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Having thus described the origin and uses of the pigment, we now come to the question, what is lithopone? It is, in short, a chemical compound usually consisting of 30.5 per cent zinc sulphide, 1.5 per cent zinc oxide and 68 per cent barium sulphate, but these proportions vary slightly in the different makes. Lithopone of this composition is sold as the highest grade, either as red seal or green seal, as it best suits the idea of the manufacturer. Many manufacturers, especially in Europe, sell and also export other brands under other seals, containing 24, 20, 18 and as little as 12 per cent of zinc sulphide with very small percentages of zinc oxide, the balance being usually barium sulphate, but sometimes certain portions of China clay or gypsum (calcium sulphate) or whiting (calcium carbonate). Such brands are not a chemical compound, but mechanical mixtures of the chemically compounded lithopone and the admixtures referred to.

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.”

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Regarding flavoring substances, JECFA concluded that there is no safety concern and established specifications for 21 agents across three classes: aliphatic primary alcohols, aldehydes, carboxylic acids, acetals, and esters containing additional oxygenated functional groups; linear and branched-chain aliphatic, unsaturated and unconjugated alcohols, aldehydes, acids, and related esters; and saturated aliphatic acyclic linear primary alcohols, aldehydes, and acids.

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if you compare the levels—which went as high as 50,000 milligrams/killigrams per day— to what humans are actually exposed to, we're talking orders of magnitude. It was a huge amount, Norbert Kaminski, PhD, a professor of pharmacology & toxicology and director of the Center for Research on Ingredient Safety at Michigan State University told Health.

The Sydney Morning Herald reported on the finding of nano particles in our food supply here in Australia, despite no testing every carried out on the safety of these products by our food safety body.

There is some concern regarding skin and intestinal absorption of titanium dioxide nanoparticles, which are less than 100 nm in diameter.

Thanks to its rheological and optical properties, Lithopone 30% offers both technical and economic advantages in the substitution of titanium dioxide in different applications. Among these advantages, it has been observed that Lithopone 30% has algaecidal properties in paints, which gives greater protection to the coating. 

Titanium IV oxide is also used in the pharmaceutical industry. It is often used as a coating for medications to improve their stability and appearance. Titanium dioxide helps to protect medications from degradation caused by light, moisture, and other environmental factors. It is commonly used in tablets, capsules, and other oral dosage forms to improve their shelf life and effectiveness.

EFSA has updated its safety assessment of the food additive titanium dioxide (E 171), following a request by the European Commission in March 2020.