Jack Caravanos
Jack Caravanos
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Clinical Professor of Environmental Public Health Sciences in the Department of Global and Environmental Health
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Professional overview
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For Dr. Jack Caravanos, life in the field ranges from jumping onto a motorcycle and navigating the jungles of Madre de Dios in the Peruvian Amazon studying toxic substances to traveling to remotes areas in Zambia, Indonesia, and Bolivia studying lead and other toxic wastes. By cooperating with local governments, his work provides safe, healthy, and evidence-based solutions for pollution problems in low- and middle-income countries.
In partnership with Pure Earth, an international non-profit organization, Dr. Caravanos is studying the impact of gold extraction with mercury in Peru and Indonesia. Since miners are in danger of mercury poisoning, his research team is planning interventions that teach safer techniques for gold extraction. In Kabwe, Zambia - a mining town with exposure to lead - his research will provide methods to institute safer mining practices and policy recommendations to improve environmental remediation laws.
Dr. Caravanos teaches Environmental Health for graduate students and Environmental Health in a Global World for undergraduate students. He also provides opportunities for student researchers in his ongoing projects, including in Indonesia (mercury) and Ghana (e-waste).
To learn more about Dr. Caravanos and his work, visit his website.
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Education
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BS, Health Science, Hunter College, New York, NYMS, Environmental Health Engineering, New York University, New York, NYDrPH, Environmental Health, Columbia University, New York, NY
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Honors and awards
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Presidential Award for Excellence in Community Service, Hunter College (2013)Presidential Award for Excellence in Teaching, Hunter College (2006)
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Areas of research and study
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Artisanal Gold MiningDissemination and Implementation of Evidence-based ProgramsEnvironmental Public Health ServicesGlobal HealthLead poisoning
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Publications
Publications
A meta-analysis of blood lead levels in India and the attributable burden of disease
AbstractEricson, B., Dowling, R., Dey, S., Caravanos, J., Mishra, N., Fisher, S., Ramirez, M., Sharma, P., McCartor, A., Guin, P., Taylor, M. P., & Fuller, R. (n.d.).Publication year
2018Journal title
Environment internationalVolume
121Page(s)
461-470AbstractMultiple studies in India have found elevated blood lead levels (BLLs) in target populations. However the data have not yet been evaluated to understand population-wide exposure levels. We used arithmetic mean blood lead data published from 2010 to 2018 on Indian populations to calculate the average BLLs for multiple subgroups. We then calculated the attributable disease burden in IQ decrement and Disability Adjusted Life Years (DALYs). Our Pubmed search yielded 1066 articles. Of these, 31 studies representing the BLLs of 5472 people in 9 states met our study criteria. Evaluating these, we found a mean BLL of 6.86 μg/dL (95% CI: 4.38–9.35) in children and 7.52 μg/dL (95% CI: 5.28–9.76) in non-occupationally exposed adults. We calculated that these exposures resulted in 4.9 million DALYs (95% CI: 3.9–5.6) in the states we evaluated. Population-wide BLLs in India remain elevated despite regulatory action to eliminate leaded petrol, the most significant historical source. The estimated attributable disease burden is larger than previously calculated, particularly with regard to associated intellectual disability outcomes in children. Larger population-wide BLL studies are required to inform future calculations. Policy responses need to be developed to mitigate the worst exposures.A multihazard, multistrategy approach to home remediation : Results of a pilot study
AbstractKlitzman, S., Caravanos, J., Belanoff, C., & Rothenberg, L. (n.d.).Publication year
2005Journal title
Environmental ResearchVolume
99Issue
3Page(s)
294-306AbstractMany residential hazards are disproportionately concentrated in older, urban dwellings and share common underlying causes, such as uncorrected moisture problems and inadequate maintenance and cleaning. Comprehensive and affordable approaches to remediation are needed, but the feasibility and efficacy of such approaches has not been well documented. To address this gap, a multihazard, multimethod intervention, addressing deteriorated lead-based paint and lead dust, vermin, mold, and safety hazards was pilot-tested in a sample of 70 pre-1940 dwellings. Dwellings received paint stabilization, dust lead cleaning, integrated pest management (IPM), mold cleaning, and safety devices, as needed. The median remediation cost for labor and materials was $864.66 (range: $120.00-5235.33) per dwelling. Environmental conditions were evaluated prior to, immediately following, and an average of 5 months after remediation. Between the baseline and 5-month follow-up periods, significant reductions were achieved in the number of dwellings with multiple (i.e., three or four) problems (75% vs. 23%, PA simplified risk-ranking system for prioritizing toxic pollution sites in low- and middle-income countries
AbstractCaravanos, J., Gualtero, S., Dowling, R., Ericson, B., Keith, J., Hanrahan, D., & Fuller, R. (n.d.).Publication year
2014Journal title
Annals of Global HealthVolume
80Issue
4Page(s)
278-285AbstractBackground In low- and middle-income countries (LMICs), chemical exposures in the environment due to hazardous waste sites and toxic pollutants are typically poorly documented and their health impacts insufficiently quantified. Furthermore, there often is only limited understanding of the health and environmental consequences of point source pollution problems, and little consensus on how to assess and rank them. The contributions of toxic environmental exposures to the global burden of disease are not well characterized. Objectives The aim of this study was to describe the simple but effective approach taken by Blacksmith Institute's Toxic Sites Identification Program to quantify and rank toxic exposures in LMICs. This system is already in use at more than 3000 sites in 48 countries such as India, Indonesia, China, Ghana, Kenya, Tanzania, Peru, Bolivia, Argentina, Uruguay, Armenia, Azerbaijan, and Ukraine. Methods A hazard ranking system formula, the Blacksmith Index (BI), takes into account important factors such as the scale of the pollution source, the size of the population possibly affected, and the exposure pathways, and is designed for use reliably in low-resource settings by local personnel provided with limited training. Findings Four representative case studies are presented, with varying locations, populations, pollutants, and exposure pathways. The BI was successfully applied to assess the extent and severity of environmental pollution problems at these sites. Conclusions The BI is a risk-ranking tool that provides direct and straightforward characterization, quantification, and prioritization of toxic pollution sites in settings where time, money, or resources are limited. It will be an important and useful tool for addressing toxic pollution problems in LMICs. Although the BI does not have the sophistication of the US Environmental Protection Agency's Hazard Ranking System, the case studies presented here document the effectiveness of the BI in the field, especially in low-resource settings. Understanding of the risks posed by toxic pollution sites helps assure better use of resources to manage sites and mitigate risks to public health. Quantification of these hazards is an important input to assessments of the global burden of disease.A survey of spatially distributed exterior dust lead loadings in New York City
AbstractCaravanos, J., Weiss, A. L., Blaise, M. J., & Jaeger, R. J. (n.d.).Publication year
2006Journal title
Environmental ResearchVolume
100Issue
2Page(s)
165-172AbstractThis work documents ambient lead dust deposition values (lead loading) for the boroughs of New York City in 2003-2004. Currently, no regulatory standards exist for exterior concentrations of lead in settled dust. This is in contrast to the clearance and risk assessment standards that exist for interior residential dust. The reported potential for neurobehavioral toxicity and adverse cognitive development in children due to lead exposure prompts public health concerns about undocumented lead sources. Such sources may include settled dust of outdoor origin. Dust sampling throughout the five boroughs of NYC was done from the top horizontal portion of pedestrian traffic control signals (PTCS) at selected street intersections along main thoroughfares. The data (n=214 samples) show that lead in dust varies within each borough with Brooklyn having the highest median concentration (730 μg/ft2), followed in descending order by Staten Island (452 μg/ft2), the Bronx (382 μg/ft2), Queens (198 μg/ft2) and finally, Manhattan (175 μg/ft2). When compared to the HUD/EPA indoor lead in dust standard of 40 μg/ft2, our data show that this value is exceeded in 86% of the samples taken. An effort was made to determine the source of the lead in the dust atop of the PTCS. The lead in the dust and the yellow signage paint (which contains lead) were compared using isotopic ratio analysis. Results showed that the lead-based paint chip samples from intact signage did not isotopically match the dust wipe samples taken from the same surface. We know that exterior dust containing lead contributes to interior dust lead loading. Therefore, settled leaded dust in the outdoor environment poses a risk for lead exposure to children living in urban areas, namely, areas with elevated childhood blood lead levels and background lead dust levels from a variety of unidentified sources.Airborne mercury levels at gold processing shops associated with artisanal and small scale gold mining at Madre de Dios, Peru
AbstractCaravanos, J. (n.d.).Publication year
2016Abstract~An exterior and interior leaded dust deposition survey in New York City : Results of a 2-year study
AbstractCaravanos, J., Weiss, A. L., & Jaeger, R. J. (n.d.).Publication year
2006Journal title
Environmental ResearchVolume
100Issue
2Page(s)
159-164AbstractEnvironmental concentrations of leaded dust were monitored by weekly sample collection of interior and exterior settled dust that had accumulated due to atmospheric deposition. The weekly deposition amounts were measured and the cumulative rates of lead in dust that deposited on a weekly basis over 2 year's time were determined. The sampling analysis revealed that the median values of leaded dust for the interior plate (adjacent to the open window), unsheltered exterior plate, and the sheltered exterior plate were 4.8, 14.2, and 32.3 μg/feet2/week, respectively. The data supports the existence of a continuous source of deposited leaded dust in interior and exterior locations within New York City. Additional data from a control plate (interior plate with the window closed) demonstrate that the source of the interior lead deposition was from exterior (environmental) sources. Because of the ubiquitous nature of lead in our environment and the toxic threat of lead to the cognitive health of children, this data provides a framework for the understanding of environmental exposure to lead and its potential for continuing accumulation within an urban environment.An innovative approach to interdisciplinary occupational safety and health education
AbstractRosen, M. A., Caravanos, J., Milek, D., & Udasin, I. (n.d.).Publication year
2011Journal title
American Journal of Industrial MedicineVolume
54Issue
7Page(s)
515-520AbstractBackground: The New York and New Jersey Education and Research Center (ERC) provides a range of graduate continuing education for occupational safety and health (OSH) professionals in training. A key element of the education is to provide interdisciplinary training to industrial hygienists, ergonomists, occupational medicine physicians and other health and safety trainees to prepare them for the collaboration required to solve the complex occupational health and safety problems they will face in their careers. Methods: This center has developed an innovative interdisciplinary training approach that provides an historical aspect, while allowing the graduate students to identify solutions to occupational issues from a multi-disciplinary approach. The ERC developed a tour that brings students to sites of historical and/or contemporary significance in the occupational safety and health and environmental fields. Results: The ERC has conducted five tours, and has included 85 students and residents as participants. 80% of participants rated the tour as providing a high amount of OSH knowledge gained. 98% of the participants felt the goal of providing interdisciplinary education was achieved. Conclusions: This tour has been successful in bridging the OSH fields to better understand how occupational and environmental exposures have occurred, in order to prevent future exposures so that workplace conditions and health can be improved.Approaches to systematic assessment of environmental exposures posed at hazardous waste sites in the developing world : The Toxic Sites Identification Program
AbstractEricson, B., Caravanos, J., Chatham-Stephens, K., Landrigan, P., & Fuller, R. (n.d.).Publication year
2013Journal title
Environmental Monitoring and AssessmentVolume
185Issue
2Page(s)
1755-1766AbstractIn the developing world, environmental chemical exposures due to hazardous waste sites are poorly documented. We describe the approach taken by the Blacksmith Institute's Toxic Sites Identification Program in documenting environmental chemical exposures due to hazardous waste sites globally, identifying sites of concern and quantifying pathways, populations, and severity of exposure. A network of local environmental investigators was identified and trained to conduct hazardous waste site investigations and assessments. To date, 2,095 contaminated sites have been identified within 47 countries having an estimated population at risk of 71,500,000. Trained researchers and investigators have visited 1,400 of those sites. Heavy metals are the leading primary exposures, with water supply and ambient air being the primary routes of exposure. Even though chemical production has occurred largely in the developed world to date, many hazardous waste sites in the developing world pose significant hazards to the health of large portions of the population. Further research is needed to quantify potential health and economic consequences and identify cost-effective approaches to remediation.Asbestos abatement response actions under AHERA
AbstractCaravanos, J. (n.d.). In Journal of the National Asbestos Council.Publication year
1988Abstract~Assessing levels of lead contamination in soil and predicating pediatric blood lead levels in Tema, Ghana
AbstractKwame-Aboh, I., Sampson, M., Atiemo, M., Nyaab, M., Abra-Kom, L., Caravanos, J., & Kuranchie-Mensah, H. (n.d.).Publication year
2013Journal title
Journal of Health and PollutionAbstract~Assessing the exposure risks and potential health effects from chemical contamination at an electronic and electrical recycling and waste site in Accra, Ghana
AbstractCaravanos, J., Clarke, E., & Lambertson, C. (n.d.).Publication year
2011Journal title
Journal of Health and PollutionVolume
1Issue
1Abstract~Assessment of the prevalence of lead-based paint exposure risk in Jakarta, Indonesia
AbstractEricson, B., Hariojati, N., Susilorini, B., Crampe, L. F., Fuller, R., Taylor, M. P., & Caravanos, J. (n.d.).Publication year
2019Journal title
Science of the Total EnvironmentVolume
657Page(s)
1382-1388AbstractWhile lead-based paint has been banned for use in residential settings in most high-income countries, it remains commonly available in many low- and middle-income countries (LMICs). Despite its continued availability, little is known about the specific exposure risk posed by lead-based paint in LMICs. To address this knowledge gap, an assessment of home and preschool dust and paint was carried out in Greater Jakarta, Indonesia. A team of investigators used field portable X-ray Fluorescence (pXRF) to measure 1574 painted surfaces for the presence of lead (mg/cm2) and collected 222 surface dust wipe samples for lead loading (μg/m2) from 103 homes and 19 preschools across 13 different neighborhoods of Jakarta. The assessment found that 2.7% (n = 42) of pXRF measurements and 0.05% (n = 1) of dust wipe samples exceeded the commonly applied USEPA guideline values for paint (1 mg/cm2) and dust (floors: 431 μg/m2; window sills: 2691 μg/m2). Thus, contrary to expectations the locations analyzed in Greater Jakarta showed that exposure risk to lead-based paint appears low. Further study is required in other settings to confirm the findings here. Precautionary measures, such as the proposed ban on lead-based paint, should be taken to prevent the significant social and economic costs associated with lead exposure.Blood lead levels in mexico and pediatric burden of disease implications
AbstractCaravanos, J., Dowling, R., Téllez-Rojo, M. M., Cantoral, A., Kobrosly, R., Estrada, D., Orjuela, M., Gualtero, S., Ericson, B., Rivera, A., & Fuller, R. (n.d.).Publication year
2014Journal title
Annals of Global HealthVolume
80Issue
4Page(s)
269-277AbstractBackground Although there has been success in reducing lead exposure with the phase-out of leaded gasoline, exposure to lead in Mexico continues to threaten the health of millions, much of which is from lead-based glazes used in pottery that leaches into food. Objectives An extensive historical review and analysis of available data on blood lead levels in Mexican populations was conducted. We used a calculated geometric mean to evaluate the effect of lead on the pediatric burden of disease. Methods An extensive bibliographic search identified 83 published articles from 1978 to 2010 with blood lead level (BLL) data in Mexican populations representing 150 data points from more than 50,000 study participants. Values from these publications were categorized into various groupings. We then calculated the incidence of disease and disability-adjusted life-years resulting from these BLLs using the World Health Organization's burden of disease spreadsheets for mild mental retardation. Results Reviewing all relevant studies, the geometric means of Mexican BLLs in urban and rural areas were found to be 8.85 and 22.24 ug/dL, respectively. Since the phase-out of leaded gasoline, the mean in urban areas was found to be 5.36 ug/dL and the average in rural areas is expected to be much higher. The U.S. Centers for Disease Control and Prevention's (CDC) upper limit of blood lead in children under the age of 6 years is 5 ug/dL and the current U.S. average is 1.2 ug/dL. Our results indicate that more than 15% of the population will experience a decrement of more than 5 IQ points from lead exposure. The analysis also leads us to believe that lead is responsible for 820,000 disability-adjusted life-years for lead-induced mild mental retardation for children aged 0 to 4 years. Conclusion Lead continues to threaten the health of millions and remains a significant cause of disability in Mexico. Additional interventions in reducing or managing lead-based ceramic glazes are necessary to protect the public health.Burden of disease from toxic waste sites in India, Indonesia, and the Philippines in 2010
AbstractChatham-Stephens, K., Caravanos, J., Ericson, B., Sunga-Amparo, J., Susilorini, B., Sharma, P., Landrigan, P. J., & Fuller, R. (n.d.).Publication year
2013Journal title
Environmental health perspectivesVolume
121Issue
7Page(s)
791-796AbstractBackground: Prior calculations of the burden of disease from toxic exposures have not included estimates of the burden from toxic waste sites due to the absence of exposure data. Objective: We developed a disability-adjusted life year (DALY)-based estimate of the disease burden attributable to toxic waste sites. We focused on three low- and middle-income countries (LMICs): India, Indonesia, and the Philippines. Methods: Sites were identified through the Blacksmith Institute's Toxic Sites Identification Program, a global effort to identify waste sites in LMICs. At least one of eight toxic chemicals was sampled in environmental media at each site, and the population at risk estimated. By combining estimates of disease incidence from these exposures with population data, we calculated the DALYs attributable to exposures at each site. Results: We estimated that in 2010, 8,629,750 persons were at risk of exposure to industrial pollutants at 373 toxic waste sites in the three countries, and that these exposures resulted in 828,722 DALYs, with a range of 814,934-1,557,121 DALYs, depending on the weighting factor used. This disease burden is comparable to estimated burdens for outdoor air pollution (1,448,612 DALYs) and malaria (725,000 DALYs) in these countries. Lead and hexavalent chromium collectively accounted for 99.2% of the total DALYs for the chemicals evaluated. Conclusions: Toxic waste sites are responsible for a significant burden of disease in LMICs. Although some factors, such as unidentified and unscreened sites, may cause our estimate to be an underestimate of the actual burden of disease, other factors, such as extrapolation of environmental sampling to the entire exposed population, may result in an overestimate of the burden of disease attributable to these sites. Toxic waste sites are a major, and heretofore underrecognized, global health problem.Burden of disease resulting from lead exposure at toxic waste sites in Argentina, Mexico and Uruguay
AbstractCaravanos, J., Carrelli, J., Dowling, R., Pavilonis, B., Ericson, B., & Fuller, R. (n.d.).Publication year
2016Journal title
Environmental Health: A Global Access Science SourceVolume
15Issue
1AbstractBackground: Though lead contaminated waste sites have been widely researched in many high-income countries, their prevalence and associated health outcomes have not been well documented in low- and middle-income countries. Methods: Using the well-established health metric disability-adjusted life year (DALY) and an exposure assessment method developed by Chatham-Stephens et al., we estimated the burden of disease resulting from exposure to lead at toxic waste sites in three Latin American countries in 2012: Argentina, Mexico and Uruguay. Toxic waste sites identified through Pure Earth's Toxic Sites Identification Program (TSIP) were screened for lead in both biological and environmental sample media. Estimates of cardiovascular disease incidence and other outcomes resulting from exposure to lead were utilized to estimate DALYs for each population at risk. Results: Approximately 316,703 persons in three countries were at risk of exposure to pollutants at 129 unique sites identified through the TSIP database. Exposure to lead was estimated to result in between 51,432 and 115,042 DALYs, depending on the weighting factor used. The estimated burden of disease caused by exposure to lead in this analysis is comparable to that estimated for Parkinson's disease and bladder cancer in these countries. Conclusions: Lead continues to pose a significant public health risk in Argentina, Mexico, and Uruguay. The burden of disease in these three countries is comparable with other widely recognized public health challenges. Knowledge of the relatively high number of DALYs associated with lead exposure may be used to generate support and funding for the remediation of toxic waste sites in these countries and others.Case 2: Hurricane Sandy: training to improve response and recovery
AbstractCaravanos, J. (n.d.).Publication year
2014Abstract~Characterization and risk of exposure to elements from artisanal gold mining operations in the Bolivian Andes
AbstractPavilonis, B., Grassman, J., Johnson, G., Diaz, Y., & Caravanos, J. (n.d.).Publication year
2017Journal title
Environmental ResearchVolume
154Page(s)
1-9AbstractArtisanal and small-scale gold mining (ASGM) offers low-skilled workers an opportunity to elevate themselves out of poverty. However, this industry operates with little to no pollution controls and the cost to the environment and human health can be large. The objectives of this study were to measure levels of arsenic (As), manganese (Mn), cobalt (Co), lead (Pb), and mercury (Hg) in the environment and characterize health risks to miners and residents in an area with active ASGM operations. An exposure assessment was conducted at two different mining sites and a nearby village in the Bolivian Anders. The resulting measurements were then used to quantify cancerous and noncancerous health risks to children and adults working at and living near ASGM areas. Soil concentrations of As were well above background levels and showed great variations between the village and mining area. Mercury vapor levels at the two mining sites were approximately 30 times larger than the EPA reference concentration. The risk of developing non-cancerous health effects were primarily due to exposure to As and Hg. The probability of individuals developing cancer was considerably increased with adult miners having a probability of 1.3 out of 100. Cancer potential was driven by exposure to As, with de minimus cancer risk from all other elements. Based on the environmental characterization of elements in soils and Hg vapors, the risk of developing cancerous and non-cancerous health outcomes were above a level of concern based on EPA risk assessment guidance. Personal protective equipment was not worn by workers and Hg amalgam is commonly heated in workers’ homes. Better education of the risks of ASGM is needed as well as simple controls to reduce exposure.Childhood blood lead reductions following removal of leaded ceramic glazes in artisanal pottery production: a success story
AbstractJones, D., Perez, M., Ericson, B., Sanchez, D., Gualtero, S., Smith-Jones, A., & Caravanos, J. (n.d.).Publication year
2013Journal title
Journal of Health and PollutionPage(s)
23Abstract~Comparison of burden of disease from toxic waste sites with other recognized public health threats in India, Indonesia and the Philippines
AbstractCaravanos, J., Gutierrez-Hernandez, L., Ericson, B., & Fuller, R. (n.d.).Publication year
2014Journal title
Journal of Health and PollutionAbstract~Conflicting conclusions or competing methodologies? Documenting soil lead pollution in Owino Uhuru, Kenya
AbstractCaravanos, J. (n.d.).Publication year
2019Journal title
Journal of Health and PollutionVolume
9Issue
21Abstract~Contaminacion por metales en suelos de la ciudad de Torreon, Coahuila, Mexico
AbstractRubio Andrade, M., Rosales Gonzalez, M., Goytia Acevedo, R., Garcia, G., Arenas, J., Meza Velazquez, R., & Caravanos, J. (n.d.).Publication year
2007Journal title
Revista Chapingo Serie Zonas AridasAbstract~Cost effectiveness and health impact of remediation of highly polluted sites in the developing world
AbstractLandrigan, P. J., Caravanos, J., & Breysse, P. (n.d.).Publication year
2012Abstract~Cost effectiveness and health impact of remediation of highly polluted sites in the developing world
AbstractLandrigan, P. J., Caravanos, J., & Breysse, P. (n.d.).Publication year
2012Abstract~Cost Effectiveness of Environmental Lead Risk Mitigation in Low-and Middle-Income Countries
AbstractEricson, B., Caravanos, J., Depratt, C., Santos, C., Cabral, M. G., Fuller, R., & Taylor, M. P. (n.d.).Publication year
2018Journal title
GeoHealthVolume
2Issue
2Page(s)
87-101AbstractEnvironmental remediation efforts in low-and middle-income countries have yet to be evaluated for their cost effectiveness. To address this gap we calculate a cost per Disability Adjusted Life Year (DALY) averted following the environmental remediation of the former lead smelter and adjoining residential areas in Paraiso de Dios, Haina, the Dominican Republic, executed from 2009 to 2010. The remediation had the effect of lowering surface soil lead concentrations to below 100 mg/kg and measured geometric mean blood lead levels (BLLs) from 20.6 μg/dL to 5.34 ug/dL. Because BLLs for the entire impacted population were not available, we use environmental data to calculate the resulting disease burden. We find that before the intervention 176 people were exposed to elevated environmental lead levels at Paraiso de Dios resulting in mean BLLs of 24.97 (95% CI: 24.45–25.5) in children (0–7 years old) and 13.98 μg/dL (95% CI: 13.03–15) in adults. We calculate that without the intervention these exposures would have resulted in 133 to 1,096 DALYs and that all of these were averted at a cost of USD 392 to 3,238, depending on assumptions made. We use a societal perspective, meaning that we include all costs regardless of by whom they were incurred and estimate costs in 2009 USD. Lead remediation in low-and middle-income countries is cost effective according to World Health Organization thresholds. Further research is required to compare the approach detailed here with other public health interventions.Development of an interactive inter-state community hospital based regional tumor registry.
AbstractCaravanos, J., Stellman, J., Caravanos, J., & Taub, R. N. (n.d.).Publication year
1983Journal title
Progress in clinical and biological researchVolume
120Page(s)
165-169Abstract~