The European Food Safety Authority (EFSA) has concluded that titanium oxide should not be considered safe as a food additive, due to uncertainties about possible inflammation and neurotoxicity (9Trusted Source).
A review published in 2022 in the journal NanoImpact evaluated the latest research related to genotoxic effects of titanium dioxide through in vivo studies and in vitro cell tests. Researchers summarized the results by stating TiO2 nanoparticles “could induce genotoxicity prior to cytotoxicity,” and “are likely to be genotoxic to humans.”
The report also provides detailed information related to the lithopone manufacturing process flow and various unit operations involved in a manufacturing plant. Furthermore, information related to mass balance and raw material requirements has also been provided in the report with a list of necessary quality assurance criteria and technical tests.
There is some evidence that ingested titanium dioxide does not completely exit the body. A 2015 review of animal studies and a few human studies suggests titanium dioxide can get absorbed into the bloodstream and expose other organs to damage.