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"Penelitian di beberapa negara menunjukkan bahwa bekerja sebagai pengemudi bus kota berisiko tinggi terhadap gangguan kesehatan (Kompier, 1996). Berbagai faktor kondisi pekerjaan maupun lingkungan kerja yang dapat menimbulkan stres, menurut pengamatan penulis, ditemui pada pengemudi Bus Patas 9B jurusan Bekasi Barat-Cililitan/Kampung Rambutan. Belum ada penelitian mengenai tingkat stres pada pengemudi Bus Patas 9B tersebut, hal ini yang membuat perlunya dilakukan penelitian mengenai gambaran stres kerja serta faktor-faktor yang berhubungan dengan stres kerja pada pengemudi Bus Patas 9B tersebut.Desain penelitian ini bersifat kuantitatif dengan pendekatan cross sectional, sejak April hingga Juli 2008. Besar sampel diambil sama dengan jumlah populasi, yaitu 49 orang, dengan rumus kecukupan sampel hypotesis test for a population proportion (two-side test) didapatkan besar sampel 48 orang.Hasil dari telitian ini menunjukkan dari 49 pengemudi Bus Patas 9B tersebut, ada sebanyak 25 orang (51%) yang mengalami stres sedang, sisanya 24 orang (49%)y ang mengalami stres ringan dan tidak ada yang mengalami stres berat. Belum terbukti ada hubungan yang signifikan antara karakteristik individu (umur, tingkat pendidikan, status perkawinan, dan masa kerja) dan stres kerja pada pengemudi Bus Patas 9B tersebut. Belum terbukti ada hubungan yang signifikan antara persepsi terhadap faktor kondisi pekerjaan (jumlah jam kerja dalam satu hari, shift kerja, hubungan interpersonal dengan kondektur, hubungan interpersonal dengan pengemudi Bus Patas 9B lainnya, dan jumlah pendapatan) dan stres kerja pada pengemudi Bus Patas 9B tersebut. Hanya persepsi terhadap faktor kondisi bus yang terbukti mempunyai hubungan signifikan dengan stres kerja pada pengemudi Bus Patas 9B tersebut, sedangkan persepsi terhadap faktor lingkungan kerja lainnya (kemacetan, penumpang bermasalah, suhu panas, dan kebisingan) belum terbukti signifikan hubungannya dengan stres kerja. Penulis memberikan saran sebaiknya dapat disediakan bus yang kondisinya layak, dengan memperbaiki, merawat, atau jika diperlukan mengganti bus yang tidak layak dengan bus yang baru, dan perlu diadakan penelitian lebih lanjut mengenai stres kerja pada pengemudi bus tersebut."

"Latar belakang: Pajanan MEK dan sinar Ultraviolet dibagian Cementing (pengeleman) dapat mengganggu kesebatan, khususnya kesehatan mata pekelja. Jumlab kasus Konjungtivitis di klinik perusabaan yang selalu masuk !islam sepulub penyakit tetbanyak, sangat meumlk unlak diteliti lebih jauh, apakab kasus konjungtivitis yang terjadi di Perusahaan P sebagai akibat pekerjaan atau bukan sebagai akibat pekerjaan.Merode: Menggunaken metude studi pre dan post, dimana dilakukan intervensi dengan menggunakan chemical goggles. Semua pekerja dibagian Cementing (pengeleman) sejumlan 44 orang yang terpajan uap MEK drul sinar Ultraviolet diikutsertakan dalam penelitian ini. Pengumpulan data dilakukan dengan wawancara, pengisian kuesioner dan informed oleh pekelja dan pemeriksan fisik dan status kesehatan mata oleh dokter pemeriksa (bukan peneliti). Pada analisis data dinilai apakeh goggles dapat menurunkan jumlab kasus Konjungtivitis AkibatKerja.Hasil: Jumlab kasus Konjungtivitis Akibat Kerja sebelum penmkaian goggles 59.1% drul pada saat pentakaian goggles 56.8%. Penggonaan goggles pada penelitian ini menjadi kurang efektif disebabkan ketidakdisiplinan responden (68.2%) melepaskan goggles pada waktu bekerja. Ketidakdisiplinan disebabkan karena tingkat pendidikan responden terbesar tarnat SD-SMP sehingga kesadaran akan kesebatan kurang dan juga ketidaknyamanan (70.4%) sehingga responden sering melepaskan gogglesnya. Ketidaknyamanan didnkung dengan suhu lingkangan yang tinggi. Secara statistik tidak ditemukan hubungan yang barmakua (p> 0.05) antam faktor resiko untuk variabel umur, masa kerja, tinggl mata saat duduk, pendidikan dan kesehatan mata ( tes Schirmer) dengan terjadinya Konjungtivitis akibat kerja. Dari analisis uji Me Nemar diperoleb basil dimana tidak ada perbedaan jumlah kasus konjungtivitis sebalum dan setelab penggonaan chemical goggles pada peke!ja yang terpajan uap Metil Etil Keton drul sinar Ultraviolet.Kesimpulan: tidak terdapat perbedaan jumlab kesus konjungtivitis akibat kelja sebelum dan setelab penggunaan chemical goggles pada peke!ja yang terpajan palarut organik Metil Etil Keton dan sinar Ultraviolet dikarenakan ketidakdisiplinan di lingkungan kerja yang panas.

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Background: exposure to MEK and UV mys at cementing division may cause various health problem, especially to the eyes of workers. It is very interesting subject to be studied that the incidence of conjunctivitis in company clinic always be among the most top ten diseases. Have the conjunctivitis occurred because of their job or not?Methods: study was conducted by pre and post design in which post study, respondents were interfered by using chemical goggle. Forty four workers who exposed to MEK and UV miss at cementing division plant 5 were included in tills study. Data was collected by interviewing, questionnaire, physical examination and eyes examination. Analyses of the data had done to assess whether the goggle could reduce the incident of occupation.al conjunctivitis.Results: Not having worn the goggle, the incidence of conjunctivitis among respondents was 59.1 %. Having worn the goggle the incidence of conjunctivitis among respondents was 56.&%. One of the reason was that respondents had not been discipline to wear the goggle. It was happened because most of respondents had have low educational level (elementary and junior high school) that influence to their health awareness. Respondents were also often to release the goggles {70.4%) because the use of goggles had been not convenient. That inconvenient could be result in the temperature so it is necessary to improve working environment. There was no significant relationship (p> 0.05) between risk factors for the variable of age, length of work, height level of the eyes when sitting, education level and health condition of the eyes (shimmer test) with occupational conjunctivitis. Using Me Nemar 1est obtained that there was no significant differences between pre and post the use of chemical goggle on workers who exposed to MEK and UV rays.Conclusions: This study couldn't prove the hypothesis that there had been differences on incideoce of occupational conjunctivitis between pre and post the use of chemical goggle on workers who had exposed to MEK and UV rays."

"ABSTRAKBatik workers are a group at highest risk of acquiring occupational contactdermatitis, especially hand dermatitis. Prevention of using personal protectiveequipment (PPE) does not provide optimal protection therefore other interventionsare needed for secondary prevention. The development of topical agents thatimprove skin barrier function is a promising approach for the management ofhand dermatitis. Topically applied lipids and humectants may interfere with skinbarrier function, and facilitate skin barrier repair. The aim of this study is toevaluate the effectiveness of Cocos nucifera and glycerine for secondaryprevention of hand dermatitis among batik workers.In a double-blind, cross-over randomized study, the effect of glycerine coconutoil-containing cream vs. glycerine alone on skin barrier functions was determinedby assessment after repeated application of moisturizers over a 2-week period inbatik workers with occupational hand dermatitis. As much as 32 batik dyeingand/or rinsing process workers were enrolled in this study for a minimum of 6months with mild to moderate occupational hand dermatitis. Assessment oftransepidermal water loss (TEWL), skin capacitance and the Hand EczemaSeverity Index (HECSI) were made at baseline and day 14.The research showed that the type of hand dermatitis among subjects that occurswere 56 palmar hyperkeratosis, 15.6 interdigital eczema, 12.5 nummularhand eczema, 9.4 pulpitis and 6.3 recurrent vesicular hand eczema. As muchas 96.97 of the subjcts have nail discoloration. 40.6 of the subjects always usePPE were at risk of developing hand dermatitis.After applying 14 days, both moisturizers showed clinical improvement by 20decreased of HECSI and TEWL and 20 increased of skin capacitance. Therewas no statistically significant treatment effect between both moisturizers. Skinstripping result was analyzed using chromatography method showed penetrationat 3rd hour (uptake) and still detected at 12th hour (clearance).The findings of the study support the skin health program for batik workers androutine usage of moisturizers are recommended for a minimal of 12 hours per dayto prevent hand dermatitis."

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Keselamatan dan kesehatan kerja merupakan bagian terpenting dalam hal memberikan perlindungan terhadap pekerja. Dengan perkembangan teknologi yang semakin pesat menimbulkan potensi yang dapat mengancam keselamatan dan kesehatan kerja. Salah satu contoh yaitu industri Rumah Sakit. Saat ini Rumah Sakit sudah didukung dengan alat-alat yang canggih dan modern untuk menunjang pelayanan kesehatan yang diberikan kepada pasien. Rumah Sakit merupakan industri pelayanan kesehatan atau tempat kerja yang memiliki risiko tinggi terhadap keselamatan dan kesehatan sumber daya manusia rumah sakit seperti pasien, pengunjung, maupun lingkungan rumah sakit. Dalam hal ini sumber daya manusia rumah sakit salah satunya yaitu Perawat. Tesis ini akan mengkaji pengaturan perlindungan hukum terhadap perawat yang terkena penyakit akibat kerja berdasarkan peraturan perundang-undangan yang berlaku di Indonesia, penerapan sistem manajemen keselamatan dan kesehatan kerja, serta bagaimana pelaksanaan keselamatan dan kesehatan kerja di Rumah Sakit X. Metode penelitian yang digunakan yaitu yuridis normatif, menggunakan data sekunder melalui studi dokumen dan dianalisis secara kualitatif. Dari hasil penelitian, Pemerintah telah memberikan perlindungan hukum terhadap perawat yang terkena penyakit akibat kerja. Kemudian sistem manajemen keselamatan dan kesehatan kerja harus diterapkan di Rumah Sakit agar tercipta lingkungan rumah sakit yang sehat, aman, selamat dan nyaman, dengan begitu dapat menurunkan angka kecelakaan kerja dan menurunkan prevalensi penyakit akibat kerja. Rumah Sakit X harus membuat prosedur atau pedoman terkait penanganan perawat yang terkena penyakit akibat kerja. Pengkajian lebih lanjut terhadap data karyawan yang berobat dan data penyakit karyawan di unit kerja yang berisiko mengalami penyakit akibat kerja belum dilakukan oleh Komite K3RS. Diperlukan peran pemerintah dalam melakukan pembinaan dan pengawasan secara berkala agar pelaksanaan keselamatan dan kesehatan kerja khususnya dirumah sakit dapat terpantau dengan baik.

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Occupational safety and health are the most important part of providing protection to workers. With the rapid development of technology raises the potential to threaten occupational safety and health. One example is the Hospital industry. At present the Hospital has been supported by sophisticated and modern tools to support the health services provided to patients. Hospital is a health service industry or workplace that has a high risk to the safety and health of hospital human resources such as patients, visitors, and the hospital environment. In this case the hospital human resources, one of them is Nurse. This thesis will examine the legal protection arrangements for nurses affected by occupational diseases based on applicable laws and regulations in Indonesia, the application of occupational safety and health management systems, as well as how the implementation of occupational safety and health in Hospital X. The research method used is juridical normative, using secondary data through document studies and analyzed qualitatively. From the results of the study, the Government has provided legal protection for nurses affected by occupational diseases. Then the occupational safety and health management system must be implemented in hospitals to create a healthy, safe and comfortable hospital environment, thereby reducing work accident rates and reducing the prevalence of occupational diseases. Hospital X must make procedures or guidelines related to the handling of nurses affected by occupational diseases. Further assessments of employee medical data and data on employee illness in work units at risk of occupational diseases have not been conducted by the K3RS Committee. The role of government is needed in conducting guidance and supervision on a regular basis so that the implementation of occupational safety and health, especially in hospitals can be monitored properly.

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"ABSTRAKKualitas kehidupan kerja perawat pelaksana dipengaruhi oleh faktor lingkungan pekerjaan, hubungan dengan kepala ruangan, kondisi pekerjaan, persepsi pekerjaan, serta layanan pendukung keperawatan. Tujuan penelitian ini adalah untuk mengetahui hubungan kualitas kehidupan kerja perawat pelaksana dengan gangguan muskuloskeletal akibat kerja. Penelitian ini merupakan penelitian analitik deskriptif dengan desain cross sectional dan memakai teknik consecutive sampling yang melibatkan 80 orang perawat pelaksana. Data dikumpulkan dengan cara membagikan tiga kuesioner kepada responden, yaitu kuesioner karakteristik perawat pelaksana, kuesioner kualitas kehidupan kerja perawat, dan kuesioner Nordic Body Map. Hasil penelitian menemukan 51,3 perawat pelaksana memiliki kualitas kehidupan kerja tinggi, 91,3 perawat pelaksana mengalami gangguan muskuloskeletal kategori rendah, dan tidak ada hubungan antara kualitas kehidupan kerja perawat pelaksana dengan gangguan muskuloskeletal akibat kerja =0,47,=0,05 . Saran untuk peneliti selanjutnya untuk mempertimbangkan jumlah sampel yang lebih besar dan terdiri dari beberapa institusi pelayanan kesehatan. Kualitas kehidupan kerja perawat pelaksana perlu ditingkatkan dengan mengoptimalkan faktor lingkungan pekerjaan, hubungan dengan kepala ruangan, kondisi pekerjaan, persepsi pekerjaan, serta layanan pendukung keperawatan. Kata kunci: gangguan muskuloskeletal akibat kerja, kualitas kehidupan kerja perawat, perawat pelaksana.

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ABSTRACTQuality of nursing work life of associate nurses is influenced by work environment, relationship with manager, work condition, job perception, and support service of nursing care. The aim of study is to identify the relationship between quality of nursing work life with work related musculoskeletal disorders among 80 associate nurses. This study was a cross sectional design and used a consecutive sampling technique. Data were collected by distributing the three questionnaires were characteristic associate nurses questionnaire, a Brooks 39 Quality of Nursing Work Life Questionnaire, and the Nordic Body Map questionnaire. This study resulted that 51.3 of associate nurses had a high quality of nursing work life, 91.3 of associate nurses experienced low musculoskeletal disorders, and there was no correlation between the quality of nursing work life with work related musculoskeletal disorders 0.47, 0.05 . This study also suggests for future researchers to consider with larger sample quantities and consist of several health care institutions. Quality of nursing work life can be increased by optimalizing the factors of work environment, relationship with manager, work condition, job perception, and support service. Keywords work related musculoskeletal disorders, quality of nursing work life, associate nurse."

"Pendahuluan Timbal merupakan salah satu bahan penting yang banyak digunakan di industri. Industri baterai timbal-asam menggunakan timbal dalam jumlah besar yang meningkatkan pajanan timbal ditempat kerja dan diperkirakan dapat mempengaruhi tekanan darah selama bertahun-tahun. Tujuan dari laporan ini adalah untuk menyajikan bukti tentang pengaruh pajanan timbal ditempat kerja terhadap kejadian hipertensi pada pekerja. Metode Pencarian literatur dilakukan melalui basis data elektronik dari PubMed, Scopus dan Cochrane. Kriteria inklusi yang diterapkan yaitu tinjauan sistematis, meta analisis, studi kohort, studi kasus kontrol, studi potong lintang, pekerja dengan pajanan timbal ditempat kerja dan dampak hipertensi atau tekanan darah tinggi. Artikel terpilih kemudian dinilai secara kritis menggunakan kriteria yang relevan dari Oxford Centre for Evidence-Based Medicine. Hasil Tiga studi potong lintang yang relevan disertakan. Studi oleh Thongsringklee M. dkk, Singamsetty dkk serta Sudjaroen dkk menunjukkan bahwa pekerja dengan paparan timbal secara langsung memiliki risiko lebih tinggi untuk terjadi hipertensi dibandingkan dengan pekerja dengan paparan tidak langsung (OR adj 1.38, 95% CI 1.01-1.89; OR 1.97, 95% CI 1.96-2.17; dan OR 1.4, 95% CI 0.97-1.73, secara berurutan) dan bermakna secara statistik, meskipun studi oleh Sudjaroen dkk tidak. Kesimpulan dan rekomendasi Bukti saat ini tidak memberikan bukti yang kuat untuk mengkonfirmasi bahwa paparan timbal dapat menyebabkan hipertensi pada pekerja. Disarankan bagi pekerja yang terpapar timbal secara langsung untuk lebih waspada karena dua dari tiga studi melaporkan kemungkinan timbal meningkatkan risiko hipertensi. Diperlukan penelitian lebih lanjut dengan desain penelitian yang lebih baik untuk memberikan bukti yang kuat bahwa paparan timbal dapat meningkatkan risiko hipertensi pada pekerja.

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Background Lead is still one of the essential materials in many industries. The lead-acid battery industry consumes the largest amount of lead which make lead exposure increases at the workplace and has been suspected to influenced blood pressure for many years. The aim of this evidence-based case report is to present the evidence about the effect of occupational lead exposure on the incidence of hypertension in worker. Method The literature searching was conducted through PubMed, Scopus and Cochrane Library. The inclusion criteria were Systematic Review, Meta-Analysis, Cohort Study, Case- control Study, Cross-sectional Study, worker with occupational lead exposure, and hypertension or high blood pressure outcome. The selected articles were then critically appraised using relevant criteria by the Oxford Center for Evidence-Based Medicine. Result Three relevant cross-sectional studies were included. Studies by Thongsringklee M. et al, Singamsetty et al. and Sudjaroen et al. showed that workers with direct-lead exposure have more risk for hypertension than workers with indirect-lead exposure (OR adj 1.38, 95% CI 1.01-1.89; OR 1.97, 95% CI 1.96-2.17; and OR 1.4, 95% CI 0.97-1.73, respectively) and significant statistically, although the last study wasn’t. Conclusion and recommendation The current evidences do not show strong evidence to ensure that lead exposure can cause hypertension in worker. It is recommended to be more alert for workers with direct-lead exposure because two out of three studies reported the possibility that lead increase the risk of hypertension in worker. Further research with better study design is needed to provide strong evidence that lead exposure can increase the risk of hypertension in worker."

"Tenaga kerja sebagai sumber daya manusia perlu diperhatikan terutama dari segi kesehatan terhadap risiko dan bahaya pekerjaan. Pengolahan kapur telah berkembang selama puluhan dekade baik dengan cara pembakaran maupun penggilingan.Tujuan dari penelitian ini, yaitu untuk mengetahui prevalensi gangguan fungsi paru dan hubungan faktor-faktor risiko dengan gangguan fungsi paru pada pekerja industri kapur. Penelitian ini dilakukan dengan metode observasi dan pendekatan studi potong-lintang. Jumlah sampel yang diperoleh, yaitu 44 orang. Variabel independen diukur melalui wawancara dan pengisian kuesioner, serta pemeriksaan fisik secara umum untuk mengetahui riwayat penyakit. Variabel dependen diukut dengan pemeriksaan uji spirometri. Analisis data dilakukan untuk mengetahui hubungan faktor-faktor risiko dengan gangguan fungsi paru, seperti umur, kebiasaan merokok, riwayat penyakit, lama kerja, dan penggunaan APD.Hasil penelitian diketahui prevalensi gangguan fungsi paru pada pekerja sbesar 36,4% dan tidak ditemukan adanya hubungan antara faktor-faktor risiko dengan gangguan fungsi paru. Pekerja dengan riwayat penyakit diharapkan mendapatkan pengobatan dan seluruh pekerja agar dapat memeriksakan kesehatannya secara rutin.

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Workers as human resources need to be paid attention, especially their health status related to the hazard and risk of working. Limestone manufacture has been burgeoning in decades whether by way of combustion or hulling.

The purpose of this research was to find out the prevalence of lung function disorder and the association between the risk factors and lung function disorder in the lime worker industry. This research was an observational method using cross-sectional study approach. The sample size was 44 people. Independent variable was measured by interviewing and filling the questioner, also general physical diagnose to find out the history of diseases. Dependent variable was measured by doing the spirometry test. Data analysis was done to find out the association between the risk factors and the lung function disorder, such as age, smoking habit, history of diseases, year of working, and using the personal protective equipment.

The result found out the prevalence of lung function disorder, 36,4% and there were no association between the risk factors with the lung function disorder. Workers who have the diseases need to get the medical treatment and all of the workers have to be examined their health."

"ABSTRAKLatar Belakang. Dermatitis pada tangan akibat kerja DTAK bersifat kronis, memiliki prognosis buruk, dan berdampak signifikan terhadap aspek psikososial dan pekerjaan. Prevalensi dermatitis kontak pada tenaga kerja bongkar muat TKBM Pelabuhan Sunda Kelapa Jakarta adalah sebesar 24,3 , dengan lesi di tangan 47,1 . Penggunaan alat pelindungdiri APD masih belum cukup untuk mengatasi masalah ini, sehingga dibutuhkan intervensi lain. Penggunaan pelembap untuk memperbaiki sawar kulit dipertimbangkan efektif untuk mencegah keparahan DTAK.Metode. Penelitian ini adalah kuasi eksperimental satu kelompok. Intervensi dilakukan dengan menggunakan gliserin 10 dalam vaselin album sekali sehari setelah bekerja selama 14 hari.Hasil. Rerata nilai transepidermal water loss TEWL setelah intervensi 11,4 3,8 g/m2/jam lebih rendah dibandingkan rerata nilai TEWL awal 14,2 4 g/m2/jam , dengan perbedaan rerata nilai TEWL sebesar 2,8 2,9 g/m2/jam p= 0,000 95 CI 1,5-4,1 . Median nilai hand eczema severity index HECSI setelah intervensi 9,5 3-34 lebih rendah dibandingkan median skor HECSI awal 29,5 6-80 , dengan perbedaaan rerata skor HECSI sebesar 19,5 -2-46 p= 0,000 . Korelasi antara perubahan nilai TEWL dan perubahan skor HECSI tidak bemakna p= 0,476 dengan kekuatan korelasi sangat lemah r= 0,160 . Variabel exposure rating tahunan debu semen berhubungan dengan perubahan skor HECSI p= 0,002 . Setelah intervensi seluruh lesi di jari-jari, telapak tangan, punggung tangan dan pergelangan tangan mengalami perbaikan yang bermakna.

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ABSTRACT

Background. Occupational hand dermatitis OHD is chronic, has a poor prognosis, and significantly affects psychosocial and occupational aspects. The prevalence of contact dermatitis of loading dockworkers at Port Sunda Kelapa Jakarta was 24,3 and 47,1 lesion was on the hands. The use of personal protective equipment PPE is deemed inadequate to solve this problem, thus requiring other intervention. Using moisturizer for improvement of skin barrier is considered to be effective for preventing severity of occupational hand dermatitis.Method. The study design was quasi experimental one group pre and post test design. The 14 days intervention was performed on the loading dockworkers by instructing them to apply 10 glycerin in vaseline album on their hands once daily after working.Result. The mean value of transepidermal water loss TEWL after intervention 11.4 3.8 g m2 hour was lower than the mean value of TEWL before the intervention 14.2 4 g m2 hour . The TEWL mean difference was 2.8 2.9 g m2 hour p 0.000 95 CI 1.53 4.1 . The median value of hand eczema severity index HECSI after intervention 9.5 3 34 was lower than the median value of HECSI before the intervention 29,50 6 80 . The HECSI mean difference was 19.5 2 46 p 0,000 . The correlation between TEWL changes and HECSI changes was not significant p 0.476 and the correlation strength was very weak r 0.160 . Annual exposure rating of cement dust associated with the HECSI changes p 0,002 . After intervention, all lesions on the fingers, palms, back of hand and wrist were significantly improved p 0,05 , except for the finger tips. Additional analysis showed that the commonly found morphology of the lesion was infiltrate papule, scaling and erythema. After intervention, the severity score of the morphology lesions was also significantly decreased p 0,05 .Conclusion. Once daily application of 10 glycerin in vaseline album for 14 days could improved skin barrier function and the severity of OHD, thus can be advised for loading dockworkers with high annual exposure rating of cement dust. "

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ABSTRAK

 

Nama                   : Yenny Rachmawati

Program studi      : Dermatologi dan Venereologi

Judul                    : Perbandingan Efektivitas serta Keamanan antara Krim Pelembap Niasinamid 4% dan Virgin Coconut Oil 30% untuk Pencegahan Sekunder Dermatitis Tangan Akibat Kerja pada Perawat Intensive Care Unit : Uji Klinis Acak Tersamar Ganda

 

Latar belakang:  Dermatitis tangan akibat kerja (DTAK) sering terjadi pada perawat Intensive Care Unit (ICU) terutama pada individu yang rentan akibat pajanan iritan berupa hand rub alcohol dan aktivitas cuci tangan berulang. Penggunaan pelembap adalah salah satu rekomendasi untuk perawatan kulit pada DTAK. Niasinamid memiliki efek antiinflamasi dan dapat memperbaiki fungsi sawar kulit. Vigin coconut oil (VCO) kaya akan kandungan lipid dan asam laurat, serta memiliki efek oklusif. Sampai saat ini belum ada panduan dan referensi jenis pelembap untuk pencegahan sekunder pada DTAK.

 

Tujuan: Mengetahui perbandingan efektivitas serta keamanan antara krim pelembap niasinamid 4% dan VCO 30% untuk pencegahan sekunder dermatitis tangan akibat kerja pada perawat ICU.

 

Metode: Penelitian ini merupakan uji klinis acak tersamar ganda terhadap perawat ICU dengan DTAK pada bulan September hingga Oktober 2019. Pasien yang memenuhi kriteria penerimaan dan bersedia mengikuti penelitian, mendapat niasinamid 4% atau VCO 30% sesuai dengan randomisasi blok. Pengolesan pelembap dilakukan dua kali sehari selama 28 hari. Perbaikan klinis dinilai dengan parameter skor Hand Eczema Scoring Index (HECSI) dan penilaian sawar kulit dinilai dengan transepidermal water loss (TEWL) serta hidrasi kulit dengan skin capasitance (SCap) pada hari ke-14 dan hari ke-28. Keamanan dinilai berdasarkan efek samping selama penelitian.

 

Hasil: Didapatkan 46 SP pada masing-masing kelompok niasinamid 4% dan VCO 30%. Terdapat penurunan skor HECSI pada kedua kelompok perlakuan di hari ke-14 dan hari ke-28. Median skor HECSI  di kelompok niasinamid 4% dan VCO 30%  pada hari ke-14 yaitu 6,5 dan 6 (p 0,160), serta pada hari ke-28 yaitu 4 dan 3 (p 0,046). Pada hari ke-28, perbedaan skor HECSI kedua kelompok secara statistik bermakna, namun secara klinis tidak bermakna. Terdapat penurunan nilai TEWL pada kedua kelompok perlakuan di hari ke-14 dan hari ke-28 dibandingkan baseline, namun pada area palmar di kelompok niasinamid 4% terdapat sedikit peningkatan nilai TEWL pada hari ke-28. Terdapat peningkatan nilai SCap pada kedua kelompok perlakuan di hari ke-14 dan hari ke-28 dibandingkan baseline. Kedua pelembap dapat ditoleransi dengan baik dengan efek samping minimal.

 

Kesimpulan: Niasinamid dan VCO efektif memperbaiki klinis DTAK pada perawat ICU, walaupun tidak terdapat perbedaan bermakna antara krim pelembap niasinamid 4% dengan VCO 30% untuk pencegahan sekunder dermatitis tangan akibat kerja pada perawat ICU

 

Kata kunci: dermatitis tangan akibat kerja, efektivitas, keamanan, pelembap, niasinamid 4%, VCO 30%

 

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ABSTRACT

 

Name                 : Yenny Rachmawati

Study Program : Dermatologi dan Venereologi

Title                   : Comparison of the Effectiveness and Safety between Moisturizing Cream Containing Niacinamide 4% and Virgin Coconut Oil 30% for Secondary Prevention of Occupational Hand Dermatitis in Intensive Care Unit Nurses: a Double Blind Randomized Clinical Trial

 

Background:  Occupational hand dermatitis (OHD) often occurs in intensive care unit (ICU) nurses, especially in individuals who are vulnerable due to irritant exposure e.g. hand rub alcohol and repeated hand washing activities. The use of moisturizer is one of the recommendations for skin care in OHD. Niacinamide which has anti-inflammatory effects and can improve the skin sawar function. Virgin coconut oil (VCO) is rich in lipids and lauric acid, and has an occlusive effect. Until now there are no guidelines and reference types of moisturizers for secondary prevention in OHD.

 

Objective: To assess the difference of effectiveness and safety between moisturizing cream containing niacinamide 4% and VCO 30%  for secondary prevention of occupational hand dermatitis in ICU nurses

 

Methods: A double blind randomized controled trial was performed in ICU nurses with OHD during September–October 2019. Patients who fulfilled inclusion criteria and willing to be involved in the study were allocated to niacinamide 4% or VCO 30% based on block randomization.  Moisturizer were applied twice daily for 28 days. Measurement of Hand Eczema Scoring Index (HECSI) scores were conducted to evaluate the clinical improvement . Measurement of transepidermal water loss (TEWL) were conducted to evaluate the barrier skin and skin capacitance (SCap) values were conducted to evaluate skin hydration on 14^th and 28^th day. Safety were assessed based on side effects during research.

 

Results: There were 46 subjects in each arms of intention, the niacinamide 4% arm and in the VCO 30% arm. There were a decrease in HECSI scores in both treatment groups on 14^th and 28th  day. The median score of HECSI in niacinamide 4% and VCO 30% on 14^th day were 6.5 and 6 (p 0.160), and on 28^th day were 4 and 3 (p 0.046). On 28^th day, the difference in HECSI scores of the two groups were statistically significant, but clinically not significant. There were a decrease in TEWL values in both treatment groups on 14^th and  28^th day compared to baseline, but there were a slight increase in TEWL values in the palmar area in the niacinamide group on 28^th day. There were an increase in SCap values in both treatment groups on 14^th and 28^th day compared to baseline. Both moisturizers were well tolerated with minimal side effects.

 

Conclusion: Niacinamide 4% and VCO 30% were effective in improving clinical OHD in ICU nurses, although there were no significant difference between moisturizing cream containing niacinamide 4% and virgin coconut oil 30% for secondary prevention of occupational hand dermatitis in ICU nurses.

 

Keywords: occupational hand dermatitis, effectiveness, safety, moisturizer, niacinamide 4%, VCO 30%

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