CD Tesis

Faktor Lingkungan Kerja Yang Mempengaruhi Kejadian Tb Serta Dampak Ekonomi Pada Penderita Tb Di Kota Pekanbaru

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Environmental health is an ecological balance that must exist between humans and the environment in order to guarantee the healthy state of humans. If the environmental health conditions are not giving so much attention, the environmental based diseases will be appeared, one of which is Tuberculosis. Pulmonary tuberculosis is an infectious disease caused by the bacteria Mycobacterium tuberculosis which mostly attacks the lungs and can also attack other organs of the body. There are three factors that can accelerate the transmission of TB in the workplace namely physical environmental factors, social environmental factors and economic impacts. The physical environment that can influence the incidence of TB is poor lighting in the room, temperature that does not meet the requirements, humidity that does not meet the requirements and the presence of ventilation. The condition of the physical environment is important to create a healthy environment. If the physical environment meets the requirements it will inhibit TB transmission.
Pekanbaru City is one of the cities with the most TB sufferers in all Riau provinces. The results of TB control program activities in Pekanbaru City show the number of TB cases in office workers until 2018 that reached 41 people.
This study aimed at analyzing the relationship between physical environmental factors (temperature, humidity, lighting and ventilation), social environment (shared eating utensils, cough ethics and sputum removal habits), and the economic impact on TB incidence in office workers in Pekanbaru City. This research was conducted in Pekanbaru City. This research was conducted from August 2019 to October 2019. The research method used was a survey method with a case control study design. The study was conducted by direct measurement of temperature, humidity and lighting of the workspace, and the provision of questionnaires to measure the behavior of workers. The data analysis used was multiple logistic regression analysis.
The results of this study showed that there is a significant relationship between temperature (p value = 0.027), humidity (p value = 0.008), lighting (p value = 0.014) and ventilation (p value = 0.008) with the incidence of TB in the workplace. Mycobacterium tuberculosis grows optimally at 37 ° C. Exposure to sunlight for 5 minutes can kill M. tuberculosis and survive in a dark place, so that the breeding of more bacteria in a dark room. A room which does not have humidity that meets health requirements will have an effect on its occupants. A damp room is a good medium for the growth of microorganisms, including the bacteria can enter the body through the air. In addition, high humidity can cause nasal mucous membranes to become dry making it less effective in blocking microorganisms. Good lighting can prevent warding off the Mycobacterum Tuberculosis bacteria that can live in the room so it is not easily attacked by diseases such as TB. All types of light can kill bacteria. The same light when emitted through colorless glass can kill bacteria in a shorter time than through colored glass. Factors of intensity of sunlight in space and ventilation are very important in the transmission of diseases related to the respiratory tract.
The results also showed that there is a significant relationship between coughing / sneezing ethics (p value = 0.015), sputum removal behavior (p value = 0.001) and the incidence of TB in the workplace. However, there was no relationship between eating utensils (0.337) and the incidence of TB in the workplace. The behavior of using shared tableware does not have the risk of causing the transmission of TB. Bacteria contained in sputum cannot be transmitted through the use of shared cutlery, because the cutlery is washed with soap so the bacteria can be lost. The source of TB transmission is TB patients. When coughing or sneezing, the patient spreads germs into the air in the form of sputum droplets (droplet nuclei). Cough ethics is a good and correct cough procedure, by covering the nose and mouth with a tissue or sleeve, so that bacteria do not spread into the air and are not transmitted to others. The ethical purpose of coughing is to prevent the spread of a disease widely through free air (Droplets) and to make comfort for those around it. Bacteria in sputum can fly in the air and then inhaled by people around. Phlegm issued by TB patients contains TB bacteria which can be inhaled by others if not properly managed.
The increasing in TB cases is a major threat to public health and a large economy. The impact of TB is measured by direct costs, such as the allocation of unplanned funds to tackle TB, the costs of medical care, such as inpatient and outpatient costs, increased household expenses to buy food, medicines, and transportation. While indirect costs, such as a decrease in household income due to loss of workdays and loss of productive workdays due to illness or to care for sick family members. Based on the results of interviews with families or respondents, household income ranges from Rp. 6,000,000 to Rp. 8,000,000 per month. For patients who do not use health insurance, medical expenses can reach more than Rp 5,000,000. While the costs incurred by families of patients outside of medical costs range between Rp 500,000 to Rp 1,000,000 in the form of food purchases during treatment, transportation, and other needs. TB patients lose an average of three to four months of work and up to 30 percent of annual household income.
Based on the results of multiple logistic regression tests it was found that the temperature variable had a value of p = 0.005 and OR 6.836, humidity had a value of p = 0.003 and OR 8.087, lighting had a value of p = 0.04 and OR 3.443, ventilation had a value of p = 0.04 and OR 2.951, ethics of sneezing cough has a value of p = 0.08 and OR 2.002, the variable sputum removal behavior has a value of p = 0.024 and OR 3.85. The value of the Negalkarke R Square coefficient explains that in this regression model that is the ability of temperature to explain the incidence of TB by 9.4% and the remaining 90.6% is explained by other variables. Humidity has the ability to explain the incidence of TB by 13% and the remaining 87% is explained by other variables. Lighting has the ability to explain the incidence of TB by 11.3% and the remaining 88.7% is explained by other variables. Ventilation has the ability to explain the incidence of TB by 13.1% and the remaining 86.9% is explained by other variables. Sneezing cough ethics has the ability to explain the incidence of TB by 11.1% and the remaining 88.9% is explained by other variables. Sputum removal behavior has the ability to explain the incidence of TB by 19.4% and the remaining 80.6% is explained by other variables.
The results of the chi square analysis and logistic regression showed that the most influential variable was humidity with an OR 8.087 meaning that humidity was eight times the risk of TB incidence. Humidity is a good tool for the growth of microorganisms, including TB germs. However, humidity is also influenced by topography so that higher regions tend to have lower humidity.
Based on the results of research conducted, it can be concluded that temperature, humidity, lighting, ventilation, cough / sneezing ethics and phlegm removal behavior are related to TB incidence. Cutlery use behavior is not related to TB incidence. The most dominant risk factor for TB incidence is humidity with an OR 8.087 meaning that humidity is 8 times the risk of TB incidence. The economic impact for TB sufferers must incur indirect costs such as transportation costs, accommodation costs, food needs during treatment, and other needs. For government subsidized medical expenses through BPJS. All medical expenses and treatment therapies are borne by the government until they recover.
It is expected that the Department of Health through the puskesmas can propel the Upaya Kesehatan Kerja (UKK) and Environmental Health Work programs, one of which is prevention of TB and transmission of TB in the workplace. Workplaces can create environmental engineering by adding lighting in the workplace, having good ventilation, adding light bulbs, using bright curtains so that lighting meets the requirements. With the improvement of ventilation can flow air circulation so as to get the temperature and humidity that meet the requirements one of them is the use of air conditioners.

Keywords: Physical Environment, Social Environment, Economy Impact, Tuberculosis

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Ketersediaan

Informasi Detail

Judul Seri

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No. Panggil

10 01. 220 (0013)

Penerbit

Pekanbaru : Universitas Riau – Pascasarjana – Magister Ilmu Lingkungan., 2020

Deskripsi Fisik

xv, 89 hlm.: ill.: 29 cm

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Indonesia

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Klasifikasi

10 01. 220 (0013)

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FATAH

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