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In a 2017 study published in Scientific Reports, researchers exposed rats to human-relevant levels of E171 to examine the effects of intestinal inflammation and carcinogenesis. They saw that “a 100-day E171 treatment promoted colon microinflammation and initiated preneoplastic lesions while also fostering the growth of aberrant crypt foci in a chemically induced carcinogenesis model.” They continued: “Stimulation of immune cells isolated from Peyer’s Patches [which are clusters of lymphoid follicles found in the intestine] showed a decrease in Thelper (Th)-1 IFN-γ secretion, while splenic Th1/Th17 inflammatory responses sharply increased,” researchers wrote. “A 100-day titanium dioxide treatment promoted colon microinflammation and initiated preneoplastic lesions.” The scientists concluded: “These data should be considered for risk assessments of the susceptibility to Th17-driven autoimmune diseases and to colorectal cancer in humans exposed to TiO2 from dietary sources.”

While IARC listed titanium dioxide as “possibly carcinogenic to humans,” they also add that “there is inadequate evidence in humans for the carcinogenicity of titanium dioxide.” Of the four human studies that they reviewed, only one showed a potential risk for occupational workers inhaling titanium dioxide particles and lung cancer, while the other three showed no risk for cancer at all. And it’s key to note that IARC did not assess the effects of titanium dioxide found in foods.

Until relevant toxicological and human exposure data that would enable reliable risk assessment are obtained, TiO₂ nanoparticles should be used with great care.