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This article reviews the uses, benefits, and safety of titanium dioxide.
EFSA’s scientific advice will be used by risk managers (the European Commission, Member States) to inform any decisions they take on possible regulatory actions.

titanium dioxide used in paper.
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Available studies in humans and postmortem analysis of tissues suggested that the oral bioavailability of titanium dioxide in humans is very low. JECFA noted that there are currently no epidemiological studies that allow any conclusions to be drawn with respect to an association between dietary exposure titanium dioxide and human health effects.
Titanium dioxide mainly comes from the earth’s crust, where it’s actually the ninth most common element. When processed, it becomes a fine powder with a vibrant white pigment.
Lithopone is an inorganic white pigment, obtained from co-precipitation of Zinc sulfide (ZnS) and Barium sulfate (BaSO4). As a white pigment, it acts as a cost-effective alternative for TiO2. Some of the properties of Lithopone include high brightness and performance under UV exposure. Lithopone requires less wetting agent to achieve optimum wetting of its surface. It is commercially graded on the basis of amount of ZnS. Its grades include 28%, 30%, and 60% ZnS. As a comparatively inexpensive white pigment, Lithopone is presently used in various paint formulations, road marking paints, jointing compounds, and putties.
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Safety
Titanium dioxide comes in the form of a white powder and is sometimes used in cosmetics to adjust a color to a lighter shade. This is also why it can produce a white cast.

However, it’s also important to note that such adverse effects depend heavily on the form of the titanium dioxide. It can come down to characteristics like “particle shape, purity, surface charge, solubility, agglomeration rate, photo-activation, etc.”