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Abstrak :

ABSTRAK
Nama : Egnes Ekaranti
Program Studi : Magister Keselamatan dan Kesehatan Kerja
Judul : Analisis Risiko Kesehatan yang Terkait dengan Pajanan Radiasi
di PTKMR BATAN
Pembimbing : Prof. Dr. dr. L. Meily Kurniawidjaja, M.Sc.,Sp.Ok
Bekerja dengan radiasi dapat menimbulkan dampak kesehatan karena pekerja radiasi
menerima pajanan radiasi yang terus menerus dan bersifat kumulatif selama bekerja.
Dampak kesehatan yang diduga terkait dengan pajanan radiasi dapat berupa kanker,
katarak, penyakit kardiovaskular, hiperkolesterol, hipertensi dan tumor jinak. Faktor –
faktor yang diteliti di penelitian ini yaitu faktor di tempat kerja seperti dosis kumulatif
TLD, lama bekerja dengan radiasi dan sistem proteksi radiasi. Faktor di luar tempat
kerja yaitu riwayat diagnosis atau terapi medis radiologis. Faktor individu yaitu
sosiodemografi, lifestyle dan riwayat penyakit keturunan. Tujuan dari penelitian ini
adalah untuk mengetahui adanya hubungan antara pajanan radiasi dan dampak
kesehatan; adanya hubungan faktor-faktor risiko dan dampak kesehatan; serta
penerapan proteksi radiasi di PTKMR BATAN. Desain penelitian ini adalah cross
sectional. Data primer diperoleh dari kuesioner, observasi lapangan dan wawancara
serta data sekunder lain yang dibutuhkan. Hasil penelitian ini didapat bahwa tidak ada
hubungan antara pajanan radiasi dengan dampak kesehatan pada pekerja di PTKMR
BATAN. Ada hubungan yang signifikan antara faktor individu yaitu usia dengan CVD,
hiperkolesterol dan hipertensi; jenis kelamin dengan hiperkolesterol; dan riwayat
penyakit keturunan dengan CVD, hiperkolesterol dan hipertensi. Penerapan sistem
protesi radiasi di PTKMR secara umum telah berjalan dengan baik. Disarankan agar
PTKMR BATAN mengadakan pemeriksaan dengan WBC secara berkala; pemeriksaan
khusus terkait dampak kesehatan yang diduga terkait dengan pajanan radiasi;
peningkatan sistem proteksi radiasi; dan mengadakan program promosi kesehatan
terkait penyakit degeneratif.
Kata kunci: Radiasi; pekerja; faktor risiko; dampak kesehatan

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ABSTRACT
Name : Egnes Ekaranti
Study Program : Master Program of Occupational Health and Safety
Title : Health Risk Analysis Related To Radiation Exposure on Workers
at PTKMR BATAN
Counsellor : Prof. Dr. dr. L. Meily Kurniawidjaja, M.Sc., Sp.Ok
Working with radiation can have adverse health effects because radiation workers
received occupational radiation exposure continuously and cumulatively. Adverse
health effects related to radiation exposure include cancer, cataracts, cardiovascular
disease, hypercholesterolemia, hypertension and benign tumors. This study investigated
the workplace risk factors such as the cumulative dose of TLD, length of work with
radiation and radiation protection system; and the outside workplace risk factors such
as diagnosis or radiological medical therapy. Individual factors are sociodemography,
lifestyle and history of hereditary disease. This study aimed to determine the
relationship between radiation exposure and health effects; the relationship between
risk factors and health effects; and the implementation of radiation protection at
PTKMR BATAN. study design was cross sectional. Primary data obtained by
questionnaires, field observations and interviews as well as secondary data needed.
This study found that there is no significant relationship between radiation exposure
and health effect; there is significant relationship between individual risk factors that is
age and CVD, hypercholesterol and hypertension; gender and hypercholesterol; and
genetics with CVD, hypercholesterol and hypertension. Radiation protection has been
well implemented at PTKMR BATAN. Some recommendation for PTKMR BATAN is to
conduct examination using WBC regularly; specific health examination related to
health effect due to radiation exposure; Increased radiation protection system; and
health promotion programs related to degenerative diseases for workers.
Keywords: Radiation; workers; risk factors; health effect

Abstrak :
Toluen telah digunakan sebagai bahan pelarut di Percetakan "X". Bersamaan dengan itu pada tenaga kerja terjadi keluhan berupa mata berair, sesak nafas, batuk pilek, lelah, dan iritasi kulit. Di Percetakan "X", data mengenai kadar toluen di lingkungan kerja dan kadar asam hipurat urin sebagai indikator terpajannya tenaga kerja dengan toluen belum ada. Dengan demikian, perlu dilakukan penelitian mengenai kadar toluen di lingkungan kerja, besar nilai kadar asam hipurat urin dengan faktor-faktor risiko yang mempengaruhinya serta efek kesehatan akut yang di timbulkan. Dalam penelitian ini digunakan studi potong lintang dengan memperhatikan perbedaan tingkat pajanan toluen di tempat kerja. Jumlah sampel yang diambil adalah total sampel berjumlah 135 orang, yaitu pada bagian printing 75 orang dan bagian gudang 60 orang. Data penelitian ini diperoleh berdasarkan observasi, status medis, kuesioner, wawancara, dan pemeriksaan kesehatan. Untuk kadar toluen di lingkungan kerja dianalisis dengan cara metoda 1510, Issue 2 dari NIOSH. Analisis deskriptif antara tenaga kerja di bagian printing dan gudang meliputi karakteristik subjek penelitian, kadar asam hipurat urin,dan efek kesehatan akut. Analisis regresi multipel dilakukan untuk melihat hubungan antara karakteristik subjek penelitian dengan kadar asam hipurat pulang kerja dan untuk melihat hubungan antara karakteristik subjek penelitian dengan peningkatan kadar asam hipurat urin. Sedangkan analisis regresi logistik dilakukan untuk melihat hubungan antara karakteristik subjek penelitian dengan efek kesehatan akut, dan hubungan antara kadar asam hipurat urin pulang kerja dengan efek kesehatan akut. Kadar toluen di lingkungan kerja bagian printing berkisar antara 82 ppm sampai 120 ppm dengan Time Weighed Average (TWA) 90,05 ppm, sedangkan di bagian gudang berkisar antara 52 ppm sampai 67 ppm dengan TWA 50,48 ppm. Kadar rata-rata toluen di udara pada bagian printing dan gudang secara statistik berbeda bermakna (p=0,000), dan telah melampaui nilai ambang batas. Pada umunmya tidak terdapat perbedaan bermakna antara karakteristik subjek yang bekerja di bagian printing maupun gudang kecuali lama kerja (p=0,01) dan pendidikan (p=0,012). Untuk kadar asam hipurat urin awal waktu kerja dan pulang kerja, peningkatan kadar asam hipurat urin, dan efek kesehatan akut antara bagian printing dan gudang secara statistik berbeda bermakna (p=0,000). Hubungan antara karakteristik subjek penelitian dengan peningkatan kadar asam hipurat urin yang berkorelasi kuat yaitu faktor umur (p=0,001); lama kerja (p=0,004) dan kebiasaan merokok (p=0,005). Hubungan antara karakteristik subjek penelitian dengan peningkatan kadar asam hipurat urin pulang kerja yang berkorelasi kuat juga faktor umur (p=0,005); lama kerja (p=0,000) dan kebiasaan merokok (p=0,001), untuk lama kerja yang dihubungkan dengan nilai (¦Â:-0,29) terlihat bahwa makin lama kerja, maka kadar asam hipurat urin pulang kerja semakin rendah. Sedangkan risiko terjadinya efek kesehatan akut berdasarkan karakteristik subjek penelitian didapatkan faktor umur (OR;2,55;CI;0,99-6,79), lama kerja (OR:1,84;CI:0,84-3,94) dan kebiasaan merokok (OR;18,7;CI;7,62-68,10). Risiko terjadinya efek kesehatan akut dengan kadar asam hipurat urin pulang kerja ¡Ý 0,99 gr/L didapatkan secara statistik berbeda bermakna, dibandingkan dengan kelompok tenaga kerja dengan kadar asam hipurat urin pulang kerja < 0,99gr/L (OR:7,6; CI:3,47-16,95). Gejala-gejala efek kesehatan akut yang ditimbulkan seperti : mata berair, sesak, lelah, reaksi kulit dan batuk. Kesimpulan: Kadar toluen di lingkungan kerja, baik di bagian printing maupun di bagian gudang Percetakan "X", di atas nilai ambang batas menurut Kep Menaker RI/1977 (NAB=50 ppm). Kadar asam hipurat urin yang didapat masih di bawah indeks biologis (1,6 gr/L). Karakteristik subjek penelitian yang berpengaruh pada bagian printing dan gudang adalah lama kerja dan pendidikan. Faktor- faktor yang mempengaruhi kinetik toluen di dalam tubuh adalah umur, lama kerja, dan kebiasaan merokok. Pengaruh efek kesehatan akut dengan kadar asam hipurat urin pada tenaga kerja terlihat berbeda bermakna antar kelompok pada titik potong (cut off point) 0,99 gr/L. The Correlation between the Level of Hippuric Acid with the Acute Health Effect among the Workers Who Exposed By Toluene at the Printing Company "X" Jakarta 2002 Background: Toluene has been used as a solvent in the printing company "x". According with it, many effects have been arisen such as: eye irritation, respiratory disfunction, cough, sore nose and throat, fatigue, skin irritation. Nevertheless in the printing company "x", the data about toluene exposure and biological monitoring indicator (hippuric acid) have not been available. As consequence, the printing company "x" studied to find the toluene exposure in the working area and determine the level of the hippuric acid in urine of workers, influencing factors and also acute health effects. Methods: The cross sectional study was used as an approach to look at the hippuric acid level in workers urine and its correlation with acute health effect. The total sample method was used to involve 135 people that consisted of 75 people in printing area and 60 people in ware house area. The data were collected by observation, medical record, questionnaire, interview, and physical examination. The level of toluene exposure was analyzed with NIOSH methods 1510, Issue 2. Descriptive analysis was applied to look at the printing department and the ware house department worker characteristics, the level of the hippuric acid and acute health effects. The multiple regressions was used to find the correlation between characteristic and the level of hippuric acid after shift and also to find the correlation between characteristic of workers and the increasing of the level of hippuric acid. In line with the analysis, the regression logistic analysis was used to find the correlation between the levels of hippuric acid after working with the acute health effect. Result: The range level of toluene in printing area 82 ppm - 1 20 ppm, with the time weighted average (TWA) was 90,05 ppm. In the ware house area the level of toluene were 52 ppm - 67 ppm, with the time weighted average (TWA) was 50,48 ppm. The mean of the exposure of toluene in printing department and ware house department are statically significant different (p=0,000). In general, there was no difference in term of worker characteristics between the printing department and ware house department, except the job time length (p=0,01) and educational level of workers (p=0,012). Level of hippuric acid were statistically significant different between the printing department and the ware house department such as: before and after shift (p=0,000), the increasing of hippuric acid (p=0,000), and acute health effect (p=0,000). The study found that the level of hippuric acid both before and after work, the increasing of hippuric acid during work, and acute health effects were statistically significant different (p=0,000) between those who work for the printing department with those who work for the ware house department. The level of after work hippuric acid has a strong correlation with age (p=0,001), job time length (p=0,004) and smoking habit (p=0,005). The correlation between job time length with hippuric acid level was - 0,29. Meanwhile, workers who were ¡Ý 40 years old showed a 2,55 fold risk of acute health effect, (OR:2,55;CI: 0,99-6,79), who experienced < 60 month job time length had a 1,84 fold risk (OR: 1,84; CI: 0,84-3,94), and who had smoking habit had 18,7 fold risk of acute health effect (OR:18,7 ; CI: 7,62-68,10). Further more, workers whose their after work hippuric acid level 0,99 gr/L showed a 7,6 fold risk of acute health effect. The symptom of the acute health effect included: eye irritations, respiratory distress, fatigue, cough and skin irritation. Conclusion: The level of toluene in the work place in the printing area and the ware house area at the printing "x" were higher than threshold limit value according to Kep. Menaker/ 1977 (TLV=50 ppm), and the increasing value of hippuric acid still below in the permissible biological index of hippuric acid in urin (TLV= 1,6 gr/L). The characteristics are consisted of significantly influence the increasing of hippuric acid as age, job time length, smoking habit, and IMT. Finally, the acute health effect in workers were found significant different between group of workers who have the hippuric acid level which its cut off point is 0,99 gr/L.

Abstrak :
Keberadaan kereta api di daerah perkotaan selain dapat menjadi sarana transportasi yang murah, cepat dan masal, dapat pula menimbulkan masalah bagi kesehatan masyarakat, terutama karena suara bising yang ditimbulkannya. Dampak bising kereta api dapat menyebabkan gangguan kesehatan non auditorik, yaitu gangguan kesehatan selain gangguan pada indera pendengaran. Penelitian ini bertujuan untuk mengetahui proporsi gangguan kesehatan non auditorik pada masyarakat yang tinggal di sepanjang jalur kereta api yang meliputi gangguan komunikasi, gangguan fisiologis yang terdiri dari peningkatan tekanan darah, peningkatan denyut jantung, melambatkan fungsi organ pencernaan, serta timbulnya gangguan psikologis. Disamping itu ingin pula diketahui faktor-faktor yang mempengaruhi gangguan kesehatan non auditorik tersebut. Rancangan penelitian ini adalah cross sectional dengan populasi penelitian masyarakat yang tinggal disepanjang jalur kereta api di Kelurahan Jembatan Besi Kecamatan Tambora. Sampel yang terlibat dalam penelitian ini adalah orang dewasa yang berumur 17 tahun keatas yang paling sering tinggal di rumah, yang berjumlah 100 orang dan diambil dengan metode random sampling. Data diambil dengan wawancara, observasi dan melakukan pengukuran. Data-data yang terkumpul diolah dengan tahapan data coding, data editing, data structure, data the, data entry dan data cleaning. Selanjutnya dilakukan analisis univariat, bivariat dan multivariate, menggunakan SPSS for Windows. Diketahui intensitas kebisingan rata-rata 70,7 dB pada umumnya bersumber dari kereta api. Umur responden rata-rata 45,3 tahun, responden terbanyak adalah wanita, lama tinggal rata-rata 30,9 tahun. jarak tempat tinggal dengan jalur kereta rata-rata 24,4 meter, waktu bising yang paling mengganggu umumnya Siang hari, suhu udara rata-rata 30,8°C dan kelembaban rata-rata 33%. Gangguan kesehatan non auditorik yang timbul terdiri dari gangguan komunikasi 53%, peningkatan tekanan darah 40% (lebih tinggi dari prevalensi hipertensi di Kelurahan Jembatan Besi dan Kecamatan Tambora), gangguan pencernaan 51%, gangguan psikologis 59%. Sedangkan peningkatan detak jantung tidak terjadi. Secara umum responden yang mengalami gangguan non auditorik sebanyak 79%. Pada analisa bivariat ditemukan adanya korelasi yang bermakna antara gangguan kesehatan non auditorik dengan jarak tempat tinggal dengan sumber bising, sumber bising dan intensitas kebisingan. Sedangkan variabel lainnya seperti umur, jenis kelamin, lama tinggal, waktu bising, suhu dan kelembaban tidak menunjukan adanya hubungan dengan gangguan kesehatan non auditorik. Pada analisis multivariat diketahui faktor yang paling berpengaruh terhadap terjadinya gangguan kesehatan non auditorik adalah jarak tempat tinggal dengan sumber bising, serta sumber bising. Yang berpeluang lebih besar adalah sumber bising (4,96 kali), sedangkan jarak tempat tinggal dengan sumber bising berpeluang 1,14 kali. Selanjutnya untuk memastikan adanya hubungan sebab akibat perlu dilakukan penelitian sejenis dengan disain kasus kontrol atau kohort, serta meningkatkan jumlah variabel yang diteliti sehingga dapat menggambarkan kondisi yang sebenarnya. Daftar bacaan : 26 (1971- 2003)

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Non Auditory Health Effect of Noise Exposure at Community Who Live Alongside the Railway in Jembatan Besi Sub-District, Tambora, West Jakarta, 2004The existence of train in urban area is a cheap, quick and mass transportation, on the other hand it can causes a lot of problems in community health , especially because of its noise. Noisy impact of train can cause non auditory health effect, which is health effect besides hearing system. The aim of this research is to know health effect proportion of non auditory on community who live alongside the railway consist of communications trouble, physiological trouble such as increasing blood pressure, increasing heartbeat, slowing down digestive organ function, and also the incidence of psychological trouble. Besides that, would also like to know the factors influencing non auditory health effect. The design of the research is cross sectional with population research is community who live alongside the railway in Sub-District of Jembatan Besi District of Tambora. The samples in this research are adult who is in the age of more than 17 years old and live in house frequently. The involving samples in this research are 100 respondents and taken with sampling random method. Data are taken by interview, observation and do measurement. The collected data are processed by step coding, editing, structuring, filing, entering and cleaning. Followed by data analysis of univariat, bivariat and multivariate with SPSS for Windows. It is known that noise intensity in average is 70.7 dB. It is generally caused by train. The average age of respondent is 45.3 years old, most of respondent are woman, the average length of stay is 30.9 years, the average of residential distance with railways is 24.4 meters, noisy time which bother most is generally daytime, the average of temperature is 30.8°C and humidity is 33%. The arising non auditory effect consists of communications trouble 53%, increasing blood pressure 40% (is higher than hypertension prevalence in Sub-District of Jembatan Besi and District of Tambora), digestive trouble 51%, psychological trouble 59%. While increasing of heartbeat does not happen. Generally respondent suffering from non auditory trouble is 79%. Bivariate analysis shows that there is a significant correlation between health effects on non auditory and the distance of residence, source of noise, and intensity of noise. While other variables like age, gender, length of stay, noisy time, humidity and temperature do not have significant correlation with health effects on non auditory. Multivariat analysis shows that most influencing factors on the occurrence of health effects on non auditory are the distance of residence and also the source of noise. Variable having bigger opportunity is the source of noise (4.96 times), while the distance of residence has opportunity 1.14 times. Furthermore, in order to ascertain the existence of causality need to be conducted by similar research with the design of case control or kohort, and also improve the amount of accurate variable so it that can describe the real condition. References : 26 (1971 - 2003)