Skip to main content
SpringerLink
Log in

Managing the Use of Copper-Based Antifouling Paints

  • Published:
Environmental Management Aims and scope Submit manuscript

Abstract

Copper is the biocide of choice for present-day antifouling (AF) paints. It is also a major source of copper loading in to the marine environment and, as such, might cause local copper levels to exceed water quality criteria. The present study is multifaceted and looks into the overall impact of copper-based AF paints on copper concentrations along a 64-km stretch of the Indian River Lagoon and at Port Canaveral, Florida. This preliminary study is one of the first to outline issues and present background evidence on the current status of copper and copper-based AF usage in Florida and to address the need for management. Previous measurements of copper levels in these waters show a history of copper contamination close to marinas, boatyards, and at Port Canaveral that often exceed state and federal water quality standards. Further, we estimate that the total annual copper input into the Indian River Lagoon is between 1.7 tons/year (sailboats) and 2.1 tons/year (powerboats) from boats in 14 marinas. We estimate the copper input into Port Canaveral to be about 1.4 tons/year from seven cruise ships. A brief survey of marina operators and boat owners revealed attitudes and practices associated with AF paint usage that ranged from excellent to inferior. Management recommendations are made for a proactive approach to improving AF paint selection and application, assessing the environmental status of copper, and redefining existing management practices for sustainable AF paint usage and environmental health.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  • Abbasi A. R., S. E. Shackley, P. E. King. 1995. Effects of copper on the ultra structure of brain cells of Atlantic herring, Clupea harengus L. Pakistan J Zool 27(3):203–206

    CAS  Google Scholar 

  • Alzieu C., J. Sanjuan, J. P. Deltriel, M. Borel. 1986. Tin contamination in Arcachon bay: Effects on oyster shell anomalies. Marine Pollut Bull 17:494–498

    Article  CAS  Google Scholar 

  • Anderson B. S., D. P. Middaugh, J. W. Hunt, S. L. Turpen. 1991. Copper toxicity to sperm, embryos, and larvae of topsmelt Atherinops affinis, with notes on induced spawning. Marine Environl Res 31(1):17–35

    Article  CAS  Google Scholar 

  • Anderson C. D. 2000. Whither antifoulings after TBT? NAV 2000 Conference Proceedings, September 2000. Venice

  • ANZECC. 2000. Code of Practice for antifouling and in-water hull cleaning and maintenance. Australian New Zealand Environmental and Conservation Council. Canberra, Australia. Available from http://www.marine.transport.sa.gov.au/pdfs/gullcode.pdf (accessed January 23, 2001)

  • Barber S., J. H. Trefry. 1981. Balanus eburneus: A sensitive indicator of copper and zinc pollution in the coastal zone. Bull Environ Contam Toxicol 27:654–659

    Article  CAS  Google Scholar 

  • BCI Engineering and Scientists, Inc. 2001. Laboratory analysis report, Brevard Teaching and Research Laboratories, Inc. Prepared by Shailesh Patel. Daytona Beach, FL

  • Beck A. B. 1956. The copper content of the liver and blood of some vertebrates. Austr J Zool. 4:1–18

    Article  CAS  Google Scholar 

  • Blossom N. 2002. Proceedings 11th International Congress on Marine Corrosion and Fouling. Session: Copper for Biofouling Control. July 22–26 July 2002, San Diego

  • Bowen H. J. M. 1985. The natural environment and biogeochemical cycles. In Hutzinger D (ed), The handbook of environmental chemistry, Vol. 1, Part D, Springer-Verlag, New York, pp 1–26

    Google Scholar 

  • Brady R. F. Jr. 2000. No more tin, what now for fouling control. J Protect Coat Linings, PCE 5(6):42–46

    Google Scholar 

  • Bryan G. W, P. E. Gibbs, L. G. Hummerstone, G. R. Burt. 1986. The decline of the gastropod Nucella lapillus around south-west England: Evidence for the effect of tributyltin from antifouling paints. J Marine Bioll Assoc UK 66:611–640

    Article  CAS  Google Scholar 

  • California Regional Water Quality Control Board. 2001. Draft technical TMDL for dissolved copper Shelter Island Yacht Basin. Draft Report, April 2001

  • Campbell P. G. C. 1995. Interactions between trace metals and aquatic organisms: A critique of free-ion activity model. In A. Tessier, D. R. Turner. (eds), Metal speciation and bioavailability in aquatic systems. Wiley, Chichester

    Google Scholar 

  • CCREM (Canadian Council of Resource and Environment Ministers). 1987. Canadian Water Quality Guidelines. Task Force on Water Quality Guidelines. Ottawa, Canada

  • Champ M. A., P. F. Seligman (eds), 1996. Organotin: environmental fate and effects. Chapman & Hall, London

    Google Scholar 

  • Claisse D., C. L. Alzieu 1993. Copper contamination as a result of antifouling paint regulations? Marine Pollut Bull 26(7):395–397

    Article  CAS  Google Scholar 

  • Daehne B., B. Watermann, M. Wiegemann, H. Michaelis, S. Sievers, R. Dannenberg, M. Lindeskog, O. Heemken. 2001. Performance of biocide-free antifouling paints. Trials on deep-sea going vessels. Volume II. Inspections and new applications of 2001 and ecotoxicological aspects. Multi-stakeholder project of WWF Germany, ship owners and paint manufacturers, WWF Bremen, Germany

  • Danish E. P. A. 2000. Ecotoxicological assessment of antifouling biocides and nonbiocidal antifouling paints. Environmental Project No. 531

  • Davies I. M., S. K. Bailey. 1991. The impact of tributyl tin from large vessels on dogwhelk (Nucella lapillus) populations around Scottish oil ports. Marine Environ Res 32:201–211

    Article  Google Scholar 

  • Davies I. M., I. Drinkwater, J. C. Mckie, P. Balls. 1988. Effects of tributyl tin compounds from antifoulants on pacific oysters Crassostrea gigas in Scottish Sea Lochs, UK. Aquaculture 74(34):319–330

    Article  Google Scholar 

  • Debourg C., A. Johnson, C. Lye, L. Törnqvist C. Unger. 1993. Antifouling products. Pleasure boats, commercial vessels, nets, fish cages and other underwater equipment. KEMI Report No. 2/93. The Swedish National Chemicals Inspectorate. Solna

  • Di Toro D. M., H. E. Allen, H. L. Bergman, J. S. Meyer Paquin, R. C. Santore 2001. A biotic ligand model of the acute toxicity of metals I. Technical Basis, Environ Toxicol Chem 20:2383–2396

    CAS  Google Scholar 

  • DPEP. 1999. Broward County’s Best Management Practices for marine facilities. Department of Planning & Environmental Protection, Ft. Lauderdale, FL. Available from http://www.co.broward.fl.us/dni05301.pdf (accessed July 15, 2001)

  • Environment Canada. 1995a. Best Management Practices (BMPs) for marinas and small boatyards in British Columbia. Prepared by PCA Consultants Ltd. Richmond, British Columbia

  • Environment Canada. 1995b. Best Management Practices (BMPs) for the ship and boat building and repairing industry in British Columbia. Background document to Environment Canada, Vancouver, British Columbia. Prepared by PCA Consultants Ltd. Richmond, British Columbia

  • EXTOXNET. 1996. Diuron. Pesticide information profiles. Extoxnet, Extension Toxicology Network, Oregon State University, Corvallis, OR. Available from http://www.ace.ace.orst.edu/info/extoxnet/pips/diuron.htm (accessed January 13, 2001)

  • FDEP. 1996. Criteria for Surface Water Quality Classification. Section 62-302.530. Florida Department of Environmental Protection, Tallahassee

  • FDEP. 2002. Florida’s water quality assessment 2002 305(b) report. Florida Department of Environmental Protection, Tallahassee

  • FDEP. 2003a. Criteria for Surface Water Quality Classification. Section 62-302.530. Florida Department of Environmental Protection, Tallahassee

  • FDEP. 2003b. Florida’s Clean Marina Program (CMP). Florida Department of Environmental Protection, Division of Law Enforcement. Tallahassee

  • Gibbs P. E., P. L. Pascoe, G. R. Burt. 1988. Sex change in the female dogwhelk, Nucella lapillus, induced by tributyl tin from antifouling paints. J Marine Biol Assoc UK 68:715–731

    Article  Google Scholar 

  • Glascock C. J. 1987. Trace metal geochemistry of sediments from Turkey Creek, Florida. MS thesis. Florida Institute of Technology. Melbourne

    Google Scholar 

  • Grovhoug J. G., P. F. Seligman, R. L. Fransham, S. Y. Cola, M. O. Stallard, P. M. Stang, A. O. Valkirs. 1989. Butylin concentration measurements in Pearl Harbor, Hawaii. Report TR 1293. Naval Ocean Systems Center. San Diego

    Google Scholar 

  • Hall W. S., S. J. Bushong, L. W. Jr. Hall, M. J. Lenkevich, A. E. Pinkey. 1988. Monitoring dissolved copper concentrations in Chesapeake Bay. Environ Monit Assess 11:33–42

    Article  CAS  Google Scholar 

  • Hand J., V. Tauxe, J. Watts. 1986. Florida Water Quality Assessment; 305(b) Technical Report. Florida Department of Environmental Regulation, Bureau of Water Quality Management. Tallahassee

    Google Scholar 

  • HDG International, Motor Boating & Sailing Magazine. 2000. 2000 Motor boating buyer’s guide. Hearst Magazines, New York, NY, pp 12–52

    Google Scholar 

  • Hiel D. C. 1986. Evaluation of trace metal monitoring in Florida shellfish. Florida Department of Natural Resources, Division of Marine Resources, Bureau of Marine Resource, Regulation and Development. Tallahassee

    Google Scholar 

  • Holbrook S. H. 1984. Partitioning and fate of antifouling paint copper released into an estuarine environment. MS thesis. Florida Institute of Technology. Melbourne

    Google Scholar 

  • IMO. 1999. Proceedings of the 21st session of the International Maritime Organization, 1999. Report No. A895 (21) Interlux Paint Company. 2000. Wetted hull area formula. Availabl from http://www.yachtpaint.com/ (accessed February 6, 2001)

  • International Coatings Ltd. 2000. Worldwide legislative positions on the use of antifouling paints. Available from http://www.international-marine.com (accessed January 25, 2000)

  • Iwata H., S. Tanabe, T. Mizuno, R. Tatsukawa. 1995. High accumulations of toxic butyltins in marine mammals from Japanese coastal waters. Environ Sci Technol 29:2950–2962

    Article  Google Scholar 

  • Johnson H. D., J. G. Johnson, A. O. Valkirs. 1998. Copper loading to US Harbors—Norfolk, VA, Pearl Harbor, HI, and San Diego, California. Technical Document 3052, December 1998, Space and Naval Warfare Systems Center (SSC), San Diego

  • Johnson L. T., J. A. Miller. 2002. What you need to know about non-toxic antifouling strategies for boats. California Sea Grant Extension Program, Report No. T-049, University of California

  • Kannan K., S. Tanabe, H. Iswata, R. Tatsukawa. 1995. Butylins in muscle and liver of fish collected from certain Asian and Oceanian countries. Environ Poll 90:279–290

    Article  CAS  Google Scholar 

  • Katranitsas A., J. Castritsi-Catharios, G. Persoone. 2003. The effects of a copper-based antifouling paint on mortality and enzymatic activity of a non-target marine organism. Marine Pollut Bull 46:1491–1494

    Article  CAS  Google Scholar 

  • Lewis J. A. 1998. Marine biofouling and its prevention on underwater surfaces. Mater Forum 22: 41–61

    CAS  Google Scholar 

  • MacDonald D. D. 1994. Approach to the assessment of sediment quality in Florida coastal waters. Florida Department of Environmental Protection, Tallahassee. Available from http://www.dep.state.fl.us/waste/quick_topics/publications/documents/sediment/volume1.pdf (accessed June 12, 2001)

  • Madsen T., K. Gustavson, L. Samsøe-Petersen, F. Simonsen, J. Jacobsen, S. Foverskov, M. M. Larsen. 1998. Survey and assessment of antifouling products for pleasure craft in Denmark. Environmental Project No. 384. The Danish Environmental Protection Agency, Copenhagen

  • Maryland Department of Natural Resources. 1998. Maryland clean marina guidebook. Product of Maryland Clean Marina Initiative. Maryland Department of Natural Resources, Annapolis. Available from http://www.dnr.state.md.us/boating/cleanmarina/cmprogram.html (accessed May 10, 2001)

  • Matthiessen P., J. Reed, M. Johnson. 1999. Sources and potential effects of copper and zinc concentrations in the estuarine waters of Essex and Suffolk, United Kingdom. Marine Pollut Bull 38(10):908–920

    Article  CAS  Google Scholar 

  • Meyer J. S. 2002. The utility of the terms “bioavailability” and “bioavailable fraction” for metals. Marine Environ Res 53:417–423

    Article  CAS  Google Scholar 

  • Mid-West Research Institute. 2001. Port Canaveral Laboratory Analysis Report 1999–2001. Prepared by Dan Gilb. Palm Bay, FL

  • Naval Sea Systems Command. 1996. Cathodic Protection Table 633-5. Estimates of wetted surface area for US navy vessels. Naval ships’ technical manual, October 1996. S9086-VF-STM-010. Naval Sea Systems Command, Arlington, VA

  • Naval Sea Systems Command. 1997. Nature of Discharge Report: Hull coating leachate 05 November 1997. Naval Sea Systems Command (00T), Arlington, VA

    Google Scholar 

  • Negri A. P., A. J. Heyward. 2001. Inhibition of coral fertilization and larval metamorphosis by tributyltin and copper. Marine Environ Res 51:17–27

    Article  CAS  Google Scholar 

  • O’Shea T. J., J. F. Moore, H. I. Kochman. 1984. Contaminant concentrations in manatees in Florida. J Wildl Manage 48(3):741–748

    CAS  Google Scholar 

  • ORTEP. 2000. Organotin Environmental Programme (ORTEP) Association. Antifoulants: regulations. Available from http://www.ortepa.org (accessed February 2, 2001)

  • Port Canaveral Directory. 2004. Canaveral and foreign trade zone 136. Produced for Canaveral Port Authority, Cape Canaveral, Florida. Wolf Jessee Pacquin Communications Cocoa Beach, FL

  • PRC Environmental Management, Inc. 1997. Report of copper loading to San Diego Bay, California for the San Diego Bay Interagency Water Quality Panel. Prepared for the California Regional Water Quality Board and the San Diego Bay Interagency Water Quality Panel

  • Rhode Island Sea Grant. 1996. Environmental guide for marinas. Controlling nonpoint source and storm water pollution in Rhode Island, 2nd ed. Corey T (ed), Rhode Island Sea Grant. Coastal Resources Center, University of Rhode Island, Naragansett, RI

  • Royal J., C. Adamus, R. Thompson. 1992. Comprehensive shellfish harvesting area survey of body F, Brevard County. Florida Department of Natural Resources Shellfish Environmental Assessment Section. Tallahassee

  • Scarlett A., P. Donkin, T. W. Fileman, S. V. Evans, M. E. Donkin. 1999. Risk posed by the antifouling agent Irgarol 1051 to the seagrass, Zostera marina. Aquat Toxicol 45:159–170

    Article  CAS  Google Scholar 

  • Schiff K., D. Diehl, A. Valkirs. 2003. Copper emissions from antifouling paint on recreational vessels. Technical Report 405. Southern California Coastal Water Research Project. Westminster, CA

    Google Scholar 

  • Schiff K., D. Diehl, A. Valkirs. 2004. Copper emissions from antifouling paint on recreational vessels. Marine Pollut Bull 48:371–377

    Article  CAS  Google Scholar 

  • Seligman P. F., A. Zirino. (eds), 1998. Chemistry, toxicity, and bioavailability of copper and its relationship to regulation in the marine environment. Office of Naval Research (ONR) Workshop Report Technical document 3044. San Diego, CA

  • Sheffield Engineering. 2001. Canaveral harbor sampling water quality data 1996–2000. Sheffield Engineering Associates Civil & Environmental Engineering Services. Prepared by John Craig, Orlando, FL

  • Srinivasan M. 2001. Management strategies for copper-based antifouling paints in Florida. MS Research Project, Florida Institute of Technology, Melbourne

    Google Scholar 

  • State of Florida. 2004. Visit Florida. Official Tourism Promotion Corporation for the State of Florida

  • Swain G. W. 1986. Accelerated testing of anti-fouling coatings for use on offshore structures. In Oceans’86 conference, Section-IEEE, Marine Technology Society. Washington DC

  • Swain G. W. 1999. Redefining antifouling coatings. Protect Coat Europe 4(7):18–25

    Google Scholar 

  • Swain G. W., C. J. Kavanagh, B. S. Kovach, R. Quinn 2001. The antifouling performance of non-toxic fouling release coatings. In Proceedings of Oceanology International Americas 2001, April 3–5, Miami, FL

  • Tanabe S., M. Prudente, T. Mizuno, J. Hasegawa, H. Iwata, N. Miyazaki. 1998. Butyltin contamination in marine mammals from North Pacific and Asian waters. Environ Sci Technol 32:192–198

    Google Scholar 

  • Tang D., K. W. Warnken, P. H. Santschi. 2001. Organic complexation of copper in surface waters of Galveston Bay. Limnol Oceanogr 46:321–330

    Article  CAS  Google Scholar 

  • ten Hallers-Tjabbes C. C., J. F. Kemp, J. P. Boon. 1994. Imposex in whelks (Buccinum undatum) from the open North Sea: Relation to shipping traffic intensities. Marine Pollut Bull 28(5):311–313

    Article  Google Scholar 

  • Touzot A., B. Lajoie. 2001. Design and cost estimation of a 55 feet cruiser. Project Engineering Class Research Project, Spring 2001. Florida Institute of Technology, Melbourne

    Google Scholar 

  • Trocine R. P., J. H. Trefry. 1993. Toxic substances survey for the Indian River Lagoon system. Florida Institute of Technology, Melbourne

    Google Scholar 

  • Trocine R. P., J. H. Trefry. 1996. Metal concentrations in sediment, water, and clams, from the Indian River Lagoon, Florida. Marine Pollut Bull 32(10):754–759

    Article  CAS  Google Scholar 

  • UNDS. 1999. Nature of Discharge Report. Uniform National Discharge Standards (UNDS) Hull Coating Leachate. Federal Register Notice (64 FR 25126; 40 CFR Part 1700)

  • University of California Sea Grant Extension. 1995. Boating pollution prevention tips. University of California Sea Grant Extension Program, San Diego County. Available from http://www.commserv.ucdavis.edu/cesandiego/seagrant/boating.htm (accessed January 12, 2001)

  • USEPA. 1996. Clean marinas clear value. Environmental business success stories. EPA 841-R-96-003. US Environmental Protection Agency, Office of Water, Washington DC

  • USEPA. 1999. National recommended water quality criteria correction. EPA 822-Z99-001. US Environmental Protection Agency, Office of Water, Washington DC

  • USEPA. 2001. 2001 Toxics Release Inventory (TRI) Public Data Release Report. EPA 260-R-03-001, Appendix B: TRI Release and Waste Management Data for metals and Metal Category

  • USEPA. 2003. 2003 Update of ambient water quality criteria for copper. EPA 822-R-03-026 (CAS Registry No. 7440-50-8), November 2003. US Environmental Protection Agency Office of Water, Office of Science and Technology, Washington DC

  • Valkirs A. O., B. M. Davidson, L. L. Kear, R. L. Fransham, A. Zirino, A. R. Grovhoug. 1994. Environmental effects of in-water hull cleaning of ablative copper from antifouling coatings. Technical document 2662. Naval Command Control and Ocean Surveillance Center Research & Development Test & Evaluation (RDT&E), San Diego, CA

  • Valkirs A. O., P. R. Seligman, E. Haslbeck, J. S. Caso. 2003. Measurement of copper release rates from antifouling paint under laboratory and in-situ conditions: Implications for loading estimation to marine water bodies. Marine Pollut Bull 46(6):763–779

    Article  CAS  Google Scholar 

  • Voulvoulis N., M. D. Scrimshaw, J. N. Lester. 2000. Occurrence of four biocides utilized in antifouling paints, as alternatives to organotin compounds, in waters and sediments of a commercial estuary in the UK. Marine Pollut Bull 40(11):938–946

    Article  CAS  Google Scholar 

  • Washington State Department of Ecology. 1999. Ship shape. Single industry campaign. Summary report. Publication No. 99-16. Prepared by Paul Stasch and Donna Lynch. Washington State Department of Ecology Water Quality Program

  • Watermann B., B. Daehne, H. Michaelis, S. Sievers, R. Dannenberg, M. Wiegemann. 2000. Performance of biocide-free antifouling paints. Trials on deep-sea going vessels. Vol. I. Application of test paints and inspections 2000. Multi-stakeholder project of WWF Germany, ship owners and paint manufacturers, Hamburg, Germany

  • Watermann B., H-D. Berger, H. Sonnichsen, P. Willemsen. 1997. Performance and effectiveness of non-stick coatings in seawater. Biofouling 11(2):101–118

    Article  CAS  Google Scholar 

  • WHOI. 1952a. History of fouling prevention. In Marine fouling and its prevention. Prepared for Bureau of Ships, Navy Department by Woods Hole Oceanographic Institution (WHOI), Woods Hole, MA. United States Naval Institute, Annapolis, MD

  • WHOI. 1952b. Physical chemistry of compounds of copper and mercury and their interactions with seawater. In Marine fouling and its prevention. Prepared for Bureau of Ships, Navy Department by Woods Hole Oceanographic Institution (WHOI), Woods Hole, MA. United States Naval Institute, Annapolis, MD, pp 264–276

  • Woodward-Clyde Consultants. 1994a. Preliminary water and sediment quality assessment of the Indian River Lagoon. Final Technical Report, Indian River Lagoon, National Estuary Program, Melbourne, FL. Project No. 92F274C

  • Woodward-Clyde Consultants. 1994b. Status and trends: Summary of the Indian River Lagoon. Final Technical Report, Indian River Lagoon, National Estuary Program, Melbourne, FL. Project No. 92F274C

  • WWF (World Wildlife Fund)-Germany. 2000. German coast ship trials testing biocide-free anti-fouling systems. Toxic Chemical Reports. Biocide-free (non toxic) anti-fouling systems—trials testing on German coast ships. WWF-Germany, September 2000 Available from http://www.wwf.org.uk/researcher/issues/toxics/0000000188.asp#bf (accessed October 10, 2005)

  • Zediker L. Z. 1982. Determination of chromium, copper, and zinc in the sediments of canals receiving electronic component industry effluent. MS thesis, Florida Institute of Technology. Melbourne

    Google Scholar 

  • Zirino A., P. F. Seligman. (eds), 2002. Copper chemistry, toxicity, and bioavailability and its relationship to regulation in the marine environment—Office of Naval Research (ONR) Second Workshop Report. SSC San Diego

Download references

Acknowledgments

The authors would like to acknowledge all marina operators for their support during the course of the project. Their participation and enthusiasm was crucial to the completion of the project. We also greatly appreciate the cooperation of Melbourne Yacht Club and West Marine in the boat owners’ survey and would like to thank all the boaters who participated in the survey. We would also like to acknowledge the help rendered by various individuals at FDEP, Canaveral Port Authority, RCI, Disney, Carnival Cruise lines, Norwegian Cruise Lines, Holland America, International Paints and other paint manufacturers, and other worldwide environmental agencies and laboratories for providing important data and reports, which were invaluable to the research project. Thanks also to Arthur Touzot for his timely help and assistance in providing valuable data. Special thanks to Jolly Rajan for manuscript reviews and valuable support throughout the project. Finally, we express our sincere gratitude to all anonymous reviewers for their constructive comments and suggestions. Financial support was provided by the Office of Naval Research (ONR grant No. N00014-02-1-0217).

Author information

Authors and Affiliations

  1. 2803 Loftview Square, Atlanta, GA, 30339, USA

    Mridula Srinivasan

  2. Department of Marine and Environmental Systems, Florida Institute of Technology, 150 West University Boulevard, Melbourne, FL, 32901, USA

    Geoffrey W. Swain

Authors
  1. Mridula Srinivasan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Geoffrey W. Swain
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mridula Srinivasan.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Srinivasan, M., Swain, G.W. Managing the Use of Copper-Based Antifouling Paints. Environmental Management 39, 423–441 (2007). https://doi.org/10.1007/s00267-005-0030-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00267-005-0030-8

Keywords

Search

Navigation