Nurse Shark: Behavior, Habitat, and Myths
The nurse shark (Ginglymostoma cirratum) is a benthic shark species found in warm coastal waters of the Atlantic and eastern Pacific Oceans. This article provides evidence-based information on nurse shark behavior, habitat use, and common misconceptions, with practical safety guidance for divers, snorkelers, and fisheries observers. The content draws on peer-reviewed research published through the National Center for Biotechnology Information and PubMed, with additional bibliographic records from related scientific sources.
Nurse sharks are frequently encountered by recreational anglers, divers, and coastal residents because they occupy shallow, nearshore habitats and exhibit relatively sedentary behavior. Despite their reputation as docile animals, nurse sharks are large predators with specialized feeding adaptations and measurable physiological responses to human interactions. Understanding their actual behavior, habitat requirements, and conservation status helps coastal users make informed decisions about safe and responsible encounters.
At a Glance: Nurse Shark Key Facts
Species Identification and Taxonomic Context
Nurse sharks belong to the family Ginglymostomatidae and are one of the most commonly observed shark species in Caribbean and western Atlantic reef systems. They are frequently confused with other benthic sharks, including wobbegongs and grey nurse sharks, which are distinct species with different ecological roles and conservation statuses.
The grey nurse shark (Carcharias taurus), also called the sand tiger or raggedtooth shark in different regions, is a separate species with a critically endangered eastern Australian population. Research on grey nurse shark conservation has documented complex cross-jurisdictional management across marine-protected area networks in New South Wales and Queensland, Australia. This species uses spear-shaped grasping teeth to capture prey, in contrast to the nurse shark's crushing and suction-based feeding apparatus. The distinction matters for observers because misidentification can lead to incorrect assumptions about behavior and risk.
Species misidentification is a documented problem in shark surveillance programs. A study of drone-based shark surveillance along New South Wales beaches found that real-time classification overestimated the presence of target shark species, with false-positive detection rates of 53 percent for bull sharks, 79 percent for white sharks, and 100 percent for tiger sharks. Non-shark species, including guitarfish and gamefish, triggered 39 countermeasures including 28 water evacuations. While this study focused on drone surveillance instead of in-water observation, it highlights the general challenge of accurate shark identification and the importance of species-specific knowledge.
Global Distribution and Habitat Preferences
Nurse sharks inhabit warm temperate and tropical coastal waters on both sides of the Atlantic Ocean and in the eastern Pacific. They are most abundant in the Caribbean Sea, the Gulf of Mexico, Florida coastal waters, and along the coasts of Central and South America. Their distribution overlaps significantly with coral reef systems, where they serve as important mesopredators.
Research on reef-associated sharks has demonstrated that nurse sharks exhibit high site restriction, fidelity, and residency on coral reefs. A study of reef sharks around Saba in the Dutch Caribbean found that nurse shark presence, measured at 0.20 plus or minus 0.45 maxN per hour using stereo-baited remote underwater video systems, was relatively high compared to other Caribbean coral reef systems. The same study documented high residence and fidelity for Caribbean reef sharks, especially immature individuals, and noted an increase in citizen science observations of both species between 2012 and 2020.
Nurse sharks show species-specific depth and habitat preferences. Citizen science data from the Cayman Islands Sharklogger Network, which involved 69 participants conducting 24,442 dives across 472 dive sites, recorded 4,666 shark sightings from eight species. Caribbean reef sharks and nurse sharks were the most frequently observed species, with both showing species-specific depth and habitat preferences. The study also confirmed that some individual nurse sharks have relatively small home ranges and high site fidelity to specific areas.
The benthic lifestyle of nurse sharks distinguishes them from more active pelagic species. Their habitat selection reflects their feeding ecology, which relies on bottom-dwelling prey and shelter in reef crevices and ledges during daylight hours.
Behavioral Ecology and Daily Activity Patterns
Nurse sharks are primarily nocturnal foragers that rest during daylight hours, often in groups or solitary positions under ledges, in caves, or on sandy bottoms. Their daily activity patterns reflect an energy conservation strategy consistent with their relatively low metabolic demands compared to more active shark species.
Research on energy metabolism in four free-ranging shark species found that plasma triglycerides were highest in less active species, including nurse and tiger sharks, while free fatty acids were highest among species with relatively high energetic demands, such as blacktip and bull sharks. This metabolic profile supports the observation that nurse sharks employ a low-energy foraging strategy that does not require sustained high-speed swimming.
Accelerometry studies have provided laboratory calibrations between activity, measured as overall dynamic body acceleration, and metabolic rate for nurse sharks, lemon sharks, and blacktip sharks. The optimal predictive model for nurse and lemon sharks used overall dynamic body acceleration in combination with activity state and temperature to predict metabolic rate. This research lays groundwork for calculating metabolic rates of these species in the wild using acceleration data, which has implications for understanding habitat requirements and energy budgets.
Nurse sharks exhibit seasonal and reproductive-related changes in physiology. A study of male nurse sharks and blacktip sharks found higher relative corticosteroid levels in adult nurse sharks during the pre-mating period and higher levels of the ketone body beta-hydroxybutyrate during the mating period. Both species showed reduced percentages of essential fatty acids during mating, suggesting that they rely on physiologically important fatty acids during this period to support spermatogenesis. These findings indicate that nurse sharks undergo measurable physiological adjustments associated with reproduction.
Foraging Behavior and Diet Composition
Nurse sharks are benthic mesopredators that feed primarily on invertebrates and small fishes. Their feeding morphology is adapted for suction feeding and crushing hard-shelled prey, which distinguishes them from sharks that use grasping or cutting teeth.
Stable isotope analysis of nurse sharks and sympatric species at Glovers Reef Atoll, Belize, provided insight into their trophic ecology. The study found that shark species, including nurse sharks and Caribbean reef sharks, exhibited comparatively restricted nitrogen isotope values and greater carbon isotope variation, with very little overlap with the trophic niche of southern stingrays. Mixing models suggested that bivalves and annelids are proportionally more important prey in stingray diets than crustaceans and teleosts at that location, while nurse sharks occupied a distinct trophic position.
Opportunistic camera surveys have documented discrete foraging behaviors in nurse sharks, providing direct observation of their feeding strategies in natural habitats. These observations complement stomach content and stable isotope studies by revealing behavioral details that are difficult to capture through other methods.
The trophic role of nurse sharks connects reef communities through their consumption of benthic invertebrates and small fishes. Their feeding activities may influence prey community structure, although the extent of this influence requires further research. The International Union for Conservation of Nature Red List assessments have identified data deficiencies for many reef shark species, and nurse sharks are among the species for which targeted research on trophic ecology, habitat use, and movement is needed.
Reproduction and Life History
Nurse shark reproduction follows a pattern of seasonal mating followed by a lengthy gestation period. Citizen science data from the Cayman Islands provided the first confirmation of reproductive behavior in both Caribbean reef sharks and nurse sharks taking place in summer, from May through August.
The reproductive physiology of male nurse sharks shows measurable changes across reproductive stages. Research published in Oecologia documented higher relative corticosteroid levels in adult nurse sharks during the pre-mating period and elevated beta-hydroxybutyrate during the mating period. These physiological markers suggest that male nurse sharks undergo energetic and nutritional adjustments linked to reproduction, with reduced essential fatty acids during mating potentially reflecting the demands of spermatogenesis.
Nurse sharks are viviparous, giving birth to live young after a gestation period that lasts approximately five to six months in some populations. Pups are born in shallow nursery habitats that provide shelter and food resources for juveniles. These nursery areas are critical for juvenile survival, and their protection is an important consideration for coastal management.
The life history characteristics of nurse sharks, including slow growth and late maturation, make them vulnerable to overexploitation and habitat degradation. Understanding reproductive timing and habitat requirements supports informed management decisions, particularly in areas where nurse sharks are exposed to recreational fishing and coastal development.
Interactions with Humans and Safety Considerations
Nurse sharks are generally considered docile and are popular subjects for dive tourism because they allow close approach and are not considered highly dangerous to humans. However, they are large predators with powerful jaws and should be treated with respect.
The physiological stress response of juvenile nurse sharks to catch-and-release recreational angling has been quantified in recent research. A study of 27 juvenile nurse sharks across 31 angling events found that lactate increased by 611 percent, reaching an average of 6.7 plus or minus 2.17 millimoles per liter, over a 30-minute fight. Significant relationships were identified between lactate and blood draw number, fight time, and temperature, with large effect sizes. These results suggest that juvenile nurse sharks may exhibit a greater physiological stress response when exposed to recreational angling than adults captured with other fishing methods.
This finding has practical implications for recreational anglers who target or incidentally catch nurse sharks. The stress response is influenced by fight time and water temperature, meaning that longer fights and warmer water temperatures are associated with greater physiological disturbance. Anglers should minimize fight time, handle sharks carefully, and release them promptly to reduce sub-lethal effects.
Boat activity also affects nurse shark behavior in urbanized coastal waterways. Research in Biscayne Bay, Florida, found that hourly presence of nurse sharks decreased with increasing boat traffic, a relationship not seen in bull sharks or great hammerhead sharks in the same study area. The researchers suggested that habituation to chronic boat activity and interspecific differences in hearing sensitivity may explain these results. Coastal managers and boat operators should be aware that high-traffic areas may displace nurse sharks from otherwise suitable habitat.
For divers and snorkelers, the following safety practices are supported by the available evidence:
- Maintain a respectful distance from nurse sharks and avoid blocking their escape routes
- Do not attempt to touch, feed, or ride nurse sharks
- Avoid approaching nurse sharks during mating season when hormonal changes may influence behavior
- Be cautious when entering water near known nurse shark resting sites, especially at dawn and dusk when foraging activity increases
- Report unusual or aggressive behavior to local authorities instead of attempting to manage the situation independently
Conservation Status and Management Context
The conservation status of nurse sharks varies across their range, and comprehensive population assessments are limited by data deficiencies. Research on reef sharks has highlighted that nine of 29 reef-shark species are designated as data deficient in the IUCN Red List, and three-fourths of reef sharks had unknown population trends at the time of their assessment. Nurse sharks are among the species for which large taxonomic and geographic gaps in knowledge remain.
The Yarari Marine Mammal and Shark Sanctuary in the Exclusive Economic Zone of Saba represents one example of a management framework that includes nurse sharks. Baseline assessments using telemetry, stereo-baited remote underwater video systems, and citizen science have documented relatively high nurse shark presence compared to other Caribbean coral reef systems. These complementary methods provide a baseline for monitoring diversity and spatiotemporal presence of reef-associated sharks.
Citizen science programs have demonstrated value for monitoring nurse shark populations. The Sharklogger Network in the Cayman Islands used a standardized, effort-based protocol with recreational SCUBA divers to document species-specific distribution and abundance patterns. The program found greater abundance of sharks in areas with less anthropogenic activity and greater exposure to strong currents, regardless of whether the area was a marine-protected area. This finding suggests that habitat quality and human disturbance, instead of protection status alone, influence nurse shark distribution.
Marine-protected area networks can support shark conservation, as demonstrated by the grey nurse shark management framework in eastern Australia. Between 2001 and 2009, 26 marine-protected areas were established to manage human interactions with a critically endangered population of grey nurse sharks. The network includes all 19 sites outlined in the National Recovery Plan, though five sites remain open to some forms of fishing. A case study at one historically occupied site that had been abandoned showed re-establishment of an aggregation of juvenile and sub-adult sharks, suggesting that protection of abandoned sites may assist recovery.
Common Misconceptions About Nurse Sharks
Several myths about nurse sharks persist despite evidence to the contrary. The following table addresses common misconceptions with evidence-based corrections.
| Myth | Evidence-Based Correction | Source |
|---|---|---|
| Nurse sharks are completely harmless and feel no stress from capture | Juvenile nurse sharks show a 611 percent increase in lactate over a 30-minute angling event, indicating measurable physiological stress | The physiological stress response of juvenile nurse sharks to catch-and-release recreational angling |
| Nurse sharks are aggressive and frequently attack humans | Nurse sharks are benthic mesopredators that feed on invertebrates and small fish, and their presence near humans is typically associated with resting or foraging behavior | Diet reconstruction and resource partitioning of a Caribbean marine mesopredator using stable isotope bayesian modelling |
| All nurse sharks are the same species as grey nurse sharks | Nurse sharks (Ginglymostoma cirratum) and grey nurse sharks (Carcharias taurus) are distinct species with different feeding morphologies and conservation statuses | Shearing Tooth Morphology May Allow Sharks to Access Higher Trophic Levels at Smaller Sizes |
| Nurse sharks are sedentary and do not move between habitats | Nurse sharks exhibit site fidelity and residency patterns, but their presence varies with boat traffic and they show seasonal reproductive movements | Space use patterns of sharks in relation to boat activity in an urbanized coastal waterway |
| Nurse shark populations are stable and require no management attention | Many reef shark species, including nurse sharks, have unknown population trends and are designated as data deficient in IUCN assessments | Reef sharks: recent advances in ecological understanding to inform conservation |
Research Methods and Knowledge Gaps
The scientific understanding of nurse shark ecology has advanced through multiple complementary research methods. Each method has specific strengths and limitations that affect the interpretation of results.
Acoustic telemetry has provided detailed information on nurse shark movement patterns and habitat use. Studies in Biscayne Bay and the Dutch Caribbean have documented residency patterns and responses to environmental factors such as boat traffic. Telemetry data are limited by the number of tagged individuals, the spatial coverage of receiver arrays, and the assumption that tagged individuals represent the broader population.
Stereo-baited remote underwater video systems offer a non-invasive method for assessing shark presence and abundance. The Saba study used this approach to document nurse shark presence at 0.20 plus or minus 0.45 maxN per hour, providing a baseline for future monitoring. This method captures only a snapshot of shark presence at bait stations and may not fully represent natural behavior.
Citizen science programs can generate large datasets at relatively low cost. The Sharklogger Network documented 4,666 shark sightings across 24,442 dives over two years, providing evidence for species-specific distribution patterns and reproductive behavior. Citizen science data depend on participant skill and consistency, requiring standardized protocols and quality control measures.
Stable isotope analysis provides insight into trophic ecology and resource partitioning. The Glovers Reef study used nitrogen and carbon isotopes to model diet composition and compare trophic niches among sympatric species. This method reflects diet over longer time scales than stomach content analysis but requires assumptions about diet-tissue discrimination factors.
Physiological sampling through non-lethal biopsy has enabled assessment of energy metabolism and stress responses. Studies measuring plasma triglycerides, free fatty acids, cholesterol, lactate, and ketone bodies have documented species-specific metabolic profiles and responses to environmental and reproductive conditions. These methods require careful handling to minimize sampling effects on the measured parameters.
Despite these advances, significant knowledge gaps remain. Research effort has focused on only a few reef shark species, including nurse sharks, in only a few locales. Large taxonomic and geographic gaps in reef shark knowledge persist, and a substantial portion of reef shark biodiversity remains uncharacterized. Future research should integrate abundance, life history, trophic ecology, genetics, habitat use, and movement studies, and expand the breadth of research to understudied species and localities.
Practical Assessment and Observation Guidelines
For researchers, fisheries observers, and dive operators who encounter nurse sharks, standardized observation protocols improve data quality and support conservation management. The following guidelines are based on methods used in published studies.
When recording nurse shark observations, document the following information:
- Date, time, and location with GPS coordinates
- Water depth and temperature
- Habitat type, including reef structure, substrate composition, and presence of ledges or crevices
- Number of individuals and estimated sizes
- Behavior, including resting, swimming, foraging, or mating activity
- Presence of tags, scars, or other identifying features
- Boat traffic and other anthropogenic activity in the area
For dive operators and citizen science programs, standardized effort-based protocols improve data comparability. The Sharklogger Network used a closely-guided protocol in which participants recorded shark sightings during routine dives, with effort measured by dive count and duration. This approach enabled calculation of encounter rates and detection of temporal patterns.
Photographic identification of individual nurse sharks can support population monitoring. The Cayman Islands study recorded recognizable individuals and showed that some individuals have relatively small home ranges and high site fidelity. Photographs should capture distinctive markings, fin shapes, and scar patterns from multiple angles to support individual recognition.
When assessing potential human-shark interactions, distinguish between observation and intervention. Most nurse shark encounters require no action beyond maintaining respectful distance. Professional escalation is appropriate when sharks show signs of distress, entanglement in fishing gear, or unusual behavior that may indicate injury or disease. In such cases, contact local fisheries or wildlife authorities with detailed observations instead of attempting intervention.
Limitations of Current Knowledge
The available evidence on nurse sharks has several limitations that affect the confidence of management recommendations.
First, most research has been conducted in a limited number of locations, primarily the Caribbean, Florida, and the Bahamas. Nurse shark populations in other parts of their range, including the eastern Pacific and western Atlantic, remain understudied. Population status and threats may vary across these regions.
Second, the physiological studies of stress responses have focused on juvenile nurse sharks captured by recreational angling. Adult nurse sharks captured with commercial or scientific fishing methods may show different responses, and the long-term consequences of sub-lethal stress are not fully understood.
Third, the relationship between boat traffic and nurse shark behavior was documented in a single urbanized waterway with high levels of chronic boating activity. The researchers noted that habituation to boat activity may explain the mixed results, and different patterns may occur in areas with lower or more variable boat traffic.
Fourth, the trophic ecology studies relied on stable isotope analysis with assumptions about diet-tissue discrimination factors. Direct observation of foraging behavior through camera surveys is limited to specific locations and conditions, and the full range of nurse shark prey selection remains incompletely characterized.
Fifth, the conservation status of nurse sharks is uncertain because of data deficiencies in population assessments. The IUCN Red List designation for many reef shark species is data deficient, and nurse shark population trends are unknown in most parts of their range.
These limitations do not invalidate the available evidence but indicate that management decisions should incorporate precautionary principles and adaptive monitoring.
Safety and Regulatory Context
Nurse shark interactions are subject to varying regulatory frameworks depending on jurisdiction. Fisheries regulations may govern catch limits, gear restrictions, and handling requirements for species that are incidentally captured. Marine-protected areas may restrict fishing or diving activities in nurse shark habitats. Wildlife viewing regulations may establish minimum approach distances or prohibit feeding.
The grey nurse shark management framework in eastern Australia illustrates the complexity of cross-jurisdictional shark conservation. The critically endangered eastern Australian population is managed across six marine-protected area systems spanning New South Wales, Queensland, and Commonwealth waters. Seven and eight rule permutations for diving and fishing, respectively, apply to this population. This complexity highlights the importance of understanding local regulations before engaging in activities that may affect protected shark species.
For recreational anglers who incidentally capture nurse sharks, the physiological stress research supports specific handling recommendations. Minimize fight time by using appropriate tackle, keep sharks in the water during hook removal, and release sharks promptly. Avoid targeting nurse sharks during warm water periods when metabolic stress is amplified. These practices reduce sub-lethal effects and support conservation objectives.
For dive operators, the evidence on nurse shark site fidelity and habitat preferences supports the value of maintaining consistent dive sites instead of concentrating activity in small areas. The re-establishment of a grey nurse shark aggregation at a previously abandoned site following protection suggests that reducing disturbance can support population recovery.
Frequently Asked Questions
Are nurse sharks dangerous to humans?
Nurse sharks are generally docile and are not considered highly dangerous to humans. They are benthic mesopredators that feed primarily on invertebrates and small fishes, and their presence near humans is typically associated with resting or foraging behavior. However, they are large predators with powerful jaws and should be treated with respect. Maintain a respectful distance and avoid touching or feeding them.
What do nurse sharks eat?
Nurse sharks feed primarily on benthic invertebrates and small fishes. Stable isotope analysis at Glovers Reef Atoll, Belize, showed that nurse sharks occupy a distinct trophic position compared to sympatric stingrays and Caribbean reef sharks. Their feeding morphology is adapted for suction feeding and crushing hard-shelled prey, and camera surveys have documented discrete foraging behaviors in natural habitats.
Where do nurse sharks live?
Nurse sharks inhabit warm temperate and tropical coastal waters in the Atlantic and eastern Pacific Oceans. They are most abundant in the Caribbean Sea, the Gulf of Mexico, and Florida coastal waters. They show high site restriction, fidelity, and residency on coral reefs, with small home ranges and high site fidelity to specific areas documented through citizen science monitoring in the Cayman Islands.
Do nurse sharks feel stress from catch-and-release fishing?
Yes. Research on juvenile nurse sharks found that lactate increased by 611 percent over a 30-minute angling event, reaching an average of 6.7 plus or minus 2.17 millimoles per liter. Significant relationships were identified between lactate and blood draw number, fight time, and temperature. These results suggest that juvenile nurse sharks may exhibit a greater physiological stress response to recreational angling than adults captured with other fishing methods.
How do nurse sharks reproduce?
Nurse sharks are viviparous, giving birth to live young. Citizen science data from the Cayman Islands provided the first confirmation of reproductive behavior in nurse sharks taking place in summer, from May through August. Male nurse sharks show measurable physiological changes across reproductive stages, including higher corticosteroid levels during the pre-mating period and elevated beta-hydroxybutyrate during mating.
Are nurse sharks the same as grey nurse sharks?
No. Nurse sharks (Ginglymostoma cirratum) and grey nurse sharks (Carcharias taurus) are distinct species with different feeding morphologies, ecological roles, and conservation statuses. Grey nurse sharks use spear-shaped grasping teeth to capture prey, while nurse sharks have crushing and suction-based feeding adaptations. The grey nurse shark has a critically endangered eastern Australian population managed through a network of marine-protected areas.
How does boat traffic affect nurse sharks?
Research in Biscayne Bay, Florida, found that hourly presence of nurse sharks decreased with increasing boat traffic, a relationship not seen in bull sharks or great hammerhead sharks in the same study area. The researchers suggested that habituation to chronic boat activity and interspecific differences in hearing sensitivity may explain these results.
What should I do if I encounter a nurse shark while diving?
Maintain a respectful distance and avoid blocking the shark's escape route. Do not attempt to touch, feed, or ride nurse sharks. Be cautious when entering water near known nurse shark resting sites, especially at dawn and dusk when foraging activity increases. Report unusual or aggressive behavior to local authorities instead of attempting to manage the situation independently.
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References and Further Reading
- NCBI Literature Resources. National Center for Biotechnology Information.
- PubMed. National Library of Medicine.
- Reef sharks: recent advances in ecological understanding to inform conservation.. Journal of fish biology, 2015.
- Physiological markers suggest energetic and nutritional adjustments in male sharks linked to reproduction.. Oecologia, 2021.
- An integrated baseline assessment of reef-associated sharks around Saba (Dutch Caribbean), combining three methods: stereo-BRUVs, telemetry and citizen science.. Royal Society open science, 2025.
- Shearing Tooth Morphology May Allow Sharks to Access Higher Trophic Levels at Smaller Sizes.. Ecology and evolution, 2025.
- Space use patterns of sharks in relation to boat activity in an urbanized coastal waterway.. Marine environmental research, 2021.
- Energy metabolism in mobile, wild-sampled sharks inferred by plasma lipids.. Conservation physiology, 2017.
- Correlations of metabolic rate and body acceleration in three species of coastal sharks under contrasting temperature regimes.. The Journal of experimental biology, 2017.
- Diet reconstruction and resource partitioning of a Caribbean marine mesopredator using stable isotope bayesian modelling.. PloS one, 2013.
- Ontogenetic shifts in morphology and ecology of eastern Pacific white sharks revealed by computer vision.. 2026.
- Assessing the soundscapes of the critically endangered grey nurse shark (Carcharias taurus) in rocky reef habitats.. 2025.
- Telemetry reveals potential mating aggregation behavior of tiger sharks (Galeocerdo cuvier) in Hawai'i.. 2025.
- The Sharklogger Network-monitoring Cayman Islands shark populations through an innovative citizen science program.. 2025.
- The physiological stress response of juvenile nurse sharks (Ginglymostoma cirratum) to catch-and-release recreational angling.. 2025.
- Conservation of the Critically Endangered Eastern Australian Population of the Grey Nurse Shark (Carcharias taurus) Through Cross-Jurisdictional Management of a Network of Marine-Protected Areas. Environmental Management, 2013.
- Grey Nurse Shark (Carcharias taurus) Diving Tourism: Tourist Compliance and Shark Behaviour at Fish Rock, Australia. Environmental Management, 2010.
- Species Misidentification in Drone-Based Shark Surveillance and Implications for Beach Management. Remote Sensing, 2026.
- A comparison of secretory component - immunoglobulin interactions amongst different species.. Advances in Experimental Medicine and Biology, 1978.
- Moving towards sustainable whale shark-human interactions: A case study in Bahía de La Paz, Baja California Sur, Mexico. Marine Policy, 2025.
- Opportunistic camera surveys provide insight into discrete foraging behaviours in nurse sharks (Ginglymostoma cirratum). Environmental Biology of Fishes, 2023.
- A float-release package for recovering data-loggers from wild sharks. Journal of Experimental Marine Biology and Ecology, 2016.
This article is educational and does not replace institutional policy, professional advice, or applicable safety and regulatory requirements.