The trend in the production of NPs is likely to lead to increasing amounts of nano-powders in the air, water and soil, which will consequently affect living organisms. Labielle et al. demonstrated that 25 % of Al(OH)₃-coated TiO₂ particles from sunscreens are dispersed as a stable colloid and become available to microorganisms and filter-feeders, while the remaining 75 % are probably incorporated into geogenic sediments, where they could become available to benthic fauna. Solar UV iradiation may penetrate as far as 20 m in the water column  and therefore photo-activate the dispersed particles, which may have an adverse effect on various aquatic organisms.

Since then, there has been a few animal studies suggesting titanium dioxide is connected to cancer. A 2017 study in Scientific Reports, for instance, found that rats with titanium dioxide in their diet had impaired immune systems, which could contribute to autoimmune diseases and colorectal cancer.

Below 10% substitution, 1 kg of TiO2 should be replaced by 1 kg of Lithopone 30%.