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"Gangguan pendengaran sensorineural merupakan salah satu komplikasi pada otitis media supuratif kronik (OMSK). Kelainan ini bisa bersifat sementara atau permanen dan dipengaruhi oleh banyak faktor. Pemeriksaan audiometri konvensional, masking dan tes Sensorinural Acuity Level (SAL) dapat menilai seberapa besar kejadian ini. Penelitian ini bertujuan untuk mengetahui prevalensi gangguan pendengaran sensorineural pada OMSK dan faktor yang berhubungan. Penelitian ini merupakan penelitian potong lintang bersifat deskriptif analitik yang dilakukan di Poli THT RSUPN dr. Cipto Mangunkusumo periode Januari-Mei 2015 melibatkan 73 telinga OMSK. Gangguan pendengaran sensorineural pada OMSK didapatkan sebanyak 24,7% dan umumnya terjadi pada frekuensi tinggi. Tipe OMSK, durasi penyakit, dan tipe perforasi dapat memengaruhi gangguan pendengaran sensorineural dan secara statistik bermakna. Gangguan pendengaran sensorineural terjadi pada OMSK dan pemeriksaan audiometri yang benar dapat menentukan kejadian ini. Tipe OMSK, durasi penyakit, dan tipe perforasi memengaruhi kejadian gangguan pendengaran sensorineural pada OMSK.

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Sensorineural hearing loss is one of the complications of chronic suppurative otitis media (CSOM). This order can be temporary or permanent and influenced by many factors. Conventional audiometry, masking, and Sensorineural Acuty Level (SAL) test can diagnose this incident. This study aims to determine the prevalence sensorineural hearing loss in chronic suppurative otitis media and related factors.

This study was a cross sectional descriptif analytic which done at ENT Department Cipto Mangunkusumo Hospital periode January to May 2015 involving 73 ears of CSOM. The prevalence of sensorineural hearing loss in CSOM is about 24,7% and generally occurs at high frequency. Type of CSOM, duration of disease, and type of perforation may affect sensorineural hearing loss and statistically significant. Sensorineural hearing loss accurs in CSOM and audiometry examination can determine this condition. Type of CSOM, duration of disease, and type of perforation influence the incidence of sensorineural hearing loss in CSOM."

"Latar belakang: Gangguan pendengaran sensorineural pada pilot merupakan masalah kesehatan yang dapat menyebabkan inkapasitasi pada saat pilot menjalankan tugas terbangnya dan berdampak terhadap keselamatan penerbangan. Tujuan penelitian ini mengidentifikasi jam terbang total dan faktor dominan lainnya terhadap risiko gangguan pendengaran sensorineural di antara pilot sipil di Indonesia. Metode: Desain penelitian potong lintang dengan purposive sampling pada tanggal 4-20 Mei 2015 terhadap pilot laki-laki berusia 20-60 tahun dan pilot memiliki lisensi Commercial Pilot License (CPL) atau Air Transport Pilot License (ATPL) yang sedang melakukan pemeriksaan kesehatan berkala (medex) di Balai Kesehatan Penerbangan, Jakarta. Gangguan pendengaran yaitu subyek memiliki ambang dengar 25 dB atau lebih. Pengumpulan data dilakukan dengan wawancara memakai kuesioner. kemudian data diambil dari rekam medis pada hari pemeriksaan. Risiko gangguan pendengaran sensorineural dianalisis menggunakan risiko relatif (RR) dengan regresi Cox. Hasil: Selama 3 minggu masa pengumpulan data terdapat 681 pilot yang melakukan medex di Balai Kesehatan Penerbangan, didapatkan 314 pilot yang memenuhi kriteria penelitian. Sebanyak 15,9% mempunyai gangguan pendengaran sensorineural. Pilot dengan jam terbang total lebih 5000 jam dibandingkan kurang 5000 jam berisiko gangguan pendengaran sensorineural 4,7 kali lipat [risiko relatif suaian (RRa)=4,73; p=0,137]. Pilot dengan usia 45-60 tahun dibandingkan usia 20-44 tahun berisiko gangguan pendengaran sensorineural 6,8 lipat (RRa=6,87; p=0,000). Simpulan: Jam terbang total 5000 jam atau lebih serta usia 45-60 tahun meningkatkan risiko gangguan pendengaran sensorineural pada pilot sipil di Indonesia.

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Background: Sensorineural hearing loss in civil pilots could interfere pilots? performance to safely operate an aircraft thus could cause incapacitation on board. This study aimed to identify risk factors of sensorineural hearing loss among civil pilots in Indonesia.

Methods: A cross-sectional study design with purposive sampling on 4-20 May 2015 was conducted on pilots of the male civilian. The inclusion criteria civilian pilots male 20-60 years old and had Commercial Pilot License (CPL) or Air Transport Pilot License (ATPL) who were taking medical examinations (medex) in Civil Aviation Medical Centre, Jakarta. Hearing impairment defined by hearing threshold of 25 dB or more. Demographic data were collected by interviewed pilots using questionnaires while audiometry and laboratory data were collected from medical records. Risk factors of sensorineural hearing loss were analyzed by Cox regression.

Results: Three weeks collecting data had 681 pilot conducted medex in Civil Aviation Medical Centre, among 314 commercial pilots were fulfilled the criteria?s. Percentage of sensorineural hearing loss from audiometry data were 15.9%. Subjects with 5000 flight hours or more had almost five times increased risk of sensorineural hearing loss compared to subjects with less than 5000 flight hours [adjusted relative risk (RRa) = 4.73; p = 0.137]. Subjects aged 45-60 year-old had almost seven times increased risk of sensorineural hearing loss compared to subjects aged 20-44 year-old (RRa= 6.87; p = 0.000).

Conclusion: Total flight hours 5000 hours or more and age of 45-60 years increased the risk of sensorineural hearing loss among civilian pilots in Indonesia."

"Latar belakang: Timpanoplasti tipe 1 merupakan prosedur untuk menangani Otitis Media Supuratif Kronik (OMSK). Prosedur ini bertujuan untuk memperbaiki membran timpani, menjaga telinga tengah dari patogen luar dan pada akhirnya memperbaiki fungsi pendengaran. Faktor yang memengaruhi hasil timpanoplasti yaitu faktor operator, alat dan pasien. Tujuan: Mengidentifikasi karakteristik klinis preoperasi sebagai faktor yang memengaruhi fungsi pendengaran pascatimpanoplasti tipe 1. Metode: Penelitian ini merupakan studi kohort prospektif pada pasien OMSK tipe aman tenang yang telah menjalani timpanoplasti tipe 1. Subjek dengan membran timpani utuh pascaoperasi masuk dalam kriteria penelitian. Karakteristik klinis preoperasi berupa ukuran perforasi, letak perforasi dan fungsi Tuba Eustachius dikumpulkan melalui rekam medis. Fungsi pendengaran pascatimpanoplasti dinilai menggunakan audiometri nada murni. Hasil: Rata-rata ambang dengar preoperasi 44,7 dB ± 15,9dB menurun menjadi 33,2 dB ± 14,4dB. Rata-rata Air Bone Gap (ABG) preoperasi 41,9 dB menurun menjadi 14,4 dB. Tidak adanya perbaikan fungsi pendengaran 1 tahun pascatimpanoplasti terjadi pada 17,6% (n = 6). Tidak ditemukan hubungan yang bermakna antara ukuran perforasi, letak perforasi dan fungsi Tuba Eustachius preoperasi terhadap fungsi pendengaran pascatimpanoplasti tipe 1. Kesimpulan: Terdapat faktor selain ukuran perforasi, letak perforasi dan fungsi Tuba Eustachius preoperasi yang memengaruhi fungsi pendengaran.

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Background: Type 1 tympanoplasty is a procedure in to treat Chronic Suppurative Otitis Media (CSOM). It aims to repair the tympanic membrane, protect the middle ear from external pathogens and ultimately improve hearing function. Factors that affect the outcome of tympanoplasty, including operator, tools and patient factors. Objective: Identify preoperative clinical characteristics as factors affecting hearing function after type 1 tympanoplasty. Methods: The study was a prospective cohort design involving patients with tubotympanic type CSOM who had undergone type 1 tympanoplasty. Subjects with an intact tympanic membrane postoperatively were included in the study criteria. Data regarding preoperative clinical characteristics such as perforation size, perforation location, and Eustachian tube function were collected from medical records. Pure tone audiometry was performed to determine postoperative hearing function. Results: The preoperative hearing threshold of 44.7 dB ± 15.9dB decreased to 33.2 dB ± 14.4dB. The preoperative Air-Bone Gap (ABG) value of 41.9 dB decreased to 14.4 dB. There was no improvement found in 17.6% subjects (n = 6). There was no significant relationship between perforation size, perforation location, and preoperative Eustachian tube function on postoperative hearing function in type 1 tympanoplasty. Conclusion: There are factors other than perforation size, perforation location and preoperative Eustachian tube function that affect hearing function."

"Pendahuluan: Pajanan bising yang didapat dari penggunaan headset pada pekerja operator call center dapat dilihat dari hasil pemeriksaan Distortion Product Otoacoustic Emissions. Penelitian ini bertujuan untuk menganalisis faktor individu dan faktor pekerjaan yang berperan terhadap profil gangguan pendengaran pada pekerja operator call center kantor pelayanan pajak di Jakarta. Metode: Studi potong lintang ini dilakukan pada 94 pekerja operator call center kantor pelayanan pajak yang berlokasi di Jakarta. Data sosiodermografi, faktor individu, dan faktor pekerjaan diperoleh menggunakan kuesioner, hasil pemeriksaan DPOAE berdasarkan data sekunder hasil pemeriksaan Medical Check Up berkala yang dilakukan oleh klinik X. Hasil Didapatkan proporsi DPOAE abnormal pada operator call center di kantor pelayanan pajak pada frekuensi 2000Hz (l , 1%), 4000 Hz (1 , 1%), 6000 Hz (6,38%), frekuensi 8000 Hz (10,63%), frekuensi 10000 Hz (14,89%), dan frekuensi 12000 Hz (46,8%). Analisis bivariate didapatkan hasil bermakna pada variabel lama kerja dengan DPOAE pada frekuensi 8000Hz (p=0,020), IOOOOHz (p=0,048), durasi penggunaan headset pada frekuensi 8000Hz (p=0,025), dan volume headset pada frekuensi 6000 Hz (p=0,028). Kesimpulan: Lama kerja, penggunaan headset lebih dari 4 jam/hari, dan volume headset >60% dari volume maksimal dapat meningkatkan risiko terhadap hasil pemeriksaan DPOAE abnormal.

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Background: Noise exposure obtained from the use of a headset on call center operator workers can be seen from the results of the Distortion Product Otoacoustic Emissions examination. This study aims to analyze individual factors and occupational factors that play a role in hearing loss profiles in call center operator operators in tax service offices in Jakarta.

Methods: This cross-sectional study was conducted on 94 call center operators operating in tax service offices located in Jakarta. Sociodermographic data, individual factors, and occupational factors were obtained using a questionnaire. DPOAE examination results are based on secondary data from the results of regular Medical Check Up examinations conducted by clinic X.

Results: Proportion of abnormal DPOAE found at frequency 2000Hz ( I . I%), 4000 Hz (I . I%), 6000 Hz (6.38%), 8000 Hz (10.63%), 10000 Hz (14.89%), and 12000 Hz (46.8%). Results of bivariate analysis obtained significant results on the variable length of work with DPOAE at 8000Hz (p = 0.020), I OOOOHz (p = 0.048), the duration of using a headset at 8000Hz (p = 0.025), and the volume of the headset at 6000 Hz (p = 0.028).

Conclusion: Length of work, use of a headset for more than 4 hours I day, and headset volume> 60% of the maximum volume can increase the risk of abnormal DPOAE examination results."

"Gangguan pendengaran merupakan gangguan yang paling umum ditemukan pada neonatus. Gangguan dapat diatasi dengan mudah bila didiagnosis pada awal kelahiran. Prevalensi global gangguan pendengaran permanen pada neonatus kebanyakan berasal dari negara berkembang sekitar 0,5-5 per 1000 kelahiran. Tujuan penelitian ini untuk mengevaluasi efek terapi aminoglikosida dan faktor yang dapat menginduksi gangguan pendengaran pada neonatus yang dirawat di NICU Rumah Sakit Dr. Cipto Mangunkusumo. Penelitian bersifat case-control dengan sampel 112 neonatus di Rumah Sakit Dr. Cipto Mangunkusumo (RSCM). Data skrining pendengaran neonatus secara retrospektif dikumpulkan melalui data rekam medis elektronik dan data medis pasien. Hanya pasien yang dirawat dan diobati di Neonatal Intensive Care Unit (NICU) dari November 2018 hingga Oktober 2019 yang diambil sebagai sampel penelitian. Usia gestasional saat kelahiran (LGA) dan anomali kraniofasial dianggap sebagai faktor risiko yang berpengaruh terhadap gangguan pendengaran karena secara statistik signifikan (p < 0,05). Penelitian menunjukkan tidak ada hubungan yang signifikan dari jenis kelamin, berat badan saat kelahiran, ventilasi mekanik, lama rawat di NICU (>5 hari), hiperbilirubinemia (> 10 mg/dl), asfiksia, dan terapi aminoglikosida (p > 0,05). Prevalensi gangguan pendengaran pada neonatus dengan usia gestasional saat lahir dibawah dari 37 minggu dan adanya anomali kraniofasial memiliki signifikansi yang tinggi dibandingkan bayi yang lahir dengan normal. Kedua faktor tersebut memiliki risiko gangguan pendengaran pada neonatus 8 hingga 14 kali lebih tinggi. Sebaliknya, terapi aminoglikosida ditemukan tidak berbeda signifikan pada penelitian ini dikarenakan nilai p sebesar 0,124 yang lebih besar dari 0,05 untuk interval kepercayaan 95%. Temuan lainnya yang tidak berbeda secara signifikan adalah jenis kelamin, berat badan saat lahir, lama rawat di NICU selama > 5 hari, dukungan ventilator > 5 hari, bayi lahir dengan asfiksia dan hiperbilirubinemia > 10 mmol/l

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Hearing loss is the most common disorder in neonates; it can be best managed if diagnosed at an early stage of life. The global prevalence of permanent neonatal hearing loss mainly occurs in developing countries, accounting for 0.5 to 5.0 per 1000 live births. This study's objective was to evaluate effects of aminoglycoside therapy, and associated factors that can induce hearing loss in neonates admitted to NICU at Dr.Cipto-Mangunkusumo Hospital. This was a case-control study conducted among 112 neonates at Dr. Cipto-Mangunkusumo Hospital (CMH). Data of neonatal hearing screening were retrospectively collected from hospital electronic medical records and medical files. Only patients admitted and treated at the Neonatal Intensive Care Unit from November 2018 to October 2019 were recruited. Out of 112 neonates studied, the Low Gestational Age at birth (L.G.A.) and Craniofacial anomalies were considered as risk factors for hearing loss since they were statistically significant (p< 0.05). The study showed no statistically significant association in gender, birth weight, mechanical ventilation, NICU stay period (>5 days), hyperbilirubinemia (>10mg/dl), asphyxia, and aminoglycoside therapy (p>0.05). The prevalence of hearing loss in neonates with a lower gestational age of leser than 37 weeks and craniofacial anomalies are significantly higher compare to full-term neonates born. They are more associated with 8 to 14 times increased risk of hearing loss in neonates. In contrast, aminoglycoside therapy was found insignificant different in this study since its p-value were 0.124 which is greter than p-value <0.05 for 95% signicant interval. Other finds that were not significantly different are gender, birth weight, extended stay at ICU for >5 days, ventilatory support > 5days, baby borns with asphyxia and hyperbilirubinemia > 10mmol/l."

"Gangguan pendengaran akibat bising masih menjadi masalah kesehatan baik di dunia maupun Indonesia. Data WHO 2005 melaporkan bahwa 278 juta 4.2 penduduk dunia mengalami gangguan pendengaran, 50 di Asia Tenggara termasuk Indonesia. Tingkat kebisingan di pelabuhan udara El Tari Kupang tahun 2010 mencapai 92,2 dB pada pagi hari dan 95,2 dB pada siang hari. Pada tahun 2011 tingkat kebisingan di area apron atau area udara mencapai rata-rata 90,48dB dengan interval 74,5-120 dB dan di area terminal rata-rata 89,2 dB. Pada tahun 2013 mencapai 91,5 dB di area apron dan 97,2 dB di ruangan check in, di ruangan keberangkatan mencapai 97 dB Data Tahunan KKP Kupang. Penelitian ini bertujuan untuk mengetahui hubungan tingkat kebisingan dengan gangguan pendengaran pada pekerja di pelabuhan udara El Tari Kupang. Penelitian ini dilakukan menggunakan desain studi cross sectional analitik. Populasi studi pada penelitian ini adalah pekerja berjenis kelamin laki-laki yang bekerja pada perusahaan ground handling di pelabuhan udara El Tari Kupang tahun 2016. Hasil penelitian menemukan prevalensi gangguan pendengaran sensorineural pada pekerja di pelabuhan udara El tari Kupang sebesar 39,5. Hasil estimasi risiko menemukan PR=1,80: 95 CI 1,01-3,19 artinya risiko gangguan pendengaran sensorineural pada pekerja ground handling yang terpapar tingkat kebisingan > 85 dBA 1,80 kali dibandingkan dengan pekerja ground handling yang terpapar tingkat kebisingan le; 85 dBA selama 8 jam TWA sehari di pelabuhan udara El Tari Kupang. Kesimpulan: ada perbedaan risiko kejadian gangguan pendengaran antara pekerja yang terpapar tingkat kebisingan > 85 dBA dengan pekerja yang terpapar tingkat kebisingan le; 85 dBA selama 8 jam TWA sehari. Upaya pencegahan penting dilakukan yaitu mewajibkan semua pekerja menggunakan APD ear plug atau ear muff terutama yang bekerja di area apron pelabuhan udara El Tari Kupang.

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Noise induced hearing impairment remained a health issue in Indonesia and the world. WHO 2005 reported 278 million 4.2 of the world population suffered from hearing impairment, 50 of them lives in South East Asia including Indonesia. In 2010, the noise level in El Tari airport of Kupang reached 92.2 dB in the morning and 95.2 dB in the noon time. In 2011, the noise level within the apron area or the air area reach the average of 90.48 dB with the interval of 74.5 ndash 120 dB and within the terminal area it reached the average of 89.2 dB. In 2013 the figure reached 91.5 dB within the apron area and 97.2 dB within the check in area, while within the departure area it reached 97 dB. Kupang Port Health Office, Annual Reports.

This research aims to find out the relationship between the noise level and the noise induced hearing impairment amongst the workers of El Tari airport in Kupang. The research applied cross sectional analytical design study. The study population of this research is male workers who works for the ground handling companies of El Tari airport in Kupang in 2016. The research found that the prevalence of sensorineural hearing impairment within the workers of El Tari airport in Kupang is 39.5.

The risk estimation result showed PR 1,80 95 CI 1,01 3,19. It means that the risk of suffering from sensorineural hearing impairment within the ground handling workers with the noise level exposure of more than 85 dB is 1.80 times compared to those with less or equal to 85 dBA noise level exposure for 8 TWA hours a day in the airport.

Conclusion there is a difference in the risk of suffering from sensorineural hearing impairment between the workers exposed to more than 85 dBA noise level and those exposed to less or equal to 85 dBA noise level per 8 TWA hours a day. It is crucial to take prevention efforts as in obliged the workers especially those working within the apron area of El Tari airport to use self protection devices ear plug or ear muff during their working hours within the apron area."

"Ruang lingkup penelitian ini adalah gangguan pendengaran yang berhubungan dengan pajanan bising di lingkungan kerja, bertujuan untuk meningkatkan pengetrapan kesehatan dan keselamatan kerja di perusahaan pelapisan kayu lapis PT X. Rancangan penelitian berupa studi intervensi, dimana identifikasi masalah dikumpulkan melalui pengamatan dan wawancara. Hasil yang diperoleh menunjukkan adanya beberapa faktor di lingkungan kerja yang dapat menimbulkan gangguan kesehatan bagi tenaga kerja yaitu faktor bising, panas, penerangan, getaran mekanis, debu kayu, zat kimia dan fisiologi kerja. Dengan menggunakan kriteria matriks, faktor bising mendapat prioritas pertama untuk diteliti lebih lanjut. Hasil pengukuran intensitas bising di bagian genset adalah 97,5 - 102,2 dBA, sawmill 84,9 - 108,2 dBA dan heating floor 86,1 - 98,5 dBA. Dari hasil pemeriksaan telinga dan pemeriksaan audiometri terhadap 22 orang tenaga kerja yang memenuhi kriteria inklusi dan eksklusi di tiga bagian tersebut diperoleh 7 orang ( 31,81 % ) menderita noise induced hearing loss (NIHL ), 13,6 % dengan keluhan tinitus dan 36,36 % dengan keluhan penurunan daya dengar sementara. Pada uji statistik hanya umur yang mernpunyai hubungan bermakna terhadap NIHL ( p < 0,05 ), sedangkan lama kerja, sikap dan perilaku tidak ( p > 0,05 ). Cara intervensi yang dilaksanakan ditetapkan berdasarkan kriteria matriks yaitu berupa penyuluhan mengenai bising dan alat pelindung telinga, serta pemberian sumbat telinga. Hasil intervensi yang dilakukan terlihat mempunyai hubungan berrnakna terhadap perubahan perilaku terhadap tenaga kerja ( p < 0,05 ).

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The scope of this study is hearing disorder related noise int he workplace, as an effort to increase health and safety in plywood industry PT X. The design used in this study is intervention study, problem were indentified throught observations and questioners.

The result showed that noise,heat, lighting, mechanical vibration, wood dust, chemicals and work physiology had influenced the worker's health. Using matrix criteria, noise had first priority to be studied. the resulth of noise's intensity in genset was 97,5-102,2 dBA, sawmill was 84,90108,2 dBA and heating floor was 86,1-98,5dBa. Audiometry examination showed that 7 (31,81%) from 22 persons had noise induced hearing loss (NHL), 13,6% complained about tinitus and 36,36% Complained temporary thershold shift.

Statistical test showed only age influence NHL significantly (p<0.05), but work time, perception, behaviour did not.

Intervention was chosen by using matrikx criteria. The intervetion were education about noise and ear protectors, and giving earplugs to workers at these area. The statistical test showed that education and using earplugs had influenced workers behaviour significantly (p<0.05)."

"ABSTRACT

INTRODUCTION : Based on Indonesian Constitution, article 2712 mention that every Indonesian citizen has the right of having a job and wages in accordance to humanity. Bajaj as an model in this study is public transportation vehicle which is noisy and vibrating and potential to induce hearing and balance disturbances which could be dangerous to himself or to others. General Objectives of this study : To investigate the risks of noise and vibration in bajaj's drivers and to find the solutions to prevent them from hearing loss and balance disturbances.

Specific objectives : To determine : 1, hearing and balance functions induced by noise and vibration by audiometric and posturography tests 2. To find other physiologic factors such as age, blood pressure, blood glucose level, smoking habit and body mass index which could influence those functions ; 3, To determine the threshold of noise frequencies, intensity and also acceleration of vibration which contributed to noise.

Setting : Subdivision of Neurotology of ENT Department of Cipto Mangunkusumo Hospital, Jakarta, Study subjects : Bajaj drivers.

METHODS: The study was carried out from March 2000 until October 2001.Noise and vibration were measured using octave band analyzer and vibration meter. Clinical ENT examination, height and body weight for body mass index, blood pressure and blood glucose level tests were performed. The subjects were divided into four groups : the normal one, only hearing or balance problem group, group of both disturbances. The risk factors were calculated by bivariate and multivariate or logistic regression analyses.

RESULTS : Mean of bajaj's intensity level was 91 dBA, with minimum intensity 64 dBA, maximum intensity 96 dBA, mean acceleration of vibration was 4,2 misec2. Those results showed that noise and vibration of bajajs were over safety threshold, which has been established by OSHA. The rate of normal subjects was 27.72 %, whereas that of those who suffered from hearing and balance problems was 27,43%, and only 17.14% had hearing problems and 27,71 % had balance problems. The total was 72,28 % of disturbance. From the multivariate analysis, hearing and balance problems were influenced by age more than 40 years old, working periods more than 9 years, daily working hours more than 8 hours, history of heavy smoking habit and obesity. Balance problems were influenced by the same factors. But the working period was 5.9 years and hearing problems were only influenced by age more than 40 years old. It was concluded that balance function was more sensitive than hearing one. For prevention, this study also introduced risk scores for hearing and balance functions based on those physiological factors for workers who worked in noisy and vibrating areas, low risk for scores 0-5, moderate risk for scares 6-10 and high risk for scores more than 11. The sensitivity level was 70,83% and specificity was 73,20 %.

CONCLUSIONS : Mean of bajaj's intensity level was 91 dBA, with minimum intensity 64 dBA, maximum intensity 96 dBA. mean acceleration of vibration was 4,2 misec2, which are over the safety threshold. Noise and vibration could induce hearing and balance problems in 72,28% of drivers. Those problems are influenced by several factors such as age, working periods, daily working hours, smoking habit and obesity."

"Latar belakang dan lingkup penelitian : Gangguan pendengaran akibat bising merupakan masalah utama dan menempati jumlah yang paling banyak pada penyakit akibat kerja. Data kepustakaan menunjukkan bahwa frekuensi 4 KHz merupakan frekuensi yang paling peka terhadap pengaruh kebisingan. Diperkirakan frekuensi ini dapat memberikan gambaran awal gangguan pendengaran yang berhubungan dengan kebisingan. Penelitian ini bertujuan untuk mengetahui gejala dan tanda gangguan pendengaran akibat bising yang berhubungan dengan frekuensi 4 KHz serta analisis mengenai faktor faktor yang berhubungan.Metode penelitian : Penelitian dilakukan dengan desain kasus kontrol pada pekerja pabrik sepatu PT "X" Tangerang Indonesia yang memiliki data audiometri. Analisis dilakukan dengan menggunakan data sekunder mengenai audiometri dan status kesehatan dan hasil pemeriksaan berkala sedangkan pengetahuan, sikap dan perilaku responden didapat dengan menggunakan kuesioner.Hasil : Didapatkan bahwa faktor yang berhubungan dengan peningkatan ambang dengar pada frekuensi 4 KHz. adalah, umur pekerja (OR=5,67; CI95% =1,96 - 16,40; p=4,041) dan kebiasaan merokok (aR=3,57;CI95% 1,27-10,03;p,02). Didapatkan juga bahwa pekerja yang mempunyai hobi yang berhubungan dengan kebisingan justru mempunyai risiko lebih kecil dibandingkan dengan pekerja yang tidak mempunyai hobi yang berhubungan dengan kebisingan (OR=0,10;CI95% 0,019-0,541; p = 0,007). Gejala telinga berdenging didapatkan dengan frekuensi yang sama pada kelompok kasus dan kelompok kontrol. Faktor-faktor lain yang juga diteliti ternyata tidak mempunyai hubungan yang bermakna secara statistik dengan peningkatan ambang dengar pada frekuensi 4 KHz seperti, jenis kelamin (p=0,77), penyakit yang berhubungan dengan pendengaran (p=1,0), riwayat hipertensi (p=0,67), pemakaian alat pelindung telinga (APT) (p=0,66), Pengetahuan, sikap, perilaku (p=4l,71) dan lingkungan tempat tinggal (p = 0,39), Kebijakan perusahaan ( p = 0,83) serta hipertensi (p = 0,83).Kesimpulan : Peningkatan ambang dengar pada frekuensi 4 KHz.akibat bising pada penelitian ini berhubungan dengan umur, hobi yang berhubungan dengan kebisingan dan kebiasaan merokok. Didapatkan faktor risiko yang lebih kecil untuk peningkatan ambang dengar frek 4 KHz, pada pekerja yang mempunyai hobi yang berhubungan dengan kebisingan disebabkan pengetahuan, sikap dan perilaku tentang kebisingan yang lebih baik. Penelitian ini perlu dilanjutkan untuk mendapatkan cara deteksi dini ketulian akibat bising.

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Background and objectives: Noise induced hearing disorder is the prominent problem and the most prevalent of occupational diseases. Some studies show that 4 KHz is the most sensitive frequency to be affected by noise. It is expected that 4 KHz frequency threshold shift will be able to represent noise related hearing disorder. This study is aimed at recognizing sign and symptom of noise related hearing disorder and determining its related factors.

Methods: using case control design in workers at shoe factory ?X?, Tangerang, Indonesia who have audiogram, carried out the study. Medical record of annual medical examination were used to obtain audiometric and health status as secondary data. Meanwhile the knowledge about, attitude to, and behavior towards occupational noise of respondents were obtained by using questionnaire.

Result : Determinant factors of noise induced hearing disorder with hearing threshold more than 25 dB at 4 KHz frequency which are statistically significant are age of the workers (OR 4,894 C195% 1.84 - 12.96), and smoking habit (OR=3,57; C195% =1,27-10,03). The workers who have noise related hobby activities have a less risk to get 4 KHz frequency threshold shift (OR 0.10; Cl 95 % 0,03 - 0.85). Both the case and the control group have complained tinnitus. The percentage of subject who was complained tinnitus were no difference between the cases and the controls. The study found that another factors have no statistically significant difference including gender (p = 0.76), hearing impairment related disease (p = 1.0), hypertension history (p = 0.67), the use of personal protection equipment (p = 0,661), the knowledge about, attitude to, behavior towards occupational noise (p = 0.708), settlement environment (p = 0.39), company's policy (p =0.83), and hypertension (p = 0.83).

Conclusion: Noise induced hearing disorder related to 4 KHz frequencies has significant association with age, smoking habit and noise related hobby activities. Probably, due to better in knowledge about, attitude to, and behavior towards occupational noise of the workers who have noise related hobby activities tend to be less risk to get 4 KHz frequency threshold shy? then those who have no this hobby. The research should be continued to find the effective way in early detection of noise related hearing disorder."