A safety review conducted by the EFSA in 2021 assessed thousands of studies published on titanium dioxide.

The National Cancer Institute tested TiO₂ for possible carcinogenicity by the oral route of exposure by feeding rats and mice with TiO₂ (size not specified) at doses 25,000 or 50,000 ppm TiO₂ for 103 weeks. They concluded that TiO₂ was not carcinogenic.Also, the study with rats fed diets containing up to 5 % TiO₂ coated mica for 130 weeks showed no treatment-related carcinogenicity. Since the size and other TiO₂ properties were not specified or determined, we cannot generalize this conclusion and we have to take into account other possible outcomes of this scenario in different exposure conditions (other size/crystalline structure of TiO₂ etc.).

≤14

A study published in the Journal of Agricultural and Food Chemistry in 2019 sought to examine the effects of titanium dioxide on intestinal inflammation. Researchers did this by feeding rats titanium dioxide nanoparticles and found that, after the course of two to three months, the animals had lower body weights and induced intestinal inflammation. The researchers also found the nanoparticles altered gut microbiota composition and aggravated chronic colitis. The rats also experienced reduced populations of CD4+T cells (which are cells that help organize immune responses by prompting other immune cells to fight infection), regulatory T cells, and white blood cells in mesenteric lymph nodes. The researchers wrote: “Dietary TiO2 nanoparticles could interfere with the balance of the immune system and dynamic of gut microbiome, which may result in low-grade intestinal inflammation and aggravated immunological response to external stimulus, thus introducing potential health risk.”

In a review published in 2022 in the journal Archives of Toxicology, researchers found that the ingestion of E171 is a “a definite health risk for consumers and their progeny.” After reviewing dozens of in vivo, ex vivo and in vitro studies on the toxicity of E171, the researchers wrote that two facts must be noted: “First, reprotoxicity studies show that animals of both sexes are impacted by the toxicity of these nanoparticles, underlining the importance of conducting in vivo studies using both male and female animals. Second, human exposure begins in utero via maternal-fetal transfer and continues after birth by breastfeeding. Children are then chronically re-exposed due to their food preferences. To be relevant to the human in vivo situation, experimental studies should therefore consider nanoparticle exposure with respect to the age or life period of the studied population.”