Titanium dioxide (TiO₂) is considered as an inert and safe material and has been used in many applications for decades. However, with the development of nanotechnologies TiO₂ nanoparticles, with numerous novel and useful properties, are increasingly manufactured and used. Therefore increased human and environmental exposure can be expected, which has put TiO₂ nanoparticles under toxicological scrutiny. Mechanistic toxicological studies show that TiO₂ nanoparticles predominantly cause adverse effects via induction of oxidative stress resulting in cell damage, genotoxicity, inflammation, immune response etc. The extent and type of damage strongly depends on physical and chemical characteristics of TiO₂ nanoparticles, which govern their bioavailability and reactivity. Based on the experimental evidence from animal inhalation studies TiO₂ nanoparticles are classified as “possible carcinogenic to humans” by the International Agency for Research on Cancer and as occupational carcinogen by the National Institute for Occupational Safety and Health. The studies on dermal exposure to TiO₂ nanoparticles, which is in humans substantial through the use of sunscreens, generally indicate negligible transdermal penetration; however data are needed on long-term exposure and potential adverse effects of photo-oxidation products. Although TiO₂ is permitted as an additive (E171) in food and pharmaceutical products we do not have reliable data on its absorption, distribution, excretion and toxicity on oral exposure. TiO₂ may also enter environment, and while it exerts low acute toxicity to aquatic organisms, upon long-term exposure it induces a range of sub-lethal effects.

It’s true that titanium dioxide does not rank as high for UVA protection as zinc oxide, it ends up being a small difference (think about it like being 10 years old versus 10 years and 3 months old). This is not easily understood in terms of other factors affecting how sunscreen actives perform (such as the base formula), so many, including some dermatologists, assume that zinc oxide is superior to titanium dioxide for UVA protection. When carefully formulated, titanium dioxide provides excellent UVA protection. Its UVA protection peak is lower than that of zinc oxide, but both continue to provide protection throughout the UVA range for the same amount of time.

The brands of lithopone of the normal class, that of chemical manufacture, are marketed under such names as Ponolith, Beckton White, Jersey Lily White, Oleum White, Zinc Sulphide White, all of these being of domestic manufacture, and their composition is of the 30 per cent. zinc sulphide type. The German manufacturers and exporters of lithopone make use of fancy names for their brands and here are a few examples of these and the composition of the pigment:-

Mexican researchers sought to evaluate the effects of E171 across a span of conditions in mice, including its influence on behavior, along with the effects on the colon and liver. The research, published in 2020 in the journal Food and Chemical Toxicology, showed that E171 promoted anxiety and induced adenomas, or noncancerous tumors, in the colon. They also found that E171 heightened goblet cells hypertrophy and hyperplasia, which is typically seen in asthma patients and triggered by smoking or external pollutants and toxins. They also noted mucins overexpression in the mice, which can be linked to cancer cell formation.