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"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."

"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)."

"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."

"ABSTRAKPelajar sekolah menengah dengan rentang usia 6-19 tahun diperkirakan telah mengalami gangguan pendengaran akibat penggunaan PLDs. Penggunaan PLDs sendiri apabila didengarkan pada volume yang tinggi dan digunakan dalam waktu yang lama akan menyebabkan gangguan pendengaran dan komunikasi verbal. Untuk menilai sensibiltas saraf pendengaran dapat dilakukan dengan pemeriksaan distorssion product otoacouatic emission (DPOAE) dan audiogram. Komunikasi verbal dinilai dengan pemeriksaan audiometri tutur. Gangguan sensibilitas saraf pendengaran dilihat dari hasil signal to noise ratio (DPOAE) dan audiometri nada murni ≥25 dB. Gangguan fungsi komunikasi verbal apabila speech recognition treshold (SRT) ≥30 dB. Penelitian potong lintang ini dilakukan di SMU Negeri di Jakarta pada bulan Oktober 2013, melibatkan 96 percontoh pengguna PLDs. Kemudian dilakukan pemeriksaan DPOAE, audiometri nada murni dan audiometri tutur. Sebanyak 27,2% mengalami gangguan sensibilitas saraf pendengaran. Didapatkan 6,3 % mengalami gangguan komunikasi verbal. Tidak ditemukan hubungan yang bermakna antara jenis kelamin, jenis earphone, besarnya intensitas dan lama pemakaian terhadap terjadinya gangguan sensibilitas saraf pendengaran. Namun dengan melihat nilai Odds Ratio pada pemakaian earphone jenis earbud memiliki resiko 3,69 kali mengalami gangguan pendengaran dan apabila mendengarkan pada 8-14 jam setiap minggu nya memiliki resiko 3,08 kali mengalami gangguan sensibilitas saraf pendengaran. Kelemahan penelitian ini pada desain penelitian , validasi output dan kurang dieskplornya faktor-faktor lain yang turut berperan dalam memengaruhi terjadinya gangguan pendengaran. Penelitian lebih lanjut perlu dilakukan untuk mencari faktor apa saja yang mempengaruhi terjadinya gangguan sensibilitas saraf pendengaran dan hubungannya terhadap terjadinya gangguan pendengaran.

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ABSTRACTHigh school students with the age range of 6-19 years old are assumed to suffer from hearing impairment from using PLDs. The usage of PLDs with high volume in long term will cause hearing and verbal communication impairments. Distorssion product otoacoustic emission (DPOAE) examination and pure tone audiometry can be used to evaluate the hearing organ function. Verbal communication function can be evaluated with speech audiometry examination. Hearing impairment is seen from the result of DPOAE signal to noise ratio and hearing threshold ≥25 dB. Communication impairment is seen from speech recognition test (SRT) ≥30 dB. This cross sectional study was conducted in the 70 General High School in October 2013, involving 96 samples using PLDs All samples had DPOAE, pure tone and speech audiometry examinations. (27,2%) had hearing impairments, in which (6,3%) had verbal communication impairments. There were no significant correlation between sex, earphone types, intensity and usage duration with the decrease of sensibility hearing impairment. Although by assessing Odds Ratio value, the usage of earbud type earphone increases the risk of hearing impairment by 3,69 times and duration of 8-14 hours every week has 3,08 higher risk of hearing impairment. The weaknesses of this study are the study design, validation output of PLDs and other factors contributing in causing hearing impairment were not explored. Further study is required to seek the factors contributing in causing hearing impairment from noise and its correlation with the occurrence of hearing impairment."

"Latar Belakang: Adanya sumber bising di tempat kerja tidak bisa dihindari. Dampak kesehatan yang paling menonjol adalah gangguan pendengaran/tuli yang merupakan penyakit akibat kerja yang seharusnya dapat dicegah. Deteksi dini dengan melakukan pemeriksaan audiometri secara rutin pada high risk worker, merupakan salah satu kunci dalam mencegah terjadinya penyakit akibat kerja ini. Metoda: Cross sectional dengan jumlah sampel 114, membandingkan data hasil audiometri Desember 2011 dengan audiometri Desember 2013 pada medical check up, serta data dari Tim P2K3 berupa data pajanan bising, jenis APD, ketaatan APD dan program pemeliharaan mesin. Hasil:. Didapatkan korelasi cukup kuat peningkatan ambang dengar tahun 2011 dan 2013 (uji Spearman p < 0.001, r + 0.486 pada telinga kanan dan + 0.598 pada telinga kiri). Prevalensi peningkatan ambang dengar tahun 2011-2013 adalah 63.2%, dengan tipe unilateral lebih banyak (65.3%). Secara umum besar peningkatan ambang dengar adalah 5 dB (73.6%). Peningkatan ambang dengar ≥ 10 dB sebanyak 44% pada tipe bilateral, dan 17% pada tipe unilateral. Pada telinga kanan besar peningkatan ambang dengar antara 5 - 45 dB dan pada telinga kiri antara 5 - 35 dB. Faktor bidang okupasi dan non okupasi tidak didapatkan hubungan yang bermakna pada penelitian ini. Faktor Kesesuaian APD, Ketaatan APD dan maintenance mesin tidak dapat dianalisis lebih lanjut karena mempunyai kesamaan data. Kesimpulan: Terdapat 63.2% pekerja terpajan bising mengalami peningkatan ambang dengar selama tahun 2011-2013, tetapi tidak didapatkan hubungan bermakna antara peningkatan ambang dengar dengan faktor-faktor yang terkait.

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Background : It is undeniable that there are sources of noise in the working area. The effects that is commonly seen are hearing loss/deafness that is considered as a occupational disease which actually can be prevented. Early detection using audiometry examination routinely on high risk worker, is an important key in preventing the occupational disease.

Methods : Cross-sectional method was used with 114 samples that compares the audiometry data from December 2011 to December 2013 from medical check up, and data from the P2K3 company team that is noise-exposure data, PPE types, PPE obedience and machine service programme.

Results: There is a moderate correlation between an increased hearing threshold in the year 2011 and 2013 (Spearman test p<0.001, r+0.486 on the right ear and +0.598 on the left ear). The prevalance of the increased in hearing threshold from the year 2011-2013 is 63.2% with the unilateral type is higher (65.3%). Commonly the amount of deviation of the hearing threshold is 5 dB (73.6%). An increased in the hearing threshold of ≥ 10 dB is 44% on bilateral type, and 17% on unilateral type. On the right ear the hearing threshold increased between 5-45dB and left ear between 5-35 dB. There is no significance relationship between occupational and non-occupational factors in this research. PPE acceptance factor, PPE obedience and machine maintenance couldnot be analyze any further because they have a similar data.

Conclusion: There were 63.2% workers that had increased in hearing threshold around the year 2011 and 2013, but there is no significance relationship between the increased hearing threshold and the factors associated."

"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."

"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."

"Aktivitas di terminal berpotensi menimbulkan pencemaran lingkungan antara lain kebisingan. Tingkat kebisingan yang tinggi berpotensi untuk terjadinya gangguan kesehatan bagi manusia khususnya gangguan pendengaran. Penelitian ini bertujuan untuk mengidentifikasi hubungan antara tingkat kebisingan terhadap gangguan pendengaran penduduk di lokasi pemukiman sekitar Terminal Pakupatan. Penelitian ini menggunakan desain studi cross sectional pada enam pemukiman di sekitar Terminal Pakupatan, Kota Serang, Provinsi Banten pada Januari-Mei 2018. Besar sampel sebanyak 100 orang dengan metode proposional random sampling.Hasil penelitian menunjukkan tingkat kebisingan di lokasi pemukiman sekitar Terminal Pakupatan mencapai 81,09 dB dimana telah melewati baku mutu kebisingan yang mengacu pada Keputusan Menteri Lingkungan Hidup Nomor 48 Tahun 1996 sebesar 55 dB. Variabel confounding yaitu umur, riwayat penyakit, status bekerja, konsumsi rokok, konsumsi alkohol dan lamanya tinggal. Masyarakat yang tinggal di lokasi dengan tingkat kebisingan lebih dari 55 dB memiliki risiko yang lebih tinggi dibandingkan dengan yang tinggal di lokasi dengan tingkat kebisingan kurang dari 55 dB 3,39; 0,61-26,91, setelah dikontrol oleh jenis pekerjaan dan lama tinggal sehingga perlu adanya upaya pencegahan rambatan bising kepemukiman dengan menerapkan jalur hijau atau penanaman pohon.

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potential to cause environmental pollution, such as noise. High noise levels have the potential to cause health problems for humans especially hearing loss. This study aimed to identify the relationship between noise level to hearing loss in residential locations around Pakupatan Bus Station. This study used cross sectional study design in six settlements around Pakupatan Bus Station, Serang City, Banten Province conducted in January May 2018. The number of samples is 100people with proportional random sampling method.

The results of the analysis showed that the noise level at the residential area around Pakupatan Bus Station reached 81.09dB where it has passed the noise quality standard based on the Decree of the Minister of the Environment Number 48 Year 1996 of 55 dB and found that people exposed to noise ge 55dB have lower risk compared to people exposed to noise."

"Pekerjaan pembuatan tabung gas beresiko terpajan oleh kebisingan Sedangkan program konservasi pendengaran yang dilakukan belum dilakukan dengan baik. Tujuan penelitian ini adalah untuk mengetahui besarnya masalah gangguan pendengaran yang terjadi akibat kebisingan pada tenaga kerja pabrik tabung EP serta melakukan upaya pencegahannya. Disain penelitian Studi intervensi. Jumlah subyek yang diteliti 59 orang dari total populasi 62 orang tenaga kerja tetap. Intervensi berupa anjuran pemakaian slat pelindung diri telinga bagi tenaga kerja serta penyuluhan bagi pimpinan dan part pengawas tentang pentingnya penerapan program konservasi pendengaran secara efektif dan efisien.Hasil dan kesimpulan. Terdapat 10 lokasi dengan tingkat kebisingan 92 dB di dalam pabrik Keluhan gangguan pendengaran pada tenaga kerja berupa kurang pendengaran 16,94 persen, tinitus - 11,86 persen atau kombinasi keduanya 3,38 persen. Prevalensi tali akibat bising (TAB) sebesar 11,86 persen Terdapat hubungan yang bermakna antara TAB dengan lama paparan dan intensitas bising (p kurang dari 0,05). Sedangkan huhungan antara TAB dengan usia, lama bekerja, pengetahuan, sikap dan perilaku tidak bermakna. Untuk kepatuhan memakai alat pelindung diri telinga terdapat perbedaan yang bermakna antara sebelum dan sesudah intervensi. Penyuluhan pada pimpinan dan para pengawas menghasilkan suatu komitmen dan dukungan pimpinan terhadap program konservasi pendengaran.

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Work in the gas cylinder production has a high exposure to noise hazard The implementation on hearing conservation program is essential for the prevention of hearing lass among workers. The objective of the study is to know the prevalence of Noise Induced Hearing Disturbance among workers in EP gas cylinder factory and the implementation of it's prevention program. The study design used was an intervention study. From the total population of 62 workers, 59 subject participated in this study. The intervention was education on NIHL and recommendation to use ear protection for workers and education to managers and supervisors on effective and efficient hearing conservation program.

Result : In 10 location in the factory the noise level was above 92 dB . Complaints in hearing decrease was found in 16,94 percent, tinnitus in 11,80 percent and both complaints in 3,38 percent of the workers. The prevalence of NI HL was 11,86 percent.Statistical test showed a significant relation between exposure period and NIHL. There was no significant relationship between NIRL and age, work period and KAP. Intervention showed a significant increase in the use of ear protection among workers. Managers and supervisors committed to support the implementation of Hearing Conservation Program."

"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."