Learning ObjectivesExplain the merits of estimating lead levels in bone as well as in blood when examining relationships between body lead stores and psychiatric symptoms.Recall the relationships, if any, between bone and blood lead levels and scores on a range of psychiatric symptom scales.Discuss possible mechanisms by which high lead levels may induce or magnify psychiatric symptoms.Blood and bone lead levels were used to investigate lead’s potential effect on psychiatric symptoms among middle-aged to elderly men from the Normative Aging Study. Symptoms were assessed using the Brief Symptom Inventory (BSI) and analyzed as individual outcomes as well as a measure that combined anxiety, depression, and phobic anxiety. Blood and bone lead averaged 6.3 &mgr;g/dL (standard deviation [SD] = 4.16), 21.9 &mgr;g/g (SD = 13.5), and 32.1 &mgr;g/g (SD = 19.8) for blood, tibia, and patella lead, respectively. In logistic regression models that adjusted for age, alcohol intake, employment status, and education status, we found that patella bone lead was significantly associated with an increased risk of phobic anxiety and the combined outcome measure at theP≤ 0.05 level. Tibia and blood lead had similar associations. We conclude that cumulative lead exposure, which bone lead levels reflect, could be a risk factor for psychiatric symptoms even at modest levels of exposure.