In a 2019 study published in the journal Nanotoxicology, researchers recreated the first phase of digestion in mice and fed them titanium dioxide, then examined whether accumulation occurred in the organs. Researchers wrote: “Significant accumulation of titanium was observed in the liver and intestine of E171-fed mice; in the latter a threefold increase in the number of TiO2 particles was also measured. Titanium accumulation in the liver was associated with necroinflammatory foci containing tissue monocytes/macrophages. Three days after the last dose, increased superoxide production and inflammation were observed in the stomach and intestine. Overall, [this] indicates that the risk for human health associated with dietary exposure to E171 needs to be carefully considered.”

The presence of so many lithopone factories in China has also led to advancements in production technology and quality control. Chinese manufacturers have invested heavily in research and development to improve the performance of their lithopone products, leading to higher quality and more consistent products on the market. This has helped to cement China's reputation as a leading producer of lithopone on the global stage.