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Abstrak :
Untuk mengembangkan upaya pencegahan kcracunan pada penggunaan pestisida oleh petani, maka perlu dH To develop efforts of prevention of poisoning in using pesticide by farmers, we should know factors that influenced. As on indicator of poisoning result of using pesticide, we use the result of measuring cholinesterase activity of b1ood_ to the farmers who using pesticide. As the information about factor of working environmental in agricultural sector is difticult to find, so in this thesis just analyze factors of individual and working characteristics that associated with cholinesterase activity of blood to the farmers who using pesticide. The object of this research is to know the relationship between individual and working characteristics with cholinesterase activity of blood to the farmers who using pesticides in Bandung District, West Java. This research used cross sectional design, by using secundary data from health service of bandung District in 2001. The result of univariate analyze from 230 respondents, there were 49,6% respondents had level of cholinesterase activity of blood at poisoning category. Individual characteristics consist of sex (Sl ,3% men), age (58,3% old), level of education (57,8% low level of education), level of knowledge (55,7% low level of knowledge) and behavior (58,3% good behavior). Working haracteristics consist of working time (58,7% average), frequency of spraying (53,9% average), spraying method (66,l% right method) and using of personal protective equipment (69,l% not using personal protective equipment). The result of bivariate analyze from 5 variable of individual characteristics (sex, age, level of education, level of knowledge, and behavior), only 2 variable that have signiticant associated with cholinesterase activity of blood, there were level of knowledge (OR=9,25) and respondent behavior (0R=3,36). All of variable of working characteristics are signiiicant related with cholinesterase activity of blood, there were working time (OR-=2,38), frequency of spraying (OR=0,38), spraying method (OR=3,36) and using of personal protective equipment (OR=3,06). The result of multivariate by analyze of logistic regression on tive independent variables indicate the dominant relation with cholinesterase activity of blood is level of knowledge (0R=6,75 atter controlled by behavior, frequency of spraying, spraying method, and using of personal protective equipment. According to the result of research, we suggest to improve the intbrmation by cross sectoral between Health Department and Agricultural Department by "Upaya Kesehatan Keija" (Occupational Health Efforts) in working area of ?Puskcsmas" which is stressed in how pesticides enter into the human body and remark of pesticides label, in order the farmer who using pesticides could improve their knowledge and skill in using pesticides safety. Besides it's necessary to inspection of cholinesterase pre-exposure as data base and inspection of cholinesterase in plasm blood beside routin cholinesterase on erytrochyte that already done could be analyze deeply from the station of the pure cholinesterase.

Abstrak :
Pestisida meningkatkan hasil 40% tanaman coklat di Amerika Latin, 33% tebu di Pakistan juga mengatasi masalah hama pada program intensifikasi di Indonesia. Pestisida memberikan dampak buruk jika penggunaannya dilakukan secara terus menerus tanpa memperhatikan aturan pemakaian dan cara mengaplikasikan yang baik dan benar. Pestisida banyak digunakan petani dengan cara disemprotkan, terutama golongan organofosfat yang dapat mempengaruhi fungsi syaraf dengan jalan menghambat kerja enzim cholinesterase. Tujuan penelitian untuk menganalisis faktor risiko pajanan pestisida terhadap aktivitas cholinesterase dalam darah petani penyemprot hama padi. Desain penelitian cross sectional. Penelitian dilakukan bulan April-Mei 2014, menggunakan data sekunder kuesioner responden serta hasil pemeriksaan cholinesterase yang dilakukan Seksi Penyehatan Lingkungan Dinas Kesehatan Kabupaten Karawang di 3 Desa pada 2 wilayah kerja UPTD Puskesmas. Hasil penelitian, 81% petani mempunyai aktivitas cholinesterase normal atau tidak mengalami keracunan pestisida. Analisis bivariat menunjukkan tidak ada hubungan antara jenis pestisida yang digunakan, umur, berat badan, masa kerja, frekuensi kerja, durasi kerja, kontak terakhir dengan pestisida dan penggunaan APD terhadap aktivitas cholinesterase.

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Pesticides increase the yield of 40% cocoa in Latin America, 33% of sugarcane in Pakistan also solving pest problems in the intensification program in Indonesia. Pesticides had a devastating impact if used continuously regardless of usage rules and how to apply the rules. Pesticides are widely used by farmers by spraying, especially the organophosphate class which can affect nerve function by inhibiting the enzyme cholinesterase. The aim of research to analyze the risk factors of pesticide exposure to cholinesterase activity in the blood of farmers rice pest sprayer. The study used Cross-sectional design. The study was conducted in April-May 2014, using secondary data of the questionnaire respondents as well as the result of cholinesterase which has been conducted by Environmental Health Section of Karawang District Health on 3 villages at 2 UPTD Puskesmas. The results, 81% of farmers had normal cholinesterase activity or no pesticide poisoning. Bivariate analysis showed no correlation between the type of pesticide used, age, body weight, years of service, working frequency, duration of action, last contact with pesticides and the use of personal protective equipment against cholinesterase activity.

Abstrak :
ABSTRAK Nama : Eval HeriansyahProgram Studi : S2 Magister Kedokteran KerjaJudul : Hubungan Perubahan Akut Gambaran EKG Dengan Penurunan Aktivitas Asetilkolinesterase Plasma Pada Petani Penyemprot Laki-Laki Yang Menggunakan OrganofosfatPembimbing : Astrid Sulistomo dan Budhi SetiantoLatar Belakang. Petani di Indonesia masih banyak menggunakan pestisida golongan organofosfat. Organofosfat memiliki efek toksik terhadap berbagai sistem tubuh, salah satunya sistem kardiovaskuler. Pestisida organofosfat yang masuk ke dalam tubuh manusia memengaruhi fungsi saraf dengan jalan menghambat kerja enzim kolinesterase. Penelitian ini bertujuan untuk mengetahui hubungan perubahan akut gambaran EKG sebelum dan sesudah pajanan organofosfat pada petani penyemprot padi laki-laki.Metode. Penelitian ini menggunakan disain potong lintang dengan rancangan pre- dan post-test tanpa kontrol di desa Pada Asih, Kecamatan Cibogo, Kabupaten Subang dengan cara pengambilan sampel menggunakan cluster random sampling. Pengumpulan data dilakukan dengan wawancara menggunakan kuesioner, pemeriksaan fisis, dan pengamatan cara kerja. Pemeriksaan AChE dan EKG dilakukan sebelum dan sesudah penyemprotanHasil. Dari 80 subjek petani penyemprot padi, 20 subjek 25 mengalami perubahan gambaran EKG sesudah melakukan penyemprotan pestisida organofosfat. Jenis perubahannya, berupa sinus bradikardia 6,25 , pemanjangan interval QT 3,75 , peninggian gelombang T 2,5 , dan pembesaran atrium kiri 12,5 . Penurunan aktivitas AChE ditemukan rata-rata -2,29 3,25 . Tidak ditemukan hubungan bermakna antara semua faktor risiko yang diteliti usia, persentase perubahan AChE, merokok saat menyemprot, status gizi, penggunaan APD, masa kerja, lama penyemprotan, dan tugas kerja dengan perubahan gambaran EKG.Kesimpulan. Perubahan akut gambaran EKG yang terjadi pada populasi petani penyemprot padi laki-laki sebesar 25 . Perubahan aktivitas asetilkolinesterase terjadi berkisar -2,29 3,25 . Tidak ditemukan faktor risiko yang berhubungan.Kata kunci. Elektrokardiografi, asetilkolinesterase, petani, pestisida, organofosfat.

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ABSTRACT
ABSTRACTName Eval HeriansyahProgram Master of Occupational MedicineTitle Acute ECG Changes Associated with Decreased Plasma Acetylcholinesterase Activity Among Male Pesticide Spraying Farmers using OrganophosphateCounselors Astrid Sulistomo and Budhi SetiantoBackground. Many farmers in Indonesia are still using organophosphorus pesticides. Organophosphates have toxic effects on various body systems, one of them is the cardiovascular system. Organophosphate pesticides that enter the human body affect the function of the nerves by inhibiting the action of cholinesterase enzymes. This study aims to determine the relationship of acute changes of ECG images before and after exposure of organophosphates among male paddy sprayers.Method. This study used cross sectional with pre and post test design without control in Pada Asih Village, Cibogo Sub district, Subang Regency. Using cluster random sampling method for sample selection. Data were collected using questionnaires, physical examination, and observation of working process. Acetylcholinesterase and EKG examination was conducted before and after spraying,Results. From 80 rice spray farmers recruited, a total of 20 subjects 25 showed changes in ECG picture after spraying with organophosphorus pesticides. The types of changes include bradycardia sinus 6.25 , QT interval lengthening 3.75 , heightening of T wave 2.5 , and left atrial enlargement 12.5 . Decrease in activity of AChE was 2,29 3,25 . No significant association between changes in ECG graph and studied risk factors age, percentage of plasma AChE changes, smoking while spray, BMI, using PPE, working period, duration of spray, and work assignment could be identified.Conclusion. Acute change in ECG picture occurred in 25 of male pesticide spraying farmers. Changes in AChE were 2,29 3,25 . No association with studied risk factors could be found.

Abstrak :
ABSTRAK Pajanan pestisida organofosfat terhadap mata dapat melalui pernafasan, pencernaan, absorbsi melalui kulit dan pajanan langsung pada mata. Efek toksik organofosfat akut yang utama pada mata adalah konstriksi pupil (miosis) melalui mekanisme menghambat aktivitas enzim kolinesterase di neuromuscular junction. Penelitian ini bertujuan untuk mengetahui hubungan penurunan diameter pupil dengan persentase penurunan aktivitas asetilkolinesterase plasma sesudah pajanan organofosfat pada petani penyemprot padi laki-laki. Penelitian ini menggunakan disain cross sectional dengan dua kali pengukuran sebelum dan sesudah penyemprotan pestisida di Desa X, Jawa Barat. Pengambilan sampel menggunakan metode cluster random sampling pada tingkat RT. Pengumpulan data dilakukan dengan wawancara menggunakan kuesioner, pemeriksaan fisis, pemriksaan darah dan pengamatan cara kerja. Pemeriksaan diameter pupil dan AChE plasma dilakukan sebelum dan sesudah penyemprotan. Dari 72 responden penelitian sebesar 64 responden (88,89%) mengalami penurunan diameter pupil baik secara unilateral maupun bilateral sesudah melakukan penyemprotan pestisida organofosfat. Nilai median perubahan aktivitas AChE plasma adalah 2,2 % dengan nilai minimum -4,26% dan maksimum 9,75%. Penurunan diameter pupil dan penurunan aktivitas asetilkolinesterase plasma secara statistik bermakna (paired t-test; p<0,001). Tidak ditemukan hubungan bermakna antara penurunan diameter pupil dengan persentase perubahan aktivitas asetilkolinesterase plasma (p=0,052). Pada penelitian ini tidak ditemukan hubungan antara penurunan diameter pupil dengan persentase perubahan asetilkolinesterase plasma dan faktor resiko lainnya seperti usia, IMT, masa kerja dan lama waktu penyemprotan pestisida.

Abstrak :
Instensifikasi pertanian merupakan langkah peningkatan produk pertanian, seperti pengolahan lahan pertanian dan pembasmian hama atau penyakit pada tanaman. Pestisida dapat membasmi hama dalam waktu singkat namun berisiko buruk terhadap kesehatan dan lingkungan. Penggunaan pestisida pada lahan pertanian dipengaruhi oleh pengetahuan, sikap, dan perilaku petani. Penelitian ini bertujuan untuk mengetahui pengetahuan, sikap, dan perilaku petani dalam penggunaan pestisida serta memprediksi berapa banyak asupan cabai, kubis, dan kentang yang dikonsumsi petani menimbulkan risiko gangguan kesehatan di Kecamatan Cikajang, Kabupaten Garut. Penelitian ini menggunakan disain cross sectional dengan pendekatan analisis risiko kesehatan lingkungan (ARKL). Sampel penelitian ini sebanyak 105 responden petani dan penyemprot tanaman menggunakan pestisida. Responden dipilih menggunakan metode purposive sampling. Berdasarkan hasil univariat, 93% berpengetahuan kurang baik, 68% bersikap baik, dan 63% berperilaku kurang baik. Berdasarkan hasil bivariat, bahwa faktor tingkat pengetahuan berhubungan signifikan dengan nilai risiko (RQ) gangguan kesehatan (p = 0,042; OR = 1,69). Hasil ini menunjukkan perlunya penyuluhan tentang penggunaan pestisida dan pengawasan aktivitas petani agar risiko gangguan kesehatan dapat dicegah. ......Instensification agriculture is a step improvement of agricultural products, such as processing of agricultural land and eradication of pests or plant diseases. Pesticides can eradicate the pest in a short time but bad risk to health and the environment. The use of pesticides on agricultural land is affected by the knowledge, attitudes, and behavior of farmers. This study aims to determine knowledge, attitudes, and behaviors of farmers in the use of pesticides and to predict how much intake of chili, cabbage, and potatoes are consumed by the farmer raises the risk of health problems in the district Cikajang, Garut. This study used cross sectional design with environmental health risk analysis approach (ARKL). The research sample of 105 respondents of farmers and crop spraying using pesticides. Respondents were selected using the method of purposive sampling. Based on the results of the univariate, 93% less knowledgeable good, 68% to be good, and 63% misbehave. Based on the results of the bivariate, that factors significantly associated with the level of knowledge of the value of risk (RQ) health problems (p = 0.042; OR = 1.69). These results show the need for education about the use of pesticides and supervision of the activities of farmers to the risk of health problems can be prevented. that the knowledge level factors significantly associated with the risk value (RQ) health problems (p = 0.042; OR = 1.69). These results show the need for education about the use of pesticides and supervision of the activities of farmers to the risk of health problems can be prevented. that the knowledge level factors significantly associated with the risk value (RQ) health problems (p = 0.042; OR = 1.69). These results show the need for education about the use of pesticides and supervision of the activities of farmers to the risk of health problems can be prevented.