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"Latar Belakang : Banyaknya pembangunan sarana prasana serta infrakstruktur diIndonesia meningkatkan kebutuhan akan bahan bangunan termasuk beton, sehinggaproduksi beton terus berjalan. Debu hasil proses produksi beton terdiri dari debu semen,pasir, dan batu kerikil, yang sebagian mengandung silika yang telah terbukti dapatmenimbulkan masalah kesehatan terutama di saluran pernapasan. Pada pabrik beton yangbaru beroperasi selama 3 tahun seharusnya belum ada masalah gangguan saluranpernapasan bila SMK3 diimplementasikan dengan baik. Penelitian ini bertujuan untukmengetahui apakah sudah ada masalah gangguan awal saluran pernapasan danmengaitkannya dengan implementasi SMK3 dan faktor-faktor lainnya. sehingga bisa diupayakan program promotif – preventif bagi pekerja sehubungan dengan pajanantersebut.Metode : Desain cross-sectional dengan sampel berjumlah 70 responden yang diambilsecara total sampling. Data penelitian diperoleh dari wawancara keluhan saluranpernapasan dengan menggunakan kuesioner Pneumobile Project dan pemeriksaanspirometri, pengukuran kadar debu, serta pengisian formulir audit SMK3.Hasil : Didapatkan 8 pekerja (11,40%) memiliki gejala awal gangguan saluranpernapasan. Pengukuran debu lingkungan kerja melebihi nilai ambang batas pada plant 1(16.5 mg/m3) dan plant 2 (12.1 mg/m3). Tidak terdapat hubungan bermakna antara, usia,tingkat pendidikan, IMT, kebiasaan merokok, masa kerja, dan lama kerja terhadap gejalaawal gangguan saluran pernapasan. Tingkat pelaksanaan SMK3 pada PT. X masih kurang(15,06%). Telah ada kebijakan K3, namun belum ada kegiatan perencanaan, pemantauan,evaluasi maupun usaha peningkatan kinerja K3 yang terdokumentasi dan sistematis.Kesimpulan : Didapatkan pekerja dengan gejala awal gangguan saluran pernapasansebanyak 8 (11,4%) orang. Hasil pemeriksaan kadar debu melebihi NAB. Tidakdidapatkan faktor risiko yang berhubungan secara statistik dengan gejala awal gangguansaluran pernapasan, akan tetapi tingkat pelaksanaan SMK3 masih kurang sehingga harusditingkatkan.

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Background : The large number of infrastructure development in Indonesia increased

the need of concrete. Therefore, the concrete factory production continues to run and

produce. The residue of the concrete production process derived from the dust of the

cement, sand, and gravel which partially contained silica, that had been proven to caused

health problems especially in the respiratory tract. The new concrete plant which had only

been operating for 3 years should have no cases of early symptoms of respiratory

disorders when the OSH management system is successfully implemented. This study

aimed to determine whether there are respondents with early symptoms of respiratory

disorders in association of the implementation of OSH management system and the other

factors, so that promotive-preventive programs in connection with the exposures able to

be planned regarding the conditions.

Method : Cross-sectional study with a total sampling of 70 respondents. Data were

obtained from interview using the Pneumobile Project questionnaire, spirometry

examination, measurement of dust levels, and OSH management system audit form

filling.

Results : There were 8 (11.40%) workers with early symptoms of respiratory disorders.

Dust measurement exceeds the threshold value, 16.5 mg/m3 on Plant 1 and 12.1 mg/m3

on Plant 2. There was no significant association between age, level of education, BMI,

smoking habits, working period and working time to early symptoms of respiratory tract

disorder. The implementation of OSH management system at PT. X was poor (15,06%).

There was already an OHS policy, but the planning, monitoring, evaluation or effort of

improvement of OSH were not documented systematically.

Conclusion : The prevalence of early symptoms of respiratory disorders is 11,40%. The

dust levels exceed the threshold level. No risk factors are found to be statistically associate

with early symptoms of respiratory disorders but the level of implementation of OSH is

below the expected results thus must be improved"

"The first section of Functional respiratory disorders : when respiratory symptoms do not respond to pulmonary treatment will help clinicians recognize functional respiratory symptoms that can arise as a result of both organic and psychological causes. The second section of this book provides detailed discussions of such disorders, links to video examples of laryngoscopic evaluation of patients with vocal cord issues, case studies and quizzes. Examples and exercises that should strengthen the clinician’s confidence in identifying and treating these functional conditions are also provided. Finally, the third section of the book will help the clinician differentiate the patients for whom referral to a mental health provider is mandatory from those for whom other approaches may be useful. For the latter group, the book teaches clinicians to empower themselves by learning how to incorporate various therapies for functional disorders into their practice, including biofeedback, breathing techniques, basic cognitive behavioral therapy techniques, and hypnosis. Links are provided to instructive video examples of biofeedback, hypnosis, and speech therapy. Practical strategies for obtaining training in these modalities are provided in the appendix. "