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Establishment of the maximum contaminant level that regulates the concentration of arsenic in public water supplies has been an extraordinarily protracted process. The U.S. Public Health Service set an interim standard of 50 mg per liter in 1942. It was another 60 years before the U.S. Environmental Protection Agency lowered the standard to 10 mg per liter, despite extensive epidemiological evidence of significant cancer risks. Smith et al. of this Policy Forum consider how the regulatory process might interpret and respond more effectively to results from epidemiological studies.