Grantee Research Project Results
Final Report: Revision Application to Support Environmental Health Disparities Research
EPA Grant Number: NIMHD010Title: Revision Application to Support Environmental Health Disparities Research
Investigators: Provencio-Vasquez, Elias , Olvera, Hector , Grineski, Sara , Collins, Timothy
Institution: The University of Texas at El Paso , The University of Texas Health Science Center at San Antonio
EPA Project Officer: Hahn, Intaek
Project Period: August 1, 2011 through July 31, 2014
Project Amount: $752,795
RFA: Transdisciplinary Networks of Excellence on the Environment and Health Disparities (2012) RFA Text | Recipients Lists
Research Category: Environmental Justice , Human Health
Objective:
This Revision award expanded the scope of the existing Hispanic Health Disparities Research Center (HHDRC) by integrating a new thematic Core focused on Environment. The Environment Core was nested within the core structure and the broader aims of the HHDRC, and advanced innovative research and practice in environmental health.
The vision for the Environment Core (EC) was to: (1) advance knowledge of interrelationships between environmental and social determinants of health disparities, particularly within heterogeneous Hispanic populations, through a commitment to transdisciplinary research; and (2) utilize this knowledge to influence policy change, public health practice and community-based interventions to reduce disparities. The vision of the Environment Core was operationalized through the following three Specific Aims that explicitly linked this core with the overall specific aims and ongoing activities of the HHDRC:
EC Specific Aim 1: Conduct research to evaluate complex interactions between social, built and natural environmental systems, while clarifying which aspects of Mexican-origin/Hispanic status are most important, as determinants of environmental health disparities
EC Specific Aim 2: Build research and training capacities to examine and address environmental health disparities
EC Specific Aim 3: Facilitate the translation of environmental health disparities research into policy, public health practice, and community-based engagement
Summary/Accomplishments (Outputs/Outcomes):
Specific Aim 1 was addressed over the funding period through two trans-disciplinary studies. Trans-disciplinary Study 1 was an analysis of social and environmental determinants of children’s lung health. Trans-disciplinary Study 2 examined the role of Hispanic ethnicity in sensitivity to daily changes in air pollution and how Hispanic ethnicity interacted with insurance status to influence respiratory and cardiovascular hospitalizations due to increases in daily air pollution.
Completed Work on Trans-disciplinary Study #1: Data Collection
Survey and protocol were IRB approved by UTEP’s IRB (initial materials submitted December 12, 2011; final approval was granted on February 14, 2012).
- Data collection for the El Paso Independent School District (EPISD) children’s health survey was completed and data were ready to use as of October 2012.
- May 2012: The data were collected from parents/guardians of 4th and 5th graders in EPISD through four waves of mailings. These included the survey, followed by a reminder postcard, a second copy of the survey, and then a second reminder postcard, each one week apart. EC students and faculty assembled packets by hand, and managed the data collection
- June 2012: 1904 surveys were completed (for a 30% response rate); 1389 were received after the first wave, and 515 after the second wave.
- July–September 2012: All surveys were processed, logged, and scanned. Project Research Assistants (RAs) manually enter open-ended responses to survey questions that could not be entered using the scanner. Raw data were quality assured.
- Air pollution monitoring was completed by December 2012, and pollution surface was ready to analyze by June 2013.
- Four seasons for PM2.5 monitoring were completed: May 2012 (Spring), July 2012 (Summer), October 2012 (Fall), and December 2012 (Winter).
- May 2013: The land use regression-based model was finalized.
- June 2013: PM2.5 surface was integrated with survey data in a geo-database and values were assigned to each child’s home address.
Completed Work on Trans-disciplinary Study #2: Data Collection
- Combined secondary data from three different sources into a daily dataset for all dates between January 1, 2005 and December 31, 2011.
- May 2012: Daily air quality and weather data were assembled for the 2005–2011 study period.
- September 2012: Received Texas Department of Health Services IRB approval to purchase needed hospitalization data set and then a secondary data exemption was awarded from UTEP, allowing the study to commence.
- Completed model building and analysis phase of the project for asthma, before beginning similar process for COPD and congestive heart failure
Specific Aim 2 was addressed through the cultivation of trans-disciplinary research and training capacity among students and faculty at UTEP/UHSPH. To these ends, the EC supported numerous undergraduate and graduate student RAs, developed an Environmental Health Research Lab (EHRL), funded three pilot grants, and was involved in the submission of an NIH U54 Building Infrastructure Leading to Diversity (BUILD) program to train future generations of biomedical scientists.
- Seven graduate research assistants (GRAs) have utilized (or currently are utilizing) data from Environment Core-funded research in their graduate thesis (master’s thesis or doctoral dissertation).
- Guadalupe Marquez-Velarde. MA in Sociology. Graduated: May 2013.
- Paola Chavez-Payan. MA in Sociology. Graduated: December 2013.
- Young-an Kim. MA in Sociology. Graduated: May 2013.
- Juana Maribel Herrera. MS in Math. Graduated: July 2013.
- Oscar Morales. MA In Sociology. Expected Graduation: December 2014.
- Stephanie Clark-Reyna. MA in Sociology. Expected Graduation: May 2015.
- Monica Sianez. Dr. of Public Health. Expected Gradation: May 2015.
- We have supported 23 student RAs (all from racial/ethnic minority backgrounds), who have been quite successful in their current and future endeavors (see the table below).
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Students Supported
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Level (Dept)
|
Graduated
|
Current status, if graduated
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1.
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Marie Gaines
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BA (SOCI)
|
Yes
|
Enrolled in Master of Social Work Program
|
2.
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Stephanie Clark-Reyna
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BA (SOCI)
|
Yes
|
Enrolled in Sociology MA Program
|
3.
|
Anthony Jimenez
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MA (SOCI)
|
Yes
|
Enrolled in Sociology PhD Program; earned Ford Fellowship
|
4.
|
Paola Chavez-Payan
|
MA (SOCI)
|
Yes
|
Enrolled in Health Sciences PhD Program
|
5.
|
Juana Maribel Herrera
|
MS (MATH)
|
Yes
|
Works as statistician
|
6.
|
Young-An Kim
|
MA (SOCI)
|
Yes
|
Enrolled in Criminology PhD Program; won best MA thesis at UTEP award
|
7.
|
Mario Lopez
|
BS (ENG)
|
Yes
|
Enrolled in Environmental Engineering MS Program
|
8.
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Omar Jimenez
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BS (ENG)
|
Yes
|
Works with construction company
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9.
|
Oscar Morales
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MA (SOCI)
|
Not yet
|
Enrolled in Sociology PhD Program
|
10.
|
Guadalupe Marquez
|
MA (SOCI)
|
Yes
|
Enrolled in Sociology PhD Program
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11.
|
Gabriel De Haro
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BS (ENG)
|
Yes
|
Has applied to graduate school
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12.
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Ismael Beltran
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BS (ENG)
|
Yes
|
Works at Texas Commission on Environmental Quality
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13.
|
Monica Sianez
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DPH
|
Not yet
|
N/A
|
14.
|
Alexander Balcazar
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BA (SOCI)
|
Not yet
|
N/A
|
15.
|
Stephanie Clark-Reyna
|
MA (SOCI)
|
Not yet
|
N/A
|
16.
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Lucia Noe
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BS (ENG)
|
Not yet
|
N/A
|
17.
|
Alejandro Franco
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BS (ENG)
|
Not yet
|
N/A
|
18.
|
Mosi Dane’el
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PhD (PSYCH)
|
Not yet
|
NA
|
19.
|
Nancy Ortega
|
MA (SOCI)
|
Not yet
|
NA
|
20.
|
Susana Diaz
|
BA (SOCI)
|
Not yet
|
NA
|
21.
|
Julia Sosa
|
BA (SOCI)
|
Not yet
|
NA
|
22.
|
Marisol Salado
|
BS (ENG)
|
Not yet
|
NA
|
23.
|
Kamie Garcia
|
DPH
|
Not yet
|
NA
|
|
|
|
|
|
Note: SOCI=Sociology; ENG=Engineering; PSYCH=Psychology; DPH=Doctorate in Public Health; MATH=Mathematical Sciences and Statistics
- Funds were used to establish an Environmental Health Research Lab (EHRL) at UTEP. The lab has a physical space in UTEP’s Burges Hall Room 106 to house the air quality monitoring infrastructure and to create a space for collaboration on environmental health projects. The EHRL is directed by Dr. Hector Olvera. During the funding period, the EHRL has contributed to various new research lines funded by NIH that include an R01 study to assess early atherogenesis in children exposed to traffic-related air pollution. The EHRL also is spearheading a series of studies to assess the impact of PM2.5 and ultrafine particle exposure on endothelial function in a low-income population. The EHRL currently is supporting a proposed expansion of the HHDRC via a Pilot Project that will investigate potential synergistic effects of exposure to social (chronic stress) and environmental factors (PM2.5 exposure). During the funding period, the EHRL has grown in capacity. Olvera has received close to $350,000 in air quality monitoring equipment for the EHRL through NIH-funded grants and support from UTEP’s School of Nursing and Center for Environmental Resource Management. The EHRL is adding a control exposure facility on campus and near Interstate-10 to further advance environmental health disparities research.
- The EC funded three faculty pilot research awards.
- Community-based Participatory Research: Health Outcomes in Westway, Colonia
- PI: Kathleen Staudt, Professor of Political Science, UTEP
- Surveyed 100 Westway residents about their environmental concerns, civic engagement, health care access and health problems. The work resulted in two articles and two conference presentations (to date).
- Health Disparities of Latino Immigrant Workers in Post-Katrina New Orleans
- PI: Aurelia Lorena Murga, Assistant Professor of Sociology, UTEP
- Completed 30 interviews with day laborers in New Orleans about their physical and mental health, health care access, and workplace hazards. Results suggest that mental health is a critical concern, as is access to health care.
- Assessment of Water Sanitation in the Colonias of El Paso County
- PI: Roberto Rodriguez, Assistant Professor, UT Houston School of Public Health
- Tested water quality at colonias without sanitary infrastructure and those in the process of getting infrastructure. Results suggest that, among colonia residents that rely on hauled water, poor storage conditions play a more important role in reducing water quality than does the source of the water.
- Building from the EC’s success in student research mentoring, Environment Core faculty (Grineski and Collins) were involved as PIs on a planning grant (awarded) and full proposal submission (pending) for an NIH U54 Building Infrastructure Leading to Diversity (BUILD) grant ($24 million over 5 years). The grant aims to develop an innovative center called BUILDing SCHOLARS (Building Infrastructure Leading to Diversity: Southwest Consortium of Health-Oriented education Leaders and Research Scholars). The goal is to implement a suite of programs and activities that will train the next generation of biomedical researchers from U.S. Southwest underrepresented groups through a multi-institution consortium to include Texas, New Mexico and Arizona, as well as several key extra-regional sites. Once it is fully ramped up in fall 2018, the center will support 135 undergraduate students on full scholarships. Environmental Health is one of the research nodes that will link students across disciplines and universities.
Specific Aim 3 will generally orient the EC’s outreach activities into the future. The primary activities related to this aim were the identification of needs of stakeholders, dissemination of findings, and the building of an environmental health disparities “community of practice” on the US-Mexico Border.
- We hosted a stakeholder meeting for local professionals representing state and local agencies and private organizations concerned with environmental health in the Paso del Norte Region on December 11, 2013. Grineski, Collins and Balcazar presented results from the EPISD survey. Then, we asked them to complete a survey about issues and research and information needs plus we had some group discussion about these. There were 27 participants. Key environmental issues centered around solid waste management, air quality, and water quality and access. Key health issues center around substance abuse, lack of access to health care, mental health, and obesity. Participants identified UTEP student engagement as a significant opportunity for both students and communities. Students could provide community assistance through internships or as volunteers. When asked what UTEP can provide or do, an important response was to involve communities more. This points to the need for community-based participatory research methodologies in future projects.
- Environment Core also co-sponsored an Environmental Health Disparities on the US-Mexico Border Conference in May 2014. The conference brought together local academics from El Paso, Las Cruces and Cd. Juarez, community stakeholders and service providers, national experts in environmental health disparities and environmental justice, and representatives from national funding agencies over the course of 2 days.
Conclusions:
- El Paso children have high rates of asthma (17%) and allergies (51%). In terms of social disparities, children that are male, not poor, obese, Hispanic, born in El Paso, have a U.S.-born caretaker, and have a caretaker who has lower level Spanish proficiency have increased odds of respiratory problems. Among children with asthma and wheezing, disparities exist in access to care; those that are poor, with a Spanish-speaking caretaker, or with a foreign-born caretaker had increased odds of seeking care in urgent care centers, emergency rooms and hospitals.
- Higher neighborhood immigrant density is associated with reduced odds of wheezing, but that the protective immigrant enclave effect is modified by poverty, general health status, body mass index (BMI), and caretaker nativity. Higher immigrant density is significantly more protective for poor children and for children of foreign-born caretakers; conversely, it is significantly less protective for children in worse health and for children with higher BMI. These findings foster a novel understanding of how immigrant enclaves may be differentially protective for Hispanic children based on individual-level factors.
- Acculturation was a significant positive predictor of asthma. The addition of interaction terms revealed that prenatal smoking, low birth weight, breastfeeding, and pest exposure significantly modified the effect of acculturation on asthma. Results suggest that while higher levels of acculturation were detrimental overall, the effects were not equally damaging for all Hispanic children. Findings foster an understanding of how the effect of acculturation on Hispanic children’s asthma is intensified or attenuated by distinct individual-level risk factors.
- We found that higher immigrant generations had better access to care. The greatest disparities between consecutive generational groups occurred between first-generation non-citizens/naturalized citizens, the 2.5/third generations, and the third/fourth generations. Results reveal greater durability of access barriers than has previously been documented.
- Economic deprivation (i.e., poverty) at both neighborhood- and individual-levels is associated with reduced odds of wheezing for Hispanic children. However, the protective effect of neighborhood-level poverty is modified by individual-level poverty, general health status, and body mass index (BMI). Greater neighborhood economic deprivation is significantly more protective for poor Hispanic children; conversely, it is significantly less protective for Hispanic children in worse health and those with higher BMI. These findings foster a novel, multilevel understanding of seemingly paradoxical effects of economic deprivation on Hispanic health, including how economic deprivation may be differentially protective for Hispanic children based on individual-level factors.
- The impacts of PM on children’s wheezing are not uniform throughout El Paso; PM has greater impacts on wheezing on the wealthier west side and poorer central side of town. Other risk factors are intensified in the presence of PM.
- Higher levels of acculturation increase the odds of respiratory health problems for children, independent of residence in an enclave, but that enclave residence is more health-harming for children with underlying risk factors, specifically having a mother with asthma, living in poverty, and being obese.
- Air toxics are a significant predictor of worse school performance (i.e., lower GPA), controlling for other relevant covariates.
- Our data suggest that temperature in particular has a significant impact not only on seasonal but also on diurnal variations of PM2.5 and thus it should be accounted for in epidemiological studies in arid regions.
- Hispanics were at lower risk than non-Hispanic whites and non-Hispanics of other races for NO2-associated admissions but at greater risk for PM2.5-associated admissions. While Hispanics were generally protected with regards to NO2, Hispanic children (vs. elderly) faced increased risk for asthma and uninsured Hispanics (vs. Private) faced increased risk for COPD admissions. While Hispanics were at increased risk of PM2.5-associated admissions, certain characteristics heightened their risks even more: being a Hispanic child (vs. Elderly) for asthma; being a Hispanic with Medicare (vs. Private) for asthma; and being a Hispanic with private insurance (vs. all other insurance types) for CHF. The direct effect of pollution on admissions was more significant for asthma and CHF than for COPD. There was heterogeneity in sensitivity to air pollution based on social characteristics and moderate evidence for a Hispanic Health Paradox in sensitivity to NO2.
Journal Articles on this Report : 16 Displayed | Download in RIS Format
Other project views: | All 40 publications | 21 publications in selected types | All 20 journal articles |
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Type | Citation | ||
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Balcazar AJ, Grineski SE, Collins TW. The Hispanic health paradox across generations: the relationship of child generational status and citizenship with health outcomes. Public Health 2015;129(6):691-697. |
NIMHD010 (Final) |
Exit Exit |
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Chavez-Payan P, Grineski SE, Collins TW. Early life and environmental risk factors modify the effect of acculturation on Hispanic children’s asthma. Hispanic Health Care International 2015;13(3):119-130. |
NIMHD010 (Final) |
Exit Exit |
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Collins TW, Jimenez AM, Grineski SE. Hispanic health disparities after a flood disaster: results of a population-based survey of individuals experiencing home site damage in El Paso (Texas, USA). Journal of Immigrant and Minority Health 2013;15(2):415-426. |
NIMHD010 (2013) NIMHD010 (Final) |
Exit Exit Exit |
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Collins TW, Kim Y-A, Grineski SE, Clark-Reyna S. Can economic deprivation protect health? Paradoxical multilevel effects of poverty on Hispanic children’s wheezing. International Journal of Environmental Research and Public Health 2014;11(8):7856-7873. |
NIMHD010 (Final) |
Exit Exit Exit |
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Grineski SE, Collins TW, Chakraborty J. Hispanic heterogeneity and environmental injustice: intra-ethnic patterns of exposure to cancer risks from traffic-related air pollution in Miami. Population and Environment 2013;35(1):26-44. |
NIMHD010 (2013) NIMHD010 (Final) |
Exit |
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Grineski SE, Collins TW, Chakraborty J, McDonald YJ. Environmental health injustice: exposure to air toxics and children's respiratory hospital admissions in El Paso, Texas. The Professional Geographer 2013;65(1):31-46. |
NIMHD010 (2013) NIMHD010 (Final) |
Exit |
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Grineski SE, Collins TW, Chavez-Payan P, Jimenez AM, Clark-Reyna S, Gaines M, Kim Y-A. Social disparities in children's respiratory health in El Paso, Texas. International Journal of Environmental Research and Public Health 2014;11(3):2941-2957. |
NIMHD010 (Final) |
Exit Exit Exit |
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Grineski SE, Hererra JM, Bulathsinhala P, Staniswalis JG. Is there a Hispanic health paradox in sensitivity to air pollution? Hospital admissions for asthma, chronic obstructive pulmonary disease and congestive heart failure associated with NO2 and PM2.5 in El Paso, TX, 2005-2010. Atmospheric Environment 2015;119:314-321. |
NIMHD010 (Final) |
Exit Exit Exit |
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Grineski SE, Collins TW, Olvera HA. Local variability in the impacts of residential particulate matter and pest exposure on children’s wheezing severity: a geographically weighted regression analysis of environmental health justice. Population and Environment 2015;37(1):22-43. |
NIMHD010 (Final) |
Exit Exit |
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Jimenez AM, Collins TW, Grineski SE. Intra-ethnic disparities in respiratory health outcomes among Hispanic residents impacted by a flood. Journal of Asthma 2013;50(5):463-471. |
NIMHD010 (2013) NIMHD010 (Final) |
Exit |
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Kim Y-A, Collins TW, Grineski SE. Neighborhood context and the Hispanic health paradox: differential effects of immigrant density on children's wheezing by poverty, nativity and medical history. Health & Place 2014;27:1-8. |
NIMHD010 (Final) |
Exit Exit |
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McDonald YJ, Grineski SE, Collins TW, Kim Y-A. A scalable climate health justice assessment model. Social Science & Medicine 2015;133:242-252. |
NIMHD010 (Final) |
Exit Exit |
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Olvera HA, Lopez M, Guerrero V, Garcia H, Li W-W. Ultrafine particle levels at an international port of entry between the US and Mexico:exposure implications for users, workers, and neighbors. Journal of Exposure Science and Environmental Epidemiology 2013;23(3):289-298. |
NIMHD010 (2013) NIMHD010 (Final) |
Exit Exit |
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Olvera HA, Jimenez O, Provencio-Vasquez E. Modeling particle number concentrations along Interstate 10 in El Paso, Texas. Atmospheric Environment 2014;98:581-590. |
NIMHD010 (Final) |
Exit Exit Exit |
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Staudt K, Marquez-Velarde G, Dane'el M. Stories, science, and power in policy change: environmental health, community-based research, and community organizing in a U.S.-Mexico border colonia. Environmental Justice 2013;6(6):191-199. |
NIMHD010 (Final) |
Exit Exit |
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Staudt K, Dane’el M, Marquez-Velarde G. In the shadow of a steel recycling plant in these neoliberal times: health disparities among Hispanics in a border colonia. Local Environment: The International Journal of Justice and Sustainability 2015;21(5):636-652. |
NIMHD010 (Final) |
Exit Exit |
Supplemental Keywords:
Hispanic health disparities, children’s asthma, Hispanic heterogeneity, air pollution, COPD, air toxicsRelevant Websites:
Laboratory for Environmental Justice Exit Exit
UTEP School of Nursing Exit Exit
Progress and Final Reports:
Original AbstractThe perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Conclusions drawn by the principal investigators have not been reviewed by the Agency.