We trust the food we eat, the drinks we drink, and the air we breathe are safe. That in case they're unsafe, someone is working to minimize our exposure, or at least tell us the risks. In The Triumph of Doubt, former head of OSHA David Michaels reveals how companies fight for their rights to sell harmful products, expose workers to health hazards, and pollute the environment. They do it by manufacturing so-called "science." Most this science is built not upon proving they're not causing harm, but by doing whatever they can to cast doubt. Here, in my own words, is a summary of The Triumph of Doubt: Dark Money and the Science of Deception.

Products we use every day cause harm

Chances are you've cooked on a pan coated with Teflon. Teflon is one of many polyfluoroalkyl substances, or PFAS. When introduced in the 1940s, they were considered safe. We now know they're linked with high cholesterol, poor immune function, cancer, obesity, birth defects, and low fertility. PFAS, it turns out, have such a long half-life, they're called "forever chemicals." PFAS can now be found in the blood of virtually all residents of the United States, and have been found in unsafe levels worldwide – in rainwater.

You've probably heard that, in moderation, alcohol is actually good for you. But even one drink a day leads to higher overall mortality risk. More than one drink, greater risk of cardiovascular disease and cancer. Alcohol is a causal factor in 5% of deaths worldwide – about 3 million a year. 13.5% of deaths between ages 20–39 are alcohol-related.

If you're in pain after an injury or surgery, your doctor might prescribe for you an opioid. But the rise in opioid addiction is responsible for the first drop in U.S. life expectancy in more than two decades. It's sent shockwaves throughout society. It's helped launch the epidemics of fentanyl and heroin overdoses, and the number of children in foster care in West Virginia, for example, rose 42% in four years.

You might love to watch professional football. But NFL players are nineteen times more likely to develop neurological disorders, and thirty percent could develop Alzheimer's or dementia from taking so many hits.

The "product defense" industry sows doubt

How have they done it? How have companies been able to manufacture and sell products that cause so much harm, for so long? They do it by defending their products, when the safety of those products are questioned. On the surface, that's not so bad. But besides lying and deliberately deceiving, they abuse society's trust in so-called "science," and our lack of understanding of how much we risk when we move forward while still in doubt.

The tobacco industry is a pioneer of product defense

There's an entire industry that helps companies defend their products from regulation: It's called, appropriately, product defense. The tobacco industry is most-known for its product defense. In 1953, John W. Hill of the PR firm Hill & Knowlton convinced the tobacco industry to start – one floor below his office in the Empire State Building – the Tobacco Industry Research Committee (TIRC). The TIRC was supposed to do rigorous scientific research to understand the health effects of smoking, but mostly they just attacked existing science, doing what they could to sow doubt.

Just a few years earlier, in 1950, a study had found heavy smokers were fifty times as likely as nonsmokers to get lung cancer. With the help of the TIRC, it would take a long time for these health risks to influence public policy. About thirty years later, most states had restricted smoking in some public places such as auditoriums and government buildings.

Smoking had proliferated in American culture when cigarettes had been provided in soldiers' rations in WWI. Michaels describes one surgeon who, in 1919, made sure not to miss an autopsy of a man who had died of lung cancer, because it was the chance of a lifetime. He didn't see another case of lung cancer for seventeen years, then saw eight within six months. All eight had started smoking while serving in the war.

Today, more than a century after cigarettes were widely introduced, we've finally seen a massive reduction in smoking in the U.S. We can fly on planes and go to restaurants and even bars, without being exposed to secondhand smoke.

The sugar industry has been at it even longer

Predating the product defense efforts of the tobacco industry is actually the sugar industry. The Sugar Research Foundation was started in 1943. Scientific evidence first linked sugar with heart disease in the 1950s. In 1967, as Dr. Robert Lustig told us, Harvard scientists published in the New England Journal of Medicine an article blaming fat rather than sugar for heart disease. Fifty years later UCSF researchers discovered the scientists had been funded by the Sugar Research Foundation – which they hadn't disclosed. Even more misleadingly, they had disclosed funding that actually made them look more impartial – from the dairy industry.

Companies and industries set up "astroturfing" organizations

The Sugar Research Foundation and the Tobacco Industry Research Committee are are early examples of "astroturfing" organizations. This tactic of the product defense industry involves setting up organizations with innocent- or even charitable-sounding names, then doing low-quality research to defend a company or industry's interests.

• The American Council for Science and Health has published articles opposing regulation of mercury emissions, and attacked science finding harm in consumption of sugar and alcohol.
• When the National Football League was first looking into the effects of playing their sport, they formed the MTBI. the "M" in MTBI gave away their stance: TBI stands for Traumatic Brain Injuries, and this committee formed for finding the effects of brain injuries was called the Mild Traumatic Brain Injuries committee.
• The alcohol industry set up the Alcoholic Beverage Medical Research Foundation. The first board of directors included Peter Stroh, William K. Coors, and August A. Busch III. Their first president, Thomas B. Turner, was former dean of Johns Hopkins University Medical School, a tie of which they made good use in promoting their agenda – more on that in a bit.
• The American Pain Foundation ran campaigns to make pain medication more widely available for veterans, running ads reminding patients of their "right" to pain treatment.

Astroturfing organizations are funded by "Dark Money"

Astroturfing organizations are funded by so-called "Dark Money". In other words, they do whatever they can to hide where their funding comes from, lest their biases become obvious.

• The American Council for Science and Health claims much of their funding comes from private foundations, but investigative reports have found 58% of it coming straight from industry, and that many of those private foundations have ties to corporations. Leaked documents show a huge list of corporate donors including McDonald's, 3M, and Coca-Cola.
• The NFL's MTBI committee's papers included a statement saying, "none of the Committee members has a financial or business relationship posing a conflict of interest." Yet the committee consisted entirely of people on the NFL's payroll: team physicians, athletic trainers, and equipment managers.
• Documents collected by the New York Times revealed that administrators at the The National Institute on Alcohol Abuse and Alcoholism wanted to do a randomized clinical trial on the effects of alcohol. To fund the study, they went to industry, calling it "a unique opportunity to show that moderate alcohol consumption is safe." They were going into the study with the conclusions already in mind, saying, "one of the important findings will be showing that moderate drinking is safe." Several companies pledged nearly $68 million toward the $100 million budget. As part of the National Institutes of Health – a federal organization – the NIAAA was pitching this as a chance for the alcohol industry to use a government-funded study to prove their product was safe. Money directly from alcohol manufacturers was to be routed through the NIH Foundation, since it's illegal for private companies to fund government studies.
• When the Senate Finance Committee began investigating ties between the American Pain Foundation and pharmaceutical companies, the APF quickly dissolved, apparently knowing what would be found otherwise.

Besides private foundations, straight-up lying, and routing money through a federal foundation, another way of keeping money "dark" is by taking advantage of attorney-client privilege. By having the law firm pay accomplices, even if there's a lawsuit, the documents are private.

Using connections and flawed science to manufacture pseudo-events

When corporations do get studies published about the risks of using their products, they're often low-quality studies. If they don't deliberately conceal their findings, they often use their connections to create what are essentially pseudo-events to prop up their flawed conclusions.

• Internal documents from DuPont show they knew the PFAS in Teflon was a problem. In 1970, they found it in their factory worker's blood. In 1981, 3M told them it caused birth defects in rats, and DuPont's own workers' children had birth defects at a high rate. In 1991, DuPont set an internal safety limit of 1 ppb. Meanw