LINGKUNGAN KERJA

Nendyah Roestijawati
PENYEBAB PAK/PAHK

Karakteristik pekerja (usia, jenis kelamin, status gizi, dll)

Beban kerja
Beban tambahan akibat lingkungan kerja
1. Fisik
2. Kimia
3. Biologi
4. Psikologi
5. Ergonomi
LINGKUNGAN FISIK

Kebisingan
Getaran
Suhu dan kelembaban
Radiasi
Tekanan udara
 KEBISINGAN

Sensitive range : 16 20.000 Hz 9 octaves

Below 16 Hz : perceive as vibration
Above 20.000 Hz : ultrasonic
Noise : any disturbing sound
Measurement : sound level meter
Sources : street, industrial, office, office
machine, VDT
Noise Induced Hearing Loss
NIHL

slow but progressive degeneration of the

sound sensitive cells of the inner ear
High frequency > low frequency
Intermittent > continues
Single very loud immediately
Starts from high frequency about 4000 Hz,
gradually to lower
Measurement : pure tone audiometer
Age Deafness

1. Greatest in the higher ranges frequency

2. More pronounced in men than in
women
3. At 3000 Hz : 50yr 10 dB, 60yr 25 dB,
70yr 35 dB
4. Loss of hearing increases progressively
as the frequency is raised
Protection

1. Reduction of noise at source 20-30 dB

2. Insulation against reflection and scattering
5-10 dB
3. Personal sound protection :
ear plug >30dB, ear muff 40-50 dB
Nilai Ambang Batas kebisingan: 85 dB(A)
 GETARAN

WHOLE BODY VIBRATION (sitting person)

Visual powers : poor acuity and visual field
become blurred unsteady > 4 Hz, greatest 10-
30 Hz
Skill : impairs visual perception, mental
processing of information, carrying out skilled
movement
Spinal ailments : disc trouble and arthritic
complaints
HAND-ARM VIBRATION
SYNDROME

Arthritis : < 40 Hz
Atrophy
Dead finger (Raynauds disease) : 40-300
Hz small amplitude of oscillation 0.2-5 mm
cramp-like condition of blood vessels
 RECOMMENDATION

1. Driving seat : type suspension 50%

2. Damping hand-operated power tools :
flexible material, thick gloves, avoid cold
conditions
3. Adjust the subjects work schedule
Nilai Ambang Batas 4 m/det2 atau 0,40 Grav
 TEMPERATUR

THERMOREGULATION
Control of blood circulation
Secretion of sweat, under nervous control
Shivering
 HEAT EXCHANGE

1. Conduction
2. Convection
3. Evaporation
4. Radiation
 TEMPERATUR TINGGI

HEAT CRAMPS
Hyperventilation
Respiratory alkalosis
Tetanic-like convulsion
HEAT EXHAUSTION

An inability of the circulation to meet

simultaneously the demands of
thermoregulation and vital organs such
as brain and active skeletal muscle
Aggravated by dehydration
Weakness, frontal headache, anorexia,
nausea, faintness or actual fainting (heat
syncope), breathlessness
HEATSTROKE

Core temperature reach 39C

General feeling of listlessness, loss of
performance in spite of every effort,
bright red skin and an increased heart
rate with feeble pulse
Severe headache, giddiness, shortness of
breath, vomiting, muscular cramps
Unconsciousness death
PRICKLY HEAT (MILIARIA)

Acute inflammatory disease of the skin

Sweat gland ducts become blocked by
a plug of keratinized cells
1. Excessive wasting away of natural skin
oil
2. Infection
3. Electrolyte imbalance sweat
composition
HEAT TOLERANCE

1. Rectal temperature should not

exceed an upper limit of 38C
2. Heart rate 100 110 beat/min
3. Evaporation sweat 0-5 L/h
RECOMMENDATIONS

1. Acclimatized by stages
2. Cooling periods
3. Drink small amounts of fluid at frequent
intervals
4. Lightly sweetened drink
5. The drinks close to the worker
6. Protection device : Google, screen,
cloth
Pengaturan waktu ISBB (C)
kerja setiap jam
Waktu Waktu Beban kerja
Kerja Istirahat
Ringan Sedang Berat
75% 25% 30,6 28,0 25,9
50% 50% 31,4 29,4 27,9
25% 75% 32,2 31,1 30,0
LOW TEMPERATURE

COLD-INDUCED INJURIES
Lowering of core body temperature local
tissue cooling tissue anoxia and freezing
Frostbite : skin turns red bluish red with
localized burning pain ischemia gangrene
Trench foot (immersion foot) : erythematous skin
pale oedem paraesthesia leg
cramps vesiculation ulceration
gangrene
Chilblain (pernio) : localized erythemia,
cyanosis, plaques and nodule
 Hypothermia : core temperature < 35C,
vasoconstriction, pallor, in coordination, muscular
weakness, dulling of cerebration
32-30C : slow heart rate, shallow breathing,
shivering diminishes, consciousness ventricular
fibrillation
PREVENTION
Weatherproof cabin
Clothing design
Layered clothing
Special footwear and gloves
HUMIDITY

Comfort : 40-50%
< 30% unhygienic mucous
membranes
Increased incidence of catarrhal
ailments, chronic irritation of nasal and
bronchial passages
 RADIASI

Nonionizing radiation
Infrared : pd kulit tdk penetrasi hanya
memanaskan lukabakar akut, pigmentasi
pd mata : katarak
Visible : photochemical injury pada retina
Ultraviolet : photokeratitis, conjunctivitis
Microwave dan radiofrequency : katarak, lesi
kornea dan retinal, lesi testikular dan produksi
sperma menurun
Laser, dll
Ionizing radiation
Sinar x
Sinar gamma
Alpha : lokal
Beta : sistemik
 DECOMPRESSION SICKNESS

Results from mechanical and physiological effects of

expanding gases and bubbles in blood and tissue
Higher than atmospheric gas pressure absorbs more
inhaled gases nitrogen concentration increase in
nervous system, bone marrow and fat
Blood supply is poor in bone marrow and fat nitrogen
enters and leaves tissues more slowly than oxygen or
carbon dioxide
As surrounding pressure decrease (decompression)
nitrogen expands and will form gas bubbles
Most cases after rapid ascension from 9 meters sea
depth, sudden pressure in excess at 7000 meters
Caisson disease
 Gejala

Joint pain
Dizziness
Headache
Difficulty thinking clearly
Extreme fatigue
Tingling or numbness
Weakness in arms or legs
A skin rash
TREATMENT
 LINGKUNGAN KIMIA

Padat : fume, asap, debu

Cair : awan, kabut
Gas : uap, gas
Partikel : debu, awan, kabut, fume
Non partikel : gas, uap
Efek Medik

Konsentrasinya di udara
Sifat fisik
Sifat kimia : daya larut dalam air
Port dentre
Faktor tenaga kerja
Efek Medik Partikel

Perangsang : kapas, sabun, bubuk

Toksik : Pb, As, Mn
Penyebab fibrosis : debu asbes
Penyebab alergi : tepung sari, kapas
Penimbul demam : fume, ZnO
 Efek Medik Non Partikel

Asfiksants : methan, helium

Perangsang : ammoniak, HCl, H2S
Racun organik dan anorganik :
nikelcarbonyl
Berefek anestesi : trichloretilen
Merusakorgan dalam : CCl4,
benzen, parathion
 Pencegahan
Substitusi : mengganti bahan kimia
Pengendalian teknik : Pelajari kontrol lingkungan (ventilasi, dll)
Administratif :
Simpan bahan kimia pada wadah tertutup
Pelajari dengan baik seluruh MSDS (Material Safety Data Sheet), kenali
bahaya potensial
Cuci tangan
Hindari kontak kulit
Jika terjadi kontak kulit, gunakan petunjuk sesuai MSDS
Mengikuti pelatihan kesehatan, training dan program monitoring
Cegah kontaminasi tempat tinggal
Tanggung jawab pengusaha dan tenaga kerja
Gunakan APD
PESTISIDA

Pestisida adalah zat untuk membunuh atau

mengendalikan hama
Penggolongan
a. Insektisida : organoklorin (DDT),
organofosfat, karbamat. piretroid
b. Herbisida : klorofenoksi, biperidil, dll
c. Fungisida : merkuri, dikarboksimida, dll
d. Rodentisida : warfarin, tiourea, dll
e. Fumigan : akrilonitril, etilen bromida,dll
Jalan masuk dan faktor yang
mempengaruhi efek

Jalan masuk
Dermal
Inhalasi
Oral
Faktor yang mempengaruhi efek
Dosis
Tingkat toksisitas
 MACAM PESTISIDA

Indikator I II III IV

Oral LD50 <50 50-500 500-5000 >5000

Inhalasi LD50 <0.2 0.2-2 2-20 >20
Dermal LD50 <200 200-2000 2000-20000 >20000
Signal word Danger Warning Caution Caution
Eye effect Corrosive, Corneal No Corneal Irritation -
Corneal opacity opacity
opacity non reversible - Irritation
reversible irritation reversible
Skin effect corrosive Severe Moderate Mild
irritation irritation irritation
Kemasan Coklat tua Merah tua Kuning tua Biru muda
 MEKANISME KERJA

Organoklorin : merangsang sistem saraf menyebabkan

parestesia, peka terhadap rangsang, terganggunya
keseimbangan, tremor dan kejang
Organofosfat dan karbamat : antikolinesterase
menghambat impuls saraf dengan mengikat kolinesterase
sehingga tidak terjadi hidrolisis asetilkolin
Pengikatan kolinesterase oleh organofosfat

Kolin +
Asetilkolin asam
asetat
Kolinesterase

Fosforilasi

Organofosfat
Penurunan aktivitas kolinesterase

Penurunan aktivtas Tingkat keracunan

kolinesterase
70 - 100% Normal
Tidak ada tindakan
>50 - 75% Keracunan ringan
Jika lemah anjurkan istirahat
selama 2 minggu
>25 - 50% Keracunan sedang
Diistirahatkan
0 25% Keracunan berat
Diistirahatkan dan dirujuk

Nilai normal 11,4 3,5 /L

 Organoklorin

Mual, muntah, gelisah, pusing, lemah, rasa geli atau menusuk pada
kulit, kejang otot, hilang koordinasi, tidak sadar
Tidak ada antidot langsung untuk mengatasi keracunan
Obat yang diberikan untuk gejala seperti anti konvulsi : diazepam
10mg iv perlahan
Hiperaktivitas dan tremor, berikan natrium fenobarbital 100mg sc
setiap jam sampai mencapai 0,5g atau sampai konvulsi terkendali
Jangan berikan epinefrin karena dapat menyebabkan fibrilasi
ventrikular
 Organofosfat dan karbamat

Lelah, sakit kepala, pusing, hilang selera makan, mual, kejang perut,
diare, penglihatan kabur, keluar airmata, keringat, air liur berlebih,
tremor, pupil mengecil, denyut jantung melambat, kejang otot, tidak
sanggup berjalan, rasa tidak nyaman dan sesak, bab dan bak tidak
terkontrol, inkontinensi, kejang, tidak sadar
Gejala keracunan karbamat cepat muncul namun cepat
menghilang dibandingkan organofosfat
Antidot : atropin sulfat 2,5mg bolus iv, teruskan 0,5 1mg setiap 5-10-
15 menit sampai gejala parasimpatik terkendali (atropinisasi : mulut
kering, muka merah, pupil dilatasi, jantung berdebar, gelisah)
Maintenance : 0,5 1 mg tiap 1-2-4-6 jam
Minimal 2 x 24 jam
Parasympatheti Muscarinic Eye,iris muscle, ciliary Contraction
c muscle
Sympathetic Contraction
Glands : lacrimal, salivary, Secretion
resp, GI, urinary, sweat
Heart : SA, AV node Slowing, refractory
period increase
Sm : bronchial, GI Contraction
Wall, sphincter Contraction,
relaxation
Bladder, fundus, sphinter Contraction,
relaxation
Neuromuscular Nicotinic Skeletal Excitation
Central nervous Brain Excitation
Depression
HEAVY METAL
 LEAD

Kegunaan : pelapis kabel, pipa, cat

Efek toksik : hematopoetik, kontraksi otot
polos dan iritasi vagal, gangguan ginjal,
Indikator biologik : kadar timbal darah, kadar
timbal urine ( indikator pemajanan udara ),
kadar timbal rambut sistem saraf
RUTE PAPARAN
MEKANISME
GEJALA
TERAPI
 MERKURI

Kegunaan : peralatan ukur, pembuatan

amalgam, desinfektan, fungisida
Efek toksik : ginjal, diskolorisasi coklat mata,
neurologis
Indikator biologis : kadar dalam urin
SIGN AND SYMPTOM
KADMIUM
TOKSISITAS
METAL FUME FEVER
ORGANIC SOLVENT
KLASIFIKASI
EFEK
EFEK
EFEK
LINGKUNGAN BIOLOGI
TOKSISITAS
PENCEGAHAN
PENCEGAHAN
TERIMAKASIH