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The most significant uncertainty identified by the EU experts was the concern that TiO₂ particles may have genotoxic effects. Genotoxicity refers to the ability of a chemical to directly damage genetic material within a cell (DNA), which may lead to cancer in certain situations. Although the experts did not conclude that TiO₂ particles in E171 are genotoxic, they could not rule out the concern that they might be.

Another common use of titanium IV oxide is in food coloring. Titanium dioxide is a FDA-approved food additive that is used to enhance the color of various food products. It is commonly used in candies, pastries, and dairy products to create vibrant colors. Titanium dioxide is a safe food additive that is used in small quantities to enhance the visual appeal of food products.