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Abstrak :
ABSTRAK
Latar Belakang : Kotinin merupakan hasil metabolit utama nikotin dan kadarnya pada urin merupakan indikator pajanan asap rokok. Penlitian ini untuk mengetahui kadar kotinin urin pada anak yang terpajan dan tidak terpajan asap rokok di lingkungan rumah. Metode : Penelitian potong lintang pada anak usia sekolah dasar yang tidak merokok. Subjek dikelompokkan menjadi kelompok terpajan dan tidak terpajan berdasarkan status pajanannya. Data yang diperoleh dari kuesioner dan sampel urin sewaktu yang diukur dengan metode ELISA. Hasil : Total subjek 128 anak usia 6-12 tahun yang terdiri dari 64 anak pada kelompok terpajan dan 64 anak yang tidak terpajan. Kadar kotinin urin pada kelompok terpajan lebih tinggi dibandingkan kelompok tidak terpajan (median 30,1 vs 8,45 ng/ml; p<0.05). Terdapat perbedaan kadar kotinin pada anak yang terpajan asap rokok dengan jumlah batang rokok yang dihisap oleh perokok di rumah (p<0.05). Status pajanan asap rokok berhubungan dengan keluhan batuk, infeksi saluran napas atas dan rawat inap karena keluhan respirasi pada anak. Nilai titik potong optimal kadar kotinin urin pada anak untuk menilai pajanan asap rokok yaitu 17,95 ng/ml (sensitifitas 81%, spesifisitas 81%, AUC 91,2%, p<0.05). Kesimpulan: Kadar kotinin urin dapat digunakan sebagai biomarker yang tidak invasif untuk evaluasi pajanan asap rokok pada anak. ABSTRACT
Introduction : The cotinine is major metabolite of nicotine and the level of urinary cotinine is an indicator of tobacco smoke exposure. This study investigate role of urinary cotinine level in children exposed and unexposed to tobacco smoke at home. Method : A Cross sectional study that enrolled elementary school nonsmokers children classified into exposed group and unexposed group based on tobacco smoke sexposure status. The questionnaire and spot urinary samples were collected and urinary cotinine levels were measured by ELISA. Results : A total 128 nonsmokers children age 6-12 years divided into 64 children in exposed group and 64 children in unexposed group. The urinary cotinine levels in exposed group significantly higher than unexposed group (median 30,1 ng/m; vs 8,45 ng/ml; p<0.05). There was significant difference of urinary cotinine level in exposed group with number of cigarettes (p<0.05). Tobacco smoke exposure status associated with frequent cough symptom, upper respiratory infection and hospitalization because of respiratory symptoms in subjects. The optimal cut off point urinary cotinine in children to distinguish unexposed children with exposed to tobacco smoke at home was 17,95 ng/ml (sensitivity 81%, spesificity 81%, p<0.05). Conclusion : The urinary cotinine level is useful and noninvasive biomarker for evaluating tobacco smoke exposure in children. ;Introduction : The cotinine is major metabolite of nicotine and the level of urinary cotinine is an indicator of tobacco smoke exposure. This study investigate role of urinary cotinine level in children exposed and unexposed to tobacco smoke at home. Method : A Cross sectional study that enrolled elementary school nonsmokers children classified into exposed group and unexposed group based on tobacco smoke sexposure status. The questionnaire and spot urinary samples were collected and urinary cotinine levels were measured by ELISA. Results : A total 128 nonsmokers children age 6-12 years divided into 64 children in exposed group and 64 children in unexposed group. The urinary cotinine levels in exposed group significantly higher than unexposed group (median 30,1 ng/m; vs 8,45 ng/ml; p<0.05). There was significant difference of urinary cotinine level in exposed group with number of cigarettes (p<0.05). Tobacco smoke exposure status associated with frequent cough symptom, upper respiratory infection and hospitalization because of respiratory symptoms in subjects. The optimal cut off point urinary cotinine in children to distinguish unexposed children with exposed to tobacco smoke at home was 17,95 ng/ml (sensitivity 81%, spesificity 81%, p<0.05). Conclusion : The urinary cotinine level is useful and noninvasive biomarker for evaluating tobacco smoke exposure in children. ;Introduction : The cotinine is major metabolite of nicotine and the level of urinary cotinine is an indicator of tobacco smoke exposure. This study investigate role of urinary cotinine level in children exposed and unexposed to tobacco smoke at home. Method : A Cross sectional study that enrolled elementary school nonsmokers children classified into exposed group and unexposed group based on tobacco smoke sexposure status. The questionnaire and spot urinary samples were collected and urinary cotinine levels were measured by ELISA. Results : A total 128 nonsmokers children age 6-12 years divided into 64 children in exposed group and 64 children in unexposed group. The urinary cotinine levels in exposed group significantly higher than unexposed group (median 30,1 ng/m; vs 8,45 ng/ml; p<0.05). There was significant difference of urinary cotinine level in exposed group with number of cigarettes (p<0.05). Tobacco smoke exposure status associated with frequent cough symptom, upper respiratory infection and hospitalization because of respiratory symptoms in subjects. The optimal cut off point urinary cotinine in children to distinguish unexposed children with exposed to tobacco smoke at home was 17,95 ng/ml (sensitivity 81%, spesificity 81%, p<0.05). Conclusion : The urinary cotinine level is useful and noninvasive biomarker for evaluating tobacco smoke exposure in children.

Abstrak :
ABSTRAK
Latar Belakang : Benzo(a)pyrene (BaP) adalah hidrokarbon aromatik polisiklik sangat karsinogenik yang terdapat dalam asap rokok. Tidak hanya perokok yang perlu menjadi perhatian, namun bahaya yang ditimbulkan akibat asap rokok pada orang yang tidak merokok juga perlu diperhatikan. Metode : Penelitian ini berjenis potong lintang pada 26 perempuan dewasa bukan perokok yang terpajan asap rokok dan 15 perempuan tidak terpajan asap rokok di rumahnya di kelurahan Palmeriam Kecamatan Matraman, Jakarta. Kadar BPDE-protein adducts diukur menggunakan metode ELISA. Kadar CO ekspirasi, informasi kebiasaan merokok anggota keluarga di rumah pada subjek penelitian dikumpulkan melalui kuesioner. Hasil : Nilai BPDE-protein adducts <40 ng/ml sebanyak 16 orang (61,5%) dan nilai BPDE-protein adducts >40 ng/ml sebanyak 10 orang (38,5%), sedangkan pada kelompok perempuan tidak terpajan asap rokok di rumah, nilai BPDE-protein adducts <40 ng/ml sebanyak 11 orang (73,3%) dan nilai BPDE-protein adducts >40 ng/ml sebanyak 4 orang (26,7%), hasil analisis menunjukkan perbedaan yang tidak bermakna (p=0,443). Pengukuran kadar CO ekspirasi pada penelitian ini memperoleh nilai tengah kadar CO ekspirasi pada kelompok perempuan yang terpajan asap rokok sebesar 5,5 ppm. Pada kelompok perempuan yang tidak terpajan asap rokok, rerata kadar CO ekspirasi sebesar 6 ppm, hasil analisis tidak menunjukkan adanya perbedaan yang bermakna (p=0,398). Lama pajanan, jenis rokok, banyaknya jumlah rokok yang dihisap serta banyaknya jumlah perokok aktif dirumah tidak mempengaruhi kadar BPDE-protein adducts. Kesimpulan : Nilai BPDE-protein adducts >40 ng/ml pada perempuan terpajan asap rokok lebih tinggi dibandingkan dengan perempuan yang tidak terpajan asap rokok di lingkungan rumah.

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ABSTRACT
Background: Benzo(a)pyrene (BaP) is a polycyclic aromatic hydrocarbon contained in cigarette smoke. This highly carcinogenic substance is also found in Environmental Tobacco Smoke (ETS) which equally dangerous to the health of population and equally require attentions as much as cigarette smoke. This study observes level of BaP among those in risk of ETS exposure. Methods: A cross-sectional study was performed involving 26 women exposed to ETS and 15 women unexposed to ETS in Palmeriam Matraman area, Jakarta, Indonesia. The BPDE (Benzo(a)pyrene Diol Epoxide) protein levels of adducts were measured using ELISA method. In addition, exhaled carbon-monoxide (CO) level during expiration was measured and family members smoking habits at home was obtained using questionnaire. Results: The mean age of women exposed to ETS was 35.8 ± 6.5 years and women unexposed to ETS was 41.7±7.5 years. In the ETS exposed women, the BPDE level of <40 ng/mL was found in 16 people (61.5%) and the BPDE level of >40 ng/mL was found in 10 people (38.5%). In the ETS unexposed women, the BPDE level of <40 ng/mL was found in 11 people (73.3%) and the BPDE level of >40 ng/mL was found in 4 people (26.7%). None of these results were significantly different (p=0.443). The median exhaled CO level of ETS exposed women was 5.5 ppm and of ETS unexposed women was 6.0 ppm. None of these results were significantly different (p=0.398). No correlation was found between length of ETS exposure, types of cigarettes, number of cigarettes smoked and number of active smokers at home and BPDE-protein adducts level. Conclusion: The BPDE level of ETS exposed women was higher than of ETS unexposed women (>40 ng/mL and <40 ng/mL, respectively). The median exhaled CO level of ETS exposed women was lower than of ETS unexposed women (5.5 ppm and 6.0 ppm). However, none of these results were statistically significant.