HEALTHY SANITATION AS EFFORTS TO RESOLVE ENVIRONMENTAL QUALITY CHANGES IN CONNECTION WITH ACUTE RESPIRATORY INFECTION IN ACEH

Prilly Agustina Mayanksari1* and Kharisma Utari2

1 2

Student Faculty of Public Health University of Indonesia, Depok 16424 Student Faculty of Public Health University of Indonesia, Depok 16424 * Email:prillyagustina@yahoo.com

Abstract Aceh province has a lot of wood processing industry which is growing very rapidly. In Banda Aceh, there are 55 furniture industry. Development in industry is a potential source sector of pollution that harm health and environment. One of the important impacts of industrial development is the result of changes in environmental quality caused by air pollution. The physical process of processing of raw materials to finished goods such as furniture be likely to result in pollution as wood dust particles. Furniture industry in Banda Aceh has not received attention in terms of occupational health services, particularly diseases associated with Acute Respiratory Infection (ARI). Acute Respiratory Infection (ARI) is an acute infection that lasts for 24 days, which affects one or more parts of the respiratory tract, from the nose (top line) to the alveoli (bottom line) includes channels such as sinuses, middle ear cavity and pleura. In Banda Aceh, prevalence of Acute Respiratory Infection (ARI) increase from 63.78% in 2008 to 70.36% in 2009. This causes morbidity Acute Respiratory Infections (ARI) topped the list of 10 most infectious diseases in Banda Aceh. Healthy means a state in which a person can live a productive social and economic, sanitation means a work that can be done to prevent, eliminate or reduce environmental factors caused disease based environment. Healthy sanitation is expected to cope with changes in environmental quality primarily in terms of decreasing the incidence of disease (prevalence) ARI in Aceh. Keywords: Aceh, Healthy, ARI, Sanitation

Problems There are many factors that can be used as an indicator to see a rise or fall in public health, for example: sanitary. Sanitation is closely related with environment-linked diseases such as Acute Respiratory Infection (ARI). Sanitation is an effort that can be done to prevent, eliminate or reduce environmental factors cause an illness. In this case, air sanitation is an attempt to do so as the host (humans) to avoid contamination or other chemicals present in the air. The number of infectious disease morbidity indicates the state of public health in the province of Aceh. Morbidity is prevalence of a disease that occurs in a population in a specified period. According to various reports, the problems that hit Aceh province are not only the problems surrounding the issue of natural disasters, like the Tsunami that occurred in 2004. But it is also associated with high rates of infections such as malaria, diarrhea, dengue fever and Acute Respiratory Infection (ARI), which is an endemic disease which one of the determinant risk factors is poor sanitation. Prevalence of Acute Respiratory Infection (ARI) in the province of Aceh is quite high compared to other infectious diseases. These health problems need serious treatment because it involves major human respiratory organs, such as lungs. Acute

Respiratory Infection, is one of diseases that spread through airborne agents (airborne disease). The majority of Acehnese prone Acute Respiratory Infection (ARI). The epidemic is growing in the community suspected due to pollution caused by industry, furniture industry and in particular due to the influence of temperature in Aceh that can reach 41 degrees Celsius. Aceh province has a relatively high prevalence of ARI that compared to other provinces in Indonesia, as shown in the following table. Table 1. Prevalence of Communicable Diseases in Aceh Province (Riskesdas, 2007)
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Province NAD North Sumatera West Sumatera Riau Jambi South Sumatera Bengkulu Lampung Bangka Belitung Kepulauan Riau DKI Jakarta West Java Middle Java DI Yogyakarta East Java

ARI D 11,98 8,26 8,98 6,28 7,54 10,08 14,50 4,10 10,38 9,88 9,78 6,95 8,74 8,22 6,38 DG 36,64 22,39 26,38 22,87 22,65 17,54 29,84 18,80 30,32 25,78 22,60 24,73 29,08 22,65 20,55

Pneumonia D DG 1,44 0,65 0,80 0,42 0,37 0,75 0,73 0,22 0,43 0,39 0,68 0,72 0,53 0,44 0,36 3,87 1,60 2,49 1,61 1,29 1,24 2,04 0,77 1,29 1,22 1,67 2,43 2,12 1,81 1,06

TB D 0,73 0,18 0,37 0,42 0,34 0,25 0,33 0,11 0,12 0,38 0,71 0,56 0,63 0,36 0,24 DG 1,45 0,48 1,03 1,00 0,75 0,20 0,86 0,31 0,49 0,83 1,26 0,98 1,47 1,58 0,54

Measles D DG 1,06 0,59 1,90 0,72 0,91 0,36 0,54 0,24 0,32 0,50 1,29 0,92 0,70 0,37 0,42 1,78 0,85 2,53 1,28 1,27 0,54 0,99 0,37 0,52 0,78 1,59 1,27 1,14 0,64 0,63

Acute Respiratory Infection (ARI) is a disease of the upper or lower respiratory tract, usually infectious, which can cause a wide spectrum of diseases ranging from asymptomatic disease or mild infection to severe and fatal disease, depending on the pathogen cause, environmental factors, and factors host. However, ARI is defined as an acute respiratory illness caused by an infectious agent that is transmitted from human to human. The onset of symptoms is usually rapid, within a few hours to several days. Symptoms include fever, cough, and often sore throat, coryza (runny nose), shortness of breath, wheezing, or difficulty breathing. Pathogens that cause acute respiratory infection is rhinovirus, respiratory syncytial virus, parain influenza virus, severe acute respiratory syndrome associated corona virus (SARS-CoV) and influenza virus. Cause Pollutant industrial activity may be the result of gas and dust that risk to human health. Effects on health is influenced by the intensity and duration of exposure, but it is also influenced by the health status of exposed. Wood processing industry is one industry is growing very rapidly. This situation affects the consumption of forest products reached 33 million m3 per year. Consumption of forest products such great among others absorbed by the polywood industry, sawmills, furniture, particle board and paper pulp. Wood processing industry requires energy, and the use of natural raw materials are great, such as hardwoods

such as: teak, meranti, mahogany and softwood include: pine and albasia. The physical process of processing the raw materials to be used as furniture tends to produce pollutants such as wood dust particles. Furniture industry has the potential to cause air pollution in the workplace in the form of wood dust. Wood dust particles about 10 to 13% which will be shaped sawed and polished wood dust flying in the air.
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Gambar 1. Teori Paradigma Kesehatan (Blum, 1981) [3] Incidence of respiratory disease in Aceh can be drawn into a model-based approach to the pathogenesis of the disease, where the environment has great potential in causing a disease. In accordance with the Theory of Paradigm Health (Blum, 1981) has the greatest influence than other indicators. Solution The solutions offered to solve the problems in Aceh ISPA is through community pencerdasan maximizing functions related to sanitation and Occupational Health and Safety in each industry Aceh, especially the furniture industry. For example for the industry needs to do initial health checks for newly enrolled workers and for all workers to periodically monitor the physical condition of workers by the company. Then also need to be implemented prevention efforts with counseling on the importance of using personal protective equipment (PPE) as well as the provision of PPE especially masks by related agencies and companies. There needs to be monitoring the work environment by conducting regular visits to the company and to provide guidance on health and safety by the relevant agencies.[4]

Figure 2. Figure 2. Knot Theory Prof. Umar Fahmi Achmadi (Professor of Environmental Health FKM-UI) [5] Knot theory above describes the linkages between the various factors that cause disease and also where prevention efforts can be made. With reference to the schematic above, the incidence of disease pathogenesis or process-based environments can be decomposed into five-node, ie node 1, we refer to as the source of disease; vertex 2, which is the environmental component of disease transmission medium; node 3, people with different demographic variables; knot 4, people are healthy or sick after an interaction or exposure to the components of the environment containing the disease agent, while node 5 are all variables that have an influence on the fourth node.[5] Ideally, by controlling the source of the disease, we can prevent a process incident to node 3, 4, or 5. However, in our respiratory illness should look into all the nodes to control the incidence of the disease. Here's a description of healthy sanitation efforts at each node: Node 1 connected source or agent of respiratory diseases, methods of prevention can be done by health education related to disease-causing pathogens. Community Aceh province. Programs related to healthy sanitation interventions done to make people aware about the importance of keeping the environment clean. Node 2 associated disease transmission media (air, water, food, vector-borne, and humans), healthy sanitation program conducted by environmental conservation. Temperature and humidity are high enough in the province due to its geographical location at the western end of Indonesia, need to be addressed by providing more open land for tree planting medium and plants such sansaviera detoxification.

Table 2. Climate statistics Aceh province, 2009-2010 [7]

URAIAN Wind Speed The Average Air Temperature The Average Moisture Rainy Day Rainfall Solar Radiation SATUAN m/s 0 C % Day/month Mm/month % 2009 4,8 22,9-32,5 78,7 13,2 131,4 51,2 2010 4,8 22,6-32,8 81,4 14,8 165,5 43,1

Demographic variables related to node 3, which is not necessarily a disease can infect an individual as it relates to demographic variables such as education, behavior, density, gender. Increased public education status, investment principles Clean and Healthy Behavior (PHBs), and limit the number of people through family planning programs need to be implemented to reduce the level of respiratory morbidity in the province of Aceh. Node 4 regarding the condition of the population, either healthy or sick. Efforts can be made to minimize the impact of the manifestations of the relationship between residents with an environment that produces the disease in the population. While a healthy society must be protected in order to avoid the threat of disease agents, through herd immunity or herd immunity. Node 5 which is supra variable system, efforts can be made in terms of policy. Macro policies of a government that is usually the decision makers of policies aimed at influencing the strategic environment. Conclusion Based on the problems and the solutions offered above, is expected to address the sanitation healthy changes in environmental quality primarily in terms of decreasing the incidence of disease (prevalence) ISPA in Aceh.

Referensi
[1] Riskesdas Indonesia tahun 2007 [2] Tulus, M.A. 1992. Manajemen Sumber Daya Manusia. Jakarta: Gramedia Pustaka Utama [3] Pratomo, Hadi. Bahan ajar mata kuliah Dasar-dasar Kesehatan Masyarakat FKM-UI. [4] Sumamur, PK. 2009. Higiene Perusahaan dan Kesehatan Kerja (HIPERKES). Jakarta: CV. Sagung Seto. [5] Achmadi, Fachmi Umar. Paradigma Kesehatan Lingkungan in Manajemen Penyakit Berbasis Wilayah. Jakarta: Penerbit Universitas Indonesia (UI-Press), 2010, 28-43 [6] Data Statistik Daerah Provinsi Aceh tahun 2011