In addition to pigments and sunscreens, titanium dioxide is also used in the production of paper, food products, and pharmaceuticals. In the paper industry, titanium dioxide is added to paper coatings to improve brightness, smoothness, and printability. In the food industry, titanium dioxide is used as a whitening agent in products such as candies, chewing gum, and icing. In the pharmaceutical industry, titanium dioxide is used as a coloring agent in tablets and capsules.

In 2023, the demand for titanium dioxide is expected to reach new heights. One of the main drivers of this growth is the cosmetics and personal care industry. Titanium dioxide is widely used in sunscreens, skin care products and cosmetics for its excellent UV protection properties and ability to provide a smooth surface. With growing awareness of the harmful effects of UV radiation, consumers are increasingly inclined to invest in products with sun protection. This trend is expected to drive the demand for titanium dioxide over the next few years.

For those wishing to limit or avoid exposure to titanium dioxide in foods, there are some steps you can take. 

EFSA Scientific Conclusion on E171

The skin of an adult person is, in most places, covered with a relatively thick (∼10 μm) barrier of keratinised dead cells. One of the main questions is still whether TiO₂ NPs are able to penetrate into the deeper layers of the skin. The majority of studies suggest that TiO₂ NPs, neither uncoated nor coated (SiO₂, Al₂O₃ and SiO₂/Al₂O₃) of different crystalline structures, penetrate normal animal or human skin. However, in most of these studies the exposures were short term (up to 48 h); only few long-term or repeated exposure studies have been published. Wu et al.83 have shown that dermal application of nano-TiO₂ of different crystal structures and sizes (4–90 nm) to pig ears for 30 days did not result in penetration of NPs beyond deep epidermis. On the other hand, in the same study the authors reported dermal penetration of TiO₂ NPs with subsequent appearance of lesions in multiple organs in hairless mice, that were dermal exposed to nano-TiO₂ for 60 days. However, the relevance of this study for human exposure is not conclusive because hairless mice skin has abnormal hair follicles, and mice stratum corneum has higher lipid content than human stratum corneum, which may contribute to different penetration. Recently Sadrieh et al. performed a 4 week dermal exposure to three different TiO₂ particles (uncoated submicron-sized, uncoated nano-sized and coated nano-sized) in 5 % sunscreen formulation with minipigs. They found elevated titanium levels in epidermis, dermis and in inguinal lymph nodes, but not in precapsular and submandibular lymph nodes and in liver. With the energy dispersive X-ray spectrometry and transmission electron microscopy (TEM) analysis the authors confirmed presence of few TiO₂ particles in dermis and calculated that uncoated nano-sized TiO₂ particles observed in dermis represented only 0.00008 % of the total applied amount of TiO₂ particles. Based on the same assumptions used by the authors in their calculations it can be calculated that the total number of particles applied was 1.8 × 10¹³ /cm² and of these 1.4 x10⁷/cm² penetrated. The surface area of skin in humans is around 1.8 m²  and for sun protection the cream is applied over whole body, which would mean that 4 week usage of such cream with 5 % TiO₂ would result in penetration of totally 2.6 × 10¹⁰ particles. Although Sadrieh et al.concluded that there was no significant penetration of TiO₂ NPs through intact normal epidermis, the results are not completely confirmative.

Lithopone B301, Lithopone B311 powder, brilliant white pigment used in paints, inks, leather, paper, linoleum, and face powder. It was developed in the 1870s as a substitute or supplement for lead carbonate (white lead), to overcome its drawbacks of toxicity, poor weathering, and darkening in atmospheres that contain sulfur compounds. Lithopone B301, Lithopone B311 powder is an insoluble mixture of barium sulfate and zinc sulfide that precipitates upon mixing solutions of barium sulfide and zinc sulfate. The precipitate is recovered by filtration, then calcined (roasted) at temperatures above 600° C (1,112° F). Although Lithopone B301, Lithopone B311 powder has been replaced in many applications by titanium dioxide, it is still widely used in a number of products, such as water paints.

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.”

Various titanium-rich minerals, including ilmenite and rutile, can serve as starting materials for the production of highly purified Titanium Dioxide. The predominant method employed in Titanium Dioxide production is the chloride process. In this process, the mineral, along with coke and chlorine, undergoes a reaction within a fluidized bed, resulting in the formation of primarily titanium tetrachloride and carbon dioxide. Subsequently, the titanium tetrachloride undergoes purification and conversion to Titanium Dioxide. Another method involves treating ilmenite with sulfuric acid to manufacture the chemical.