Regulasi Pengendalian Bahan Karsinogen di Tempat Kerja: Upaya Mitigasi Morbiditas dan Mortalitas Kejadian Kanker pada Pekerja

Paparan bahan karsinogen di tempat kerja banyak menyebabkan terjadinya kasus penyakit kanker. Indonesia merupakan negara tertinggi kedua setelah Thailand terkait paparan karsinogen di tempat kerja. Hal ini disebabkan belum adanya regulasi khusus untuk mencegah terjadinya hal tersebut. Selain itu, terdapat tiga faktor penyebab permasalahan ini belum teratasi antara lain faktor tata kelola, ekonomi, dan ketersediaan layanan yang cukup sebagai tindakan preventif. Oleh karena itu, diharapkan adanya program pengendalian bahan industri, optimalisasi peran dokter perusahaan dalam melakukan skrining dan deteksi dini, serta pembukaan program studi pendidikan spesialis kedokteran okupasi sebagai tindakan pencegahan untuk mengurangi kasus morbiditas dan mortalitas kejadian kanker pada pekerja

The Trends of Neonatal Mortality Rate Among South East Asia Countries from 2000-2017

Background: Neonatal MortalityRate (NMR) reflects the quality of health services provided by the government. It is very important to disclose the health system capability of each country in managing mother and child health programs because it is an essential health policy that should be prioritized.  The health system capability of a country will determine the welfare and social guarantee because most of NMR causes are preventable. Several components such as maternal factors, neonatal and health services were determined as predictors of NMR. The objective of this study is to compare neonatal mortality trends among eight South East Asia Countries (SEAC) from 2000 to 2017. Method: A cross-sectional design was used to analyze the data regarding the causes of neonatal death between 2000 and 2017. Data were taken from World Health Organization Maternal Child Epidemiology Estimation (WHO MCEE) database.The collected data were live birth; neonatal mortality rate; and the big five of neonatal mortality etiologies in the eight SEAC.  Data were then analyzed descriptively with line chart to describe the trend of NMR. Result: This study found that Indonesia  had the highest neonatal mortality rate, yet the trend decreased gradually from 102.700 in 2000 to 60.986 in 2017, followed by Philippines, Vietnam, Myanmar, Cambodia, Thailand, Laos, and Malaysia respectively.  On the other hand, the trend of live birth was the lowest in Indonesia  and the highest in Philippines . According to the data regarding the leading cause of NMR, preterm birth was the major cause of neonatal mortality followed by birth asphyxia and congenital defects. Conclusion: Indonesia has the highest mortality rate, yet the etiology such as as premature birth, asphyxia, and congenital disorder is similar to the other eight countries

Levels of Octachlorostyrene in Mothers' Milk and Potential Exposure Among Infants in Sendai City, Japan 2012

Persistent organic pollutants can accumulate inside the human body, including in mothers’ milk, which may affect infant development. This cross-sectional study aimed to examine selected persistent organic pollutants in the milk of 100 mothers in Sendai city, Miyagi Prefecture, Japan. We used gas-chromatography-electron capture negative chemical ionization-mass spectrometry to check for octachlorostyrene, dechlorane (Dec) plus, Dec 602, Dec 603, and Dec 604. Octachlorostyrene was detected in 86 samples at more than the method detection limit (84 pg g-lipid⁻¹) but no dechloranes were above the method detection limit (1 ng mL⁻¹ for dechlorane plus, Dec 602, and Dec 603; 20 ng mL⁻¹ for Dec 604). The mean octachlorostyrene concentration was 461 pg g-lipid−1, the median was 337 pg g-lipid⁻¹, and the standard deviation 450 pg g-lipid⁻¹. No baseline characteristics were associated with octachlorostyrene level except for mother’s occupation (stay-at-home mother, 353 ± 327 pg g-lipid⁻¹; others, 531 ± 509 pg g-lipid⁻¹). Octachlorostyrene was also significantly negatively correlated with lipid content (r = −0.35, p = 0.0004). However, the maximum intake of octachlorostyrene among infants in this study (3.5 ng/kg/day) was under the acceptable daily intake (30 ng/kg/day, derived from 12−month study in rats), and is therefore unlikely to pose a health risk

Conflict-related environmental damages on health: lessons learned from the past wars and ongoing Russian invasion of Ukraine

On 24 February 2022, Russian military forces invaded Ukraine. The fighting has already caused unimaginable conditions and millions of people were forced to flee their homes. For decades, conflicts have been linked to environmental pollution, exposure to radioactivity and heavy metals as well as infectious diseases. The invasion may cause specific environmental risks, like the release of radioactive substances from nuclear power plants and contaminated soils. Because international collaboration is one of the most effective ways to address environmental problems, it is critical to establish scientific bodies within a global framework to identify concrete actions and tangible measures to provide immediate assistance to citizens. This commentary discusses the above issues from lessons learned from the past wars and the way forward in the Russian invasion of Ukraine

Efficacy of Personal Protective Equipment to Prevent Environmental Infection of COVID-19 among Healthcare Workers: A Systematic Review

Background: Healthcare workers (HCWs) employed personal protective equipment (PPE) during the COVID-19 pandemic, crucial to protecting themselves from infection. To highlight the efficacy of PPE in preventing environmental infection among HCWs, a systematic review was conducted in line with PRISMA guidance. Methods: A search of the PubMed and Web of Science databases was conducted from January 2019 to April 2021 using pre-defined search terms. Articles were screened by three researchers. The approved papers were read in full and included in this review if relevance was mutually agreed upon. Data were extracted by study design and types of PPEs. Results: 47 of 108 identified studies met the inclusion criteria, with seven reviews and meta-analyses, seven cohort, nine case-control, fifteen cross-sectional studies, four before and after, four case series, and one modeling studies. Wearing PPE offered COVID-19 protection in HCWs but required adequate training. Wearing surgical masks provided improved protection over cloth masks, while the benefit of powered air-purifying respirators is less clear, as are individual gowns, gloves, and/or face shields. Conclusions: Wearing PPE, especially facial masks, is necessary among HCWs, while training in proper use of PPE is also important to prevent COVID-19 infection

Evaluation of the public health clinical rotation in medical school: a qualitative case study design

Public health clinical rotation in the Faculty of Medicine, Universitas Islam Indonesia, was conducted in Puskesmas (community health center). This study aims to evaluate the public health clinical rotation in Puskesmas, part of the clinical clerkship of the Faculty of Medicine, Universitas Islam Indonesia. Several concerns have been highlighted regarding the implementation of clinical rotations in public health in Puskesmas. A briefing session before placement in the village must be coherent with a guidebook. The placement of students in the village was based on community health issues determined by the Puskesmas supervisor. Priority in the curriculum was given to converting the alertness village (Desa Siaga) into a Program Indonesia Sehat-Pendekatan Keluarga (Healthy Indonesia Program-Family Education) program throughout implementation. Moreover, scheduling after four major clinical programs was difficult, and the writing of reports served as a guide for establishing the correct format. Therefore, the objective of the evaluation was to assess knowledge, skill, and psychomotor, and the burden of assignment in Puskesmas was difficult to accomplish a primary task in the community

KUALITAS FISIK, BEBAN KERJA FISIK DAN KELUHAN MUSKULOSKELETAL PADA PEKERJA DI BALAI YASA YOGYAKARTA

Background. Musculoskeletal symptoms are the main problems in occupation not only related to work productivity but also with another factors that influence to physical quality, physical workload, individual, ergonomic, physical work environment and psychosocial. Musculoskeletal symptoms often finds in workers who work with heavy equipment such as workers in Balai Yasa Yogyakarta. Objective. The objective of this research is to knows the correlation of physical quality and physical workload against work related to musculoskeletal symptoms to locomotive workshop workers in Yogyakarta. Method. This research is an analytical observasional with cross sectional design. This research conducted in Balai Yasa Yogyakarta with total population of 122 workers consist of two part of body locomotives, that is upper body and lower body with sampel estimate 70 workers. Sampel was taking as simple propotional random sampling method while measurement tool used questionnaire and direct measurement to know correlation between physical quality, physical workload and work related to musculoskeletal symptoms. The data will be analyzed using multiple regression to knows the correlation of physical quality and physical workload against work related to muscukoskeletal symptoms to workers in Balai Yasa Yogyakarta. Conclusion. There were significant correlations between physical quality (hemoglobin and calori) and no significant correlation between Body Mass Index and protein against musculoskeletal symptoms. There were significant correlation among workload, age, smoking and no significant correlation to work duration againts musculosksletal symptoms

Quantitative detection of organic mercury in whole blood using derivatization and gas chromatography-negative chemical ionization-mass spectrometry

The Minamata disease, first identified in Japan in the 1950s, is caused by severe methylmercury (MeHg) poisoning. To prevent the development of this disease, routine evaluation of MeHg levels in blood samples is crucial. The purpose of this research was to explore the use of derivatization and capillary gas chromatography-negative chemical ionization-mass spectrometry (GC-NCI-MS) for the quantitative detection of both organic and inorganic mercury in blood samples. Alkyl mercury in standard solutions was extracted as halide salts in toluene with hydrohalic acid. Fat contents in whole blood samples were removed by methyl isobutyl ketone and hexane using a cysteine/alkaline solution and then organic mercury was extracted as a bromide complex using toluene and cupper chloride solution. The linearity of the response ratio vs. concentration curves (R2) was 0.987 for methylmercury bromide and 0.990 for ethylmercury (EtHg) bromide, over the calibration range of 0.02 ng/mL to 20 ng/mL. The recovery of MeHg and EtHg was 67.1% and 49.3%, respectively. The concentrations of MeHg in whole blood samples determined using GC with an electron capture detector agreed with those determined using GC-NCI-MS, with a correlation coefficient of 0.923. The mean concentration of MeHg in a certified reference material (NMIJ CRM 7402-a) determined using GC-NCI-MS was 0.64 μg/g, comparable with the certified value of 0.58 μg/g. Our study demonstrates a simple and low-cost approach for analyzing mercury in biological samples, although further optimization is required given the relatively low recovery and the concern about the toxicity of methyl isobutyl ketone

Plasma eicosapentaenoic acid, a biomarker of fish consumption, is associated with perfluoroalkyl carboxylic acid exposure in residents of Kyoto, Japan: a cross-sectional study

Background: Per- and polyfluoroalkyl substances (PFASs) are highly fluorinated organic compounds that have been widely used in industry during the past few decades. The main exposure routes for PFASs are thought to be the diet, drinking water, and dust. In this study, we aimed to evaluate the relationship between perfluoroalkyl carboxylic acids (PFCAs, members of the PFAS family) and the plasma eicosapentaenoic acid-to-arachidonic acid ratio (EPA/AA), a biological indicator of seafood intake, to determine whether seafood intake may represent a means of exposure to PFASs in the Japanese population. Methods: We performed a cross-sectional study using 131 plasma samples collected from residents of Kyoto, Japan in 2013 and held in the Kyoto University biological sample bank. The concentrations of perfluoroheptanoic acid (PFHpA), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluoroundecanoic acid (PFDA), perfluoroundecanoic acid (PFUnDA), perfluorododecanoic acid (PFDoDA), perfluorotridecanoic acid (PFTrDA), EPA, and AA were quantified by gas chromatography-mass spectrometry, and multiple linear regression was used to analyze the results. Results: In multiple linear regression analyses with age and eGFR, PFOA showed a significant positive linear association with age (p = 0.0005); PFHpA showed a significant negative linear association with estimated glomerular filtration rate (eGFR; p = 0.0338); and PFHpA, PFOA, PFNA, PFUnDA, and PFDoDA exhibited significant positive linear associations with EPA/AA (p = 0.0358, 0.0056, 0.0242, <0.0001, and <0.0001, respectively). Because only PFHpA and PFOA were associated with smoking, their concentrations were examined again with smoking variable included and neither showed an association with smoking habit. PFOA showed a significant linear association with EPA/AA ratio (p = 0.0072), but PFHpA did not (p = 0.051). Conclusions: The plasma concentrations of PFOA, PFNA, PFUnDA and PFDoDA significantly associated with the EPA/AA ratio in residents of Kyoto