Lithopone is rather nontoxic, due to the insolubility of its components. It has been used in medicine as a radiocontrast agent. Lithopone is allowed to be in contact with foodstuffs in the US and Europe.

As a food additive, titanium dioxide and its nanoparticles in particular have been associated with DNA damage and cell mutations, which in turn, have potential to cause cancer. When used as a food coloring, it is known as E171.

The lack of clear regulations and controls explains that P25TiO₂NPs are still found in many of the commercialized sunscreens in the market. Some of them are coated to reduce the photoactivity of the anatase form, which is known to be responsible for tissue damage, but not enough studies were made on these coated forms. The anatase photoactivity could trigger the production of reactive oxygen species (ROS) generation, as it was stated before. The ROS are chemically reactive species containing oxygen, such as peroxides, superoxide, hydroxyl radical, and singlet oxygen. They are regularly produced in the biological milieu and counterbalanced by physiological antioxidant defense mechanisms. However, an abrupt increase of ROS may result in non-reversible damage to the skin cells. The effects of coated and uncoated P25TiO₂NPs need therefore to be studied, and articles on this topic present different conclusions. [11], [12], [13] Recent literature on this topic found that TiO₂NPs inhalation provokes serious genotoxicity and DNA damage [14], [15], [16], [17]. On the other hand, some studies in rats have reported no significant harm to genetic material [18], [19], [20], [21], [22].

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.

Food preservation and packaging

As a food additive, titanium dioxide and its nanoparticles in particular have been associated with DNA damage and cell mutations, which in turn, have potential to cause cancer. When used as a food coloring, it is known as E171.

Is titanium dioxide illegal in other countries?