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Abstrak :
Latar belakang : Terpajan pelarut organik merupakan kejadian sehari-hari yang dialami oleh banyak pekerja. Pelarut organik banyak digunakan dalam proses pembuatan alas kaki disektor formal maupun informal. Menurut beberapa penelitian beberapa jenis pelarut organik mempunyai sifat neurotoksik sehingga perlu deteksi gejala-gejala tersebut yang mungkin timbul pada para pekerja. Kuesioner Swedish Q16 adalah kuesioner deteksi dini yang paling sering digunakan untuk penupisan pekerja yang terpajan pelarut organik. Penelitian ini bertujuan untuk mengetahui prevalensi gejala neurotoksik akibat pajanan pelarut organik menggunakan Kuesioner Swedish Q16, serta mengetahui beberapa faktor yang mempengaruhi seperti : umur, pendidikan, masa kerja, status gizi, pemakaian APD, kebiasaan minum alkohol, merokok, cuci tangan, makan minum di tempat kerja dan hasil pemantauan kadar pelarut organik di lingkungan,kerja. Metode : Penelitian ini menggunakan desain penelitian cross-sectional dengan subyek penelitian 138 orang pekerja alas kaki di sektor informal Ciomas Bogor. Pengumpulan data dilakukan dengan menggunakan kuesioner dan pengamatan langsung, sedangkan lingkungan kerja dilakukan dengan pengukuranpersonal sampling dan hasilnya diperiksa menggunakan teknik Gas Chromatography. Gejala neurotoksik dideteksi menggunakan kuesioner Swedish Q16. Pengumpulan data dilakukan pada bulan September-Oktaber 2006. Hasilnya diolah menggunakan program statistik SPSS 11,5. Hasil : Hasil identifikasi lem didapatkan lem kuning mengandung : toluen (45,3%), benzen (5,18%) dan metil etil keton (18,68%), lem putih mengandung : toluen (41,31%), benzen (3,52%) dan aseton (19,24%). Kadar toluen di lingkungan kerja rata-rata 1,12 ppm, tertinggi 2,48 ppm dan terendah 0,33 ppm. Keluhan terbanyak kesemutan (62,3%), sakit kepala (62,3%), mudah Ietih (56,5%). Prevalensi gejala neurotoksik pads subyek penelitian sebesar 55,8%. Pada analisis bivariat faktor umur, masa kerja dan IMT memiliki hubungan bermakna terhadap terjadinya gejala neurotoksik. Setelah dilakukan analisis multivariat didapatkan umur < 28 tahun memiliki risiko 6 kali lipat untuk mengalami gejala neurotoksik. (p = 0,000; OR = 6,235). Penieriksaan finger tapping test dilakukan secara sub sampling pada 53 subyek dan dipemleh basil tidak normal pada tangan kanan 47,2% dan tangan kiri 43,3%. Kesimpulan : Prevalensi gejala neurotoksik pada pekerja industri alas kaki sektor informal , Ciomas , Bogor yang terpajan pelarut organik sebesar 55,8%. Faktor umur berhubungan dengan terjadinya gejala neurotoksik (OR = 6,235 ; p = 0,000).

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Background : Exposured by organic solvent is form of occurrence day by day for many workers. Organic solvent is used in many process on footwear manufacture both formal and informal sector. According to several studies , many organic solvent has neurotoxic char tcterisl it:, so need to early detection for symptoms that influences to workers. The Swedish Q16 is a questionnaire that often use for workers screening from exposured by organic solvent. The goal of this study is to identification of glue, prevalence neurotoxic symptoms cause by organic solvent exposure, with Swedish Q16 Questionnaire, and to know factors of influences as : age, education, working periode, body mass index, using of PPE, drink of alcohol, washing hand, smoking, eat and drink at workplace and organic solvent level in workplace. Method : The design of this study was cross sectionai,and the total number of sample were 138 footwear workers. Data collecting was conducted to interview, direct monitoring and measuring personal sampling at workplace which checking by Gas Chromatography technique. Neurotoxic symptoms detected by Swedish Q16 Quetionnaire. Data collecting was done on September-October 2006. All data research result processing by Statistic Program SPSS version 11.5. Result : Identification of glue has result that content of yellow glue are toluene (45,3%), benzene (5,18%) dan metyl etyl ketone (18,68%), white glue content are : toluene (41,31%), benzene (3,52%) dan acetone (19,24%). Degree of toluene at workplace was average 1,12 ppm, and range 2,48 ppm to 0,33 ppm. Highest complaint from subject are : tingling ((62,3%), headache (62,3%), fatigue (56,5%). Study's subject neurotoxic symptoms prevalence was 55,8%. On bivariate analysis, age factor, work periode, body mass index, have related to neurotoxic symptoms outcome. On multivariate analysis be found that age < 28 years have risk six time to experience with neurotoxie symptoms, (p0,000; OR = 6,235). Examination on finger tapping test to be done as sub sampling on 53 subject and the result is unnormally on right hand 47,2% and left hand 43,3%. Conclutions : Prevalence of neurotoxicity symptoms in informal sector footwear workers at Ciomas Bogor was 55,8%. Age factor was related to the neurotoxic symptoms (OR = 6,235 ; p = 0,000).

Abstrak :
Latar Belakang. Lebih dari 750 bahan kimia dan beberapa kelompok senyawa kimia termasuk pelarut organik diduga bersifat neurotoksik. Namun pada umumnya bahan kimia tersebut belum pernah dilakukan tes untuk menilai efek neurotoksik yang ditimbulkan. Pelarut organik seperti MEK digunakan secara luas pada industri alas kaki yang pada umumnya bersifat padat karya, sehingga jumlah pekerja yang terpajan juga sangat besar. Pelarut organik dapat mengakibatkan ensefaloti toksik kronik pada pekerja yang terpajan berlebihan. Oleh karena keluhan subyektif mungkin mengindikasikan suatu ensefalopati maka deteksi dini sangatlah penting. Kuesioner Swedish Q16 adalah kuesioner deteksi dini yang paling sering digunakan untuk skrining pekerja yang terpajan pelarut organik. Penelitian ini bertujuan untuk mengetahui prevalensi gejala dini neurotoksik akibat terpajan pelarut organik metil etil keton, serta pengaruh faktor umur, jenis kelamin, pendidikan , masa kerja, status gizi, pemakaian APD, kebiasaan minum alkohol, minum kopi, merokok, kadar pajanan tempat kerja, serta hasil pemantauan biologis terhadap timbutnya gejala dini neurotoksik. Metode. Penelitian ini menggunakan disain penelitian cross-sectional dengan jumlah subyek penelitian 123 orang pekerja pada sebuah kelompok perusahaan sepatu. Pengukuran pajanan dilakukan dengan personal sampling dan pemantauan biologis. Pengumpulan data dilakukan pada bulan Desember 2003 sampai Januari 2004. Hasilnya diolah menggunakan program statistik SPSS 11,5. Hasil dan Kesimpulan. Prevalensi gejala dini neurotoksik pada pekerja yang terpapar pelarut organik metil etil keton sebesar 52%, jika prevalensi didasarkan alas kadar pajanan MEK lingkungan kerja, maka pekerja yang terpajan tinggi prevalensinya sebesar 72,1%, sedangkan yang terpajan rendah 41,3%. Secara statistik yang menunjukkan hubungan bermakna dengan timbulnya gejala dini neurotoksik adalah kadar MEK lingkungan kerja (OR 3,68; p 0,001; 95% CI 1,65 - 8,20), basil pemantauan biologik pads urine (OR 4,17; p 0,000; 95% CI 1,87 - 9,29) dan faktor umur (OR 4,07; p 0,001; 95% CI 1,78 - 9,30).

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The Correlation Between Metil Etil Keton Exposure And Early Symptoms Of Neurotoxicity Among Footwear Factory Workers (Based On Swedish Q16 Questionnaire)Back Ground. More than 750 chemicals and several classes of chemical compound including organic solvent are suspected to be neurotoxic, but majority of chemicals are never been tested for neurotoxic properties. Organic solvent such as MEK are widely use in footwear industry. Footwear manufacturing is a labour intensive industry, as a result large group of workers are exposed. Organic solvent can cause a chronic toxic encephalopathy in overexposed workers. Because subjective complaint may indicate an encephalopathy, early recognition is important. Swedish Q16 questionnaire is the most commonly used for screening workers who are exposed to organic solvent . The aim of the study was to examine the effect of exposure to MEK on the prevalence of complaints. Further objective were to analyse the influences of sex, education, alcohol consumption, smoking habits, caffeinated beverage, nutriotional status, PPE, length of service, MEK concentration, and Bio-monitoring result. Method. In a cross sectional study, 123 workers with occupational exposure to MEK were interviewed by means of Swedish Q16 questionnaire. Exposure estimation was made by personal sampling and biological monitoring. Data collecting was conducted from December 2003 to January 2004. The statistical analysis was performed with SPSS 11,5 statistical software. Result and conclusions. Prevalence of workers with early symptoms of neurotoxicity was 52%. Age (OR 4,07; p 0,001; 95% CI 1,78 - 9,30), Exposure level of MEK (OR 3,68; p 0,001; 95% CI 1,65 - 8,20), and result of biomonitoring (OR 4,17; p 0,000; 95% CI 1,87 - 9,29) showed statistical significant influence on the early symptoms of neurotoxicity.