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As for titanium dioxide, the FDA approved titanium dioxide for use as a food additive in 1966. The last time the agency reviewed the additive’s safety, according to the Guardian, was in 1973.

With 30% of the world's lithopone factories located in China, the country has become a major player in the global lithopone market. Chinese manufacturers are able to produce lithopone at a competitive price, making it an attractive option for companies looking to reduce their production costs. In addition, China's large production capacity ensures a steady and reliable supply of lithopone to markets around the world.

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

R-895:

How can I tell if a product has titanium dioxide in it? How can I avoid the ingredient?

In a 2019 study published in the journal Nanotoxicology, researchers recreated the first phase of digestion in mice and fed them titanium dioxide, then examined whether accumulation occurred in the organs. Researchers wrote: “Significant accumulation of titanium was observed in the liver and intestine of E171-fed mice; in the latter a threefold increase in the number of TiO2 particles was also measured. Titanium accumulation in the liver was associated with necroinflammatory foci containing tissue monocytes/macrophages. Three days after the last dose, increased superoxide production and inflammation were observed in the stomach and intestine. Overall, [this] indicates that the risk for human health associated with dietary exposure to E171 needs to be carefully considered.”

Titanium dioxide has similar uses in non-food products. It is used in sunscreen as effective protection against UVA/UVB rays from the sun, which creates a physical barrier between the sun’s rays and the skin. It’s also used to whiten paint, paper, plastic, ink, rubber, and cosmetics.