Managing risks to drivers in road transport

This report presents a number of case studies in managing risks to road transport drivers. The cases feature a variety of initiatives and interventions to protect drivers.In the road transport sector, as with any other, it is important to pay attention to working conditions in order to ensure a skilled and motivated workforce. Certain characteristics of the sector make it more difficult to practice risk management than in other sectors. But by taking account of how the sector operates in practice, and the characteristics of drivers themselves and the way they work, risks can be successfully manage

New risks and trends in the safety and health of women at work

In 2009 and 2010, the Agency commissioned an update to its previous research on gender issues at work (EU-OSHA, 2003), which found that inequality both within and outside the workplace can have an effect on the health and safety of women at work. This report provides that update and the first figures on the effects of the recent economic downturn on women at work. It aims to fulfil the task outlined by the European strategy on health and safety at work (EC, 2002) for EU-OSHA’s European Risk Observatory: ‘examining the specific challenges in terms of health and safety posed by the more extensive integration of women in the labour market’. Gender inequalities in the workplace and work–life balance issues have become increasingly important as the employment rates of women have continued to grow in all Member States. Although in 2012 58.6 % of working age women (in the EU-27) were in employment and women filled 59 % of all newly created jobs in 2009(1 ), the extent to which women contribute economically still seems to be underestimated. At its start, women were affected less than men by the recent economic crisis, as the first jobs to be lost were mostly in the male-dominated construction and manufacturing industries. However, between 2008 and 2012, European gender differences in employment fell by an average of 7.6 to 6.3 percentage points, mainly because male employment rates fell more than those of women, which have returned to the 2007 level. A modern organisation of work, a knowledge economy, competitiveness and more and better jobs are central to the post-2010 Lisbon Strategy and the EU’s 2020 Strategy. Women are essential to the workforce in terms of providing an active and sustainable source of labour, and in June 2010 the European Council set a new, ambitious target aiming to raise the employment rate for women and men aged 20–64 to 75 % by 2020, partly through the greater participation of young people, older workers and low-skilled workers and the better integration of legal migrants. However, although employment rates for women are rising, much remains to be done, especially for older and younger women, to reach this goal and at the same time ensure decent work for all. The issue of occupational safety and health (OSH) for women who work in the European Union (EU) is central to an understanding of the working environment. Previous research has shown that women’s OSH has to be improved. Research from the European Commission illustrates that, even by 1995, women accounted for close to or above half of all cases of work-associated ill health, including allergies (45 %), infectious illnesses (61 %), neurological complaints (55 %) and hepatic and dermatological complaints (48 %). The situation has not improved. Further, for ‘women’s jobs’, such as those in the health and social services, retail and hospitality sectors, there is a stagnation in accident rates in some countries; women are more likely to be bullied and harassed, subjected to sexual harassment and have to use poorly fitting personal protective equipment that is not usually sized for a smaller frame. The aims of this review are to: Provide a statistical overview of the trends in employment and integration of women in the labour market, and explore how they impact on their occupational safety and health. Identify and highlight the main issues and trends in employment characteristics, working conditions, hazard exposure and work-related accidents and health problems for women at work and explore more in-depth selected issues not addressed thoroughly before, such as combined exposures, informal work and the rehabilitation of women into work. Identify emerging issues for OSH research and the prevention of occupational diseases and accidents affecting women at work. This focus on OSH benefits not only women but also men who work, and thus reinforces the considerable potential to be gained by improved workplaces. A summary of the findings and trends and a more detailed list of suggestions is included in every chapter of this report and in the conclusions

A CD8+ T cell transcription signature predicts prognosis in autoimmune disease.

Autoimmune diseases are common and debilitating, but their severe manifestations could be reduced if biomarkers were available to allow individual tailoring of potentially toxic immunosuppressive therapy. Gene expression-based biomarkers facilitating such tailoring of chemotherapy in cancer, but not autoimmunity, have been identified and translated into clinical practice. We show that transcriptional profiling of purified CD8(+) T cells, which avoids the confounding influences of unseparated cells, identifies two distinct subject subgroups predicting long-term prognosis in two autoimmune diseases, antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), a chronic, severe disease characterized by inflammation of medium-sized and small blood vessels, and systemic lupus erythematosus (SLE), characterized by autoantibodies, immune complex deposition and diverse clinical manifestations ranging from glomerulonephritis to neurological dysfunction. We show that the subset of genes defining the poor prognostic group is enriched for genes involved in the interleukin-7 receptor (IL-7R) pathway and T cell receptor (TCR) signaling and those expressed by memory T cells. Furthermore, the poor prognostic group is associated with an expanded CD8(+) T cell memory population. These subgroups, which are also found in the normal population and can be identified by measuring expression of only three genes, raise the prospect of individualized therapy and suggest new potential therapeutic targets in autoimmunity

The potential utility of B cell-directed biologic therapy in autoimmune diseases

Increasing awareness of the importance of aberrant B cell regulation in autoimmunity has driven the clinical development of novel B cell-directed biologic therapies with the potential to treat a range of autoimmune disorders. The first of these drugs—rituximab, a chimeric monoclonal antibody against the B cell-specific surface marker CD20—was recently approved for treating rheumatoid arthritis in patients with an inadequate response to other biologic therapies. The aim of this review is to discuss the potential use of rituximab in the management of other autoimmune disorders. Results from early phase clinical trials indicate that rituximab may provide clinical benefit in systemic lupus erythematosus, Sjögren’s syndrome, vasculitis, and thrombocytopenic purpura. Numerous case reports and several small pilot studies have also been published reporting the use of rituximab in conditions such as myositis, antiphospholipid syndrome, Still’s disease, and multiple sclerosis. In general, the results from these preliminary studies encourage further testing of rituximab therapy in formalized clinical trials. Based on results published to date, it is concluded that rituximab, together with other B cell-directed therapies currently under clinical development, is likely to provide an important new treatment option for a number of these difficult-to-treat autoimmune disorders

The business case for safety and health at work : cost-benefit analyses of interventions in small and medium-sized enterprises

This report examines the economic aspects of occupational safety and health (OSH) interventions in small and medium-sized businesses (SMEs). First, case studies in the existing literature were identified and examined. Second, 13 new case studies on OSH initiatives in European SMEs were developed, with a business case for each intervention prepared according to a common model. The OSH interventions studied were generally profitable, and these new case studies therefore provide a useful tool to allow owners and managers of SMEs an insight into the potential benefits of improving OSH and the key factors involved in carrying out a cost–benefit analysis

Prospective monitoring of BK virus replication in renal transplant recipients

Background. BK virus-associated nephropathy (BKVAN) can be diagnosed only with renal graft biopsy. Definitive diagnosis of BKVAN requires demonstration of BK virus (BKV) replication in renal allograft tissues. Non-invasive analysis of urine and blood is considered essential in screening renal transplant recipients. Patients and methods. This study evaluated prospectively the replication of BKV in plasma and urine with qualitative and quantitative real-time polymerase chain reaction in 32 de novo (group A) and 34 chronic (group B) renal transplant recipients and the long-term impact on graft function. Results. In group A, 456 samples (228 plasma, 228 urine) were examined and BKV was detected in 31 (31/228, 14%) samples of plasma and 57 (57/228, 25%) samples of urine in 20 (20/32, 62.5%) and 23 (23/32, 72%) recipients, respectively. Incidence of viremia and viruria increased during the first 6 months presenting a peak the third postoperative month (viremia: 28% and viruria: 31%). Immune suppressive treatment with tacrolimus showed significant relation with viremia. Renal graft function in de novo renal transplant recipients remained stable throughout the follow-up period without influence of BKV replication. In group B, incidence of viremia and viruria were 3% (1/34) and 9% (3/34) correspondingly, indicating that after the first post-transplant year the risk of BKV re-activation is diminished. Conclusion. The highest incidence of BK viremia and viruria is observed the third post-transplantation month, confirming previously published studies in Europe and the United States, and long-term follow up shows that BKV replication decreases significantly after the third post-transplant month and even transient viremia or viruria does not have an impact on renal function. © 2008 Wiley Periodicals, Inc