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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.”

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According to the EFSA's Expert Panel on Food Additives and Flavorings 2021 opinion regarding titanium dioxide, it could not rule out a concern for genotoxicity from ingestion of the material based on a perceived gap in data on this risk, which serves as the basis for current ban, said a March report on the decision.

Drobne et al. used the terrestrial arthropod Porcellio scaber as a test organism for determining the cytotoxic effect of TiO₂ NPs (anatase). The animals were exposed to TiO₂ NPs of two different sizes (25 nm and 75 nm) in the concentration range 10–1000 μg TiO₂/g dry food for 3 to 14 days. No adverse effects, such as mortality, body weight changes or reduced feeding, were observed. In fact, quite the opposite, an enhanced feeding rate, food absorption efficiency and increase in catalase activity were observed. The intensity of these responses appeared to be time- but not dose-dependent. It should also be noted that the concentrations tested in this study were much higher than the predicted concentration (4.8 μg/g soil) at high emission scenario of nano-sized TiO₂. Using the same test organism another group showed that exposure to TiO₂ NPs induced destabilization of cell membrane in the epithelium of digestive glands isolated from exposed animals. They also showed that this effect can be observed after just 30 minutes of exposure.