Doing the 'dirty work of the green economy: Resource recovery and migrant labour in the EU

Europe has set out its plans to foster a ‘green economy’, focused around recycling, by 2020. This pan-European recycling economy, it is argued, will have the triple virtues of: first, stopping wastes being ‘dumped’ on poor countries; second, reusing them and thus decoupling economic prosperity from demands on global resources; and third, creating a wave of employment in recycling industries. European resource recovery is represented in academic and practitioner literatures as ‘clean and green’. Underpinned by a technical and physical materialism, it highlights the clean-up of Europe’s waste management and the high-tech character of resource recovery. Analysis shows this representation to mask the cultural and physical associations between recycling work and waste work, and thus to obscure that resource recovery is mostly ‘dirty’ work. Through an empirical analysis of three sectors of resource recovery (‘dry recyclables’, textiles and ships) in Northern member states, we show that resource recovery is a new form of dirty work, located in secondary labour markets and reliant on itinerant and migrant labour, often from accession states. We show therefore that, when wastes stay put within the EU, labour moves to process them. At the micro scale of localities and workplaces, the reluctance of local labour to work in this new sector is shown to connect with embodied knowledge of old manufacturing industries and a sense of spatial injustice. Alongside that, the positioning of migrant workers is shown to rely on stereotypical assumptions that create a hierarchy, connecting reputational qualities of labour with the stigmas of different dirty jobs – a hierarchy upon which those workers at the apex can play

Clinical efficacy of fidaxomicin compared with vancomycin and metronidazole in Clostridium difficile infections:a meta-analysis and indirect treatment comparison

To evaluate the efficacy of fidaxomicin treatment, which has a limited effect on the normal gut flora, compared with vancomycin and metronidazole treatment in Clostridium difficile infections (CDIs). A systematic literature review was conducted in July to August 2011 and updated in July 2013. For fidaxomicin versus vancomycin, efficacy was evaluated using meta-analysis of data from two Phase III direct comparative studies (naEuroS=aEuroS1164). As there were no studies comparing fidaxomicin and metronidazole, an indirect comparison was made using data from three vancomycin versus metronidazole studies (naEuroS=aEuroS345), using the methodology of Bucher et al. (J Clin Epidemiol 1997; 50: 683-91). This provides an OR for the indirect comparison of fidaxomicin versus metronidazole when direct evidence of fidaxomicin versus vancomycin and vancomycin versus metronidazole is available. Clinical cure rates were similar for fidaxomicin and vancomycin; the OR (95% CI) was 1.17 (0.82, 1.66). Recurrence [0.47 (0.34, 0.65)] was significantly lower and sustained cure rates [1.75 (1.35, 2.27)] significantly higher for fidaxomicin than vancomycin. Similar results were obtained in patient subgroups with severe CDI and with non-severe CDI. From the indirect comparison, the likelihood of recurrence [0.42 (0.18, 0.96)] and sustained cure [2.55 (1.44, 4.51)] were significantly improved for fidaxomicin versus metronidazole. Again, similar results were obtained in those with severe and non-severe CDI. Fidaxomicin provides improved sustained cure rates in patients with CDI compared with vancomycin. An indirect comparison indicates that the same is also true for fidaxomicin versus metronidazole. In view of these data, fidaxomicin may be considered as first-line therapy for CDI