of September, news of Chemours' forthcoming titanium dioxide factory in Georgia valued USD 86 million alleviated fears about supply strain.

However, the use of titanium dioxide has also raised concerns about its potential impact on human health and the environment. Some studies have suggested that titanium dioxide nanoparticles may have harmful effects when inhaled or ingested. Manufacturers of titanium dioxide are therefore taking steps to minimize the risk of exposure and develop safer products.

Historically, the first mentions of zinc sulfide being utilized as a pigment were approximately sixty years before the everyday use of lithopone. Originally, it was thought to be appropriate for coloring rubber. In England, a patent was granted for this process. Two decades after this, the focus shifted to zinc sulfide as a suitable pigment for paint. The year 1874 witnessed the patenting of a manufacturing process for a novel white pigment composed of zinc sulfide and barium sulfate. Dubbed Charlton white or Orr’s white enamel, this began a new era for white pigments.

For a review published in 2023 in the journal Environmental Pollution, researchers examined E171 as a possible factor promoting obesity-related metabolic disorders. Because gut microbiota play an important role in immune function maintenance and development, and because titanium dioxide as a food additive has been shown to alter gut microbiota, researchers wanted to review “the dysregulations along the gut microbiota-immune system axis after oral TiO2 exposure compared to those reported in obese or diabetic patients, and to highlight potential mechanisms by which foodborne TiO2 nanoparticles may increase the susceptibility to develop obesity-related metabolic disorders.” The study authors discovered recurrent changes in the gut microbiota composition when exposed to titanium dioxide nanoparticles, with an imbalance of intestinal symbiotic microbiota. These changes and imbalances were also reported and played a role in the development of obesity, the authors wrote. This highlights “foodborne TiO2 nanoparticles as an endocrine disruptor-like chemical promoting obesity-related disorders,” the authors concluded.

The US and Canada, however, approve the use of titanium dioxide as a food additive. Canada's recent review of titanium dioxide reconfirmed its safety and pointed out that many of the toxicity studies the EU reviewed were not relevant to the safety of titanium dioxide as a food ingredient, and that the ban is based on an abundance of caution and uncertainty.