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"Latar belakang: PT X adalah produsen tepung gandum, dimana dalam proses produksinya dihasilkan debu tepung yang mencemari lingkungan kerja. Debu tepung gandum yang masuk ke saluran nafas pekerja dapat menyebabkan penyakit pada saluran nafas yaitu Rinitis Akibat Kerja.Metode: Tujuan dari penelitian ini yaitu diketahuinya faktor-faktor risiko yang berhubungan dengan Rinitis Akibat Ketja. Penelitian ini dilakukan dengan desain studi kasus kontrol untuk mengetahui hubungan antara faktor-faktor risiko pada pekerja dan terjadinya Rinitis Akibat Kerja. Responden adalah pekerja yang bekerja di bagian Pengepakan yang memenuhi syarat inkiusi, berjumlah 215 responden. Data yang dikumpulkan yaitu variabei babas (umur, masa kerja, pakai APD, riwayat atopi dan kebiasaan merokok) dan variabel iergantungnya Rinitis Akibat Kerja.Hasil: Hasil pengukuran kadar debit personal melebihi NAB (4 mg/m3) yaitu di proses pengepakan sebesar 5.66 mglm3 dan proses pengayakan sebesar 15.12 mg/rn3. Dari 215 responder didapatkan 82 responden (38.1%) yang menderita Rinitis Akibat Kerja atau kasus dan 133 responden (61.9%) yang tidal( menderita Rinitis Akibat Kerja sebagai kontrol. Riwayat atopi dan Pemakaian Mat Pelindung Diri yang kurang baik, berhubungan dengan terjadinya Rinitis Akibat Kerja yaitu masing-masing dengan OR--4.24; p 0.00; 95% CI 2.35-7.66 dan OR 2.06; p 0.014; 95%CI 1.16-3.65.Kesimpulan: Pajanan debu tepung di udara bagian Pengepakan melebihi Nilai Ambang Batas. Faktor yang berhubungan dengan Rinitis Akibat Kerja pada pekerja bagian Pengepakan adalah adanya riwayat atopi dan pemakaian Alat Peiindung Diri (masker) yang kurang baik.

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Background: PT X is a factory produces whole-wheat flour which its process generates flour dust that contamined working environment especialy at packaging area Inhaled flour dust may affect to workers'respiratory tract, then included Occupational Rhinitis.

Method: This study was conducted by using ease control design to look at the relation between worker characteristics, length of service, atopic history, personal protection equipment use and smoking habit. 215 study subjects who work for Packaging Department and fulfilled inclution criteria were involved in this study. Collected data were consisted of Occupational Rhinitis as dependent variable and its risk factors as independent variables.

Result: The level of personal dust exposure were 5.66 mg/m3 at packaging area and 15.12 mg/m' at the filtering process which exceeded Treshold Limit Value of 4 mglm3. 82 subjects (38.1%) of 215 total respondent were diagnosed Occupational Rhinitis. In contrast 133 subjects (61.9%) were not Occupational Rhinitis as a control group. Statistical analysis shows that unappropriate use of personal protection equipment and atopic history have significant association with the risk of Occupational Rhinitis (OR 2.06; 95%Cl; 1.16-3.65 and OR 4.24; 95%Cl; 2.35-7.66).

Conclusion: The exposure levels of the flour dust in the air of Packaging Department were above Treshold Limit Value. Factors assosiated with the Occupational Rhinitis at the workers of the Department of Packaging are atopic history, and unappropriate use of personal protection equipment (masker)."

"Latar belakang: Gangguan tidur merupakan keluhan yang sering terjadi pada rinitis kronis, dengan penyebab tersering adalah hidung tersumbat. Hidung tersumbat juga merupakan faktor risiko terjadinya sleep disordered breathing (SDB). SDB memiliki spektrum penyakit yang luas, salah satunya adalah obstructive sleep apnea (OSA). Walaupun berbagai literatur telah membuktikan adanya gangguan tidur pada pasien rinitis alergi, penelitian mengenai gangguan tidur pada pasien rinitis nonalergi masih terbatas. Tujuan penelitian: Membandingkan derajat gangguan tidur antara kelompok rinitis alergi dan rinitis nonalergi di RSUPN Cipto Mangunkusumo. Metode: Penelitian ini menggunakan desain potong lintang pada 11 subjek rinitis alergi dan 11 subjek rinitis nonalergi yang berusia 18-60 tahun di Poliklinik THT RSUPN Ciptomangunkusumo. Derajat obstruksi nasal dinilai menggunakan kuesioner NOSE. Derajat gangguan tidur dinilai secara subjektif dengan kuesioner ESS, PSQI, dan ISI serta secara objektif dengan polisomnografi. Hasil: Tidak didapatkan perbedaan pada hasil skor NOSE, ESS, RSI, PSQI, ISI, maupun parameter polisomnografi antara kelompok rinitis alergi dengan kelompok rinitis nonalergi (p > 0,05). Didapatkan hubungan bermakna antara RDI NREM, RERA, saturasi minimum oksigen dan saturasi baseline oksigen dengan klasifikasi OSA pada kelompok rinitis kronis (p< 0,05). Kesimpulan: Tidak didapatkan perbedaan derajat gangguan tidur antara rinitis alergi dan rinitis nonalergi.

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Background: Sleep disturbance is common in chronic rhinitis, primarily caused by nasal congestion. Nasal congestion is also a risk factor for sleep disordered breathing (SDB). SDB refers to a spectrum of breathing abnormalities, one of which includes obstructive sleep apnea (OSA). Although many studies have linked sleep disturbance with allergic rhinitis, data regarding its association with nonallergic rhinitis seem to be limited. Aim : To compare the severity of sleep disturbance between allergic and nonallergic rhinitis. Methods: This cross-sectional study consisted of 11 subjects with allergic rhinitis and 11 subjects with nonallergic rhinitis at ORL-HNS outpatient clinic, Cipto Mangunkusumo Hospital. NOSE questionnaire was used to assess the degree of nasal obstruction. The severity of sleep disturbance was subjectively assessed using ESS, PSQI, and ISI questionnaires and objectively assessed using polysomnography. Results: No significant differences in NOSE, ESS, RSI, PSQI, and ISI scores were found between both groups (p > 0,05). There was a significant relationship between RDI NREM, RERA, minimum oxygen saturation and baseline oxygen saturation with OSA classification in the chronic rhinitis group (p <0.05). Conclusion: The type of rhinitis (allergic or nonallergic) did not influence the severity of sleep disturbance."

"Background: Vitamin D role in immune system have been investigated due to the presence of VDR on immune cells. Based on this information deficient level of vitamin D could affect the progression of allergic rhinitis. Unfortunately the data regarding vitamin D status in the normal population and allergic rhinitis patient were very limited in Indonesia. This research was done to provide illustration regarding the status of vitamin D in healthy and allergic rhinitis patients in Jakarta and also to investigate the factor that might affect the level of vitamin D in allergie rhinitis. Methods: This research was an observational cross sectional research. There were 22 subjects used during this research all diagnosed with moderate-severe allergic rhinitis. The study used the Electrochemiluminescence Immunoassay (ECLIA) technique. The data then were analyzed with IBM® SPSS statistic version 22 Results: The difference between the mean vitamin D of patients suffering from allergic rhinitis with healthy controls (12.7±10.3 ng/mL to 15.1±8.1 ng/mL). There was no significant diference in mean vitamin D between the gender groups (Independent Sample T-test p= 0.62). There were no statistical difference between the vitamin D level in patient with different eosinophil count and IL-5 level (IL-5 group: one-way ANOVA: p= 0.897; eosinophil group: One Way ANOVA: p = 0.752). Conclusion: The mean level of vitamin D in allergic rhinitis patients compared to healthy controls showed no significant difference. Comparison studies about level of vitamin D between groups with different gender, IL-5 and eosinophil count showed no significant difference"

"Latar Belakang:Hidung adalah organ saluran napas bagian atas yang terpajan secara langsung terhadap agent debu tepung terigu. Deposit partikel debu tepung yang terjadi pada saat inhalasi maupunekshalasi terbanyak pada hidung. Partikel debu tepung tersebut merupakan stimulus dan rangsangan inflamasi pads mukosa hidung dan sinus paranasal.Metoda:Penelitian ini menggunakan desain kros seksional, dilakukan pada pabrik tepung Jakarta, bulan Agustus 2.005 sampai Juli 2006. Responden adalah pekerja PT X bagian pengepakan yang menderita Rinitis Akibat Kerja.Hasil Penelitian:Kadar debu personal melebihi ambang batas (NAB = 4 mg/m3). Jumlah responden pada penelitian ini 80 orang, yang menderita Rinosinusitis Kronis Akibat Kerja sebanyak 35 orang.Berbagai variabel diteliti untuk mencari hubungan dengan terjadinya Rinosinusitis Kronis Akibat Kerja, yaitu karakteristik responden, aspek K3 dan faktor rinogenik. Dengan uji statistik diketahui variabel yang bermakna adalah pendidikan (p = 0,037), merokok (p = 0,045) dan prosesus unsinatus (p = 0,000). Dengan analisis multivariat diketahui prosesus unsinatus merupakan faktor yang dominan untuk terjadinya Rinosinusitis Kronis Akibat Kerja. Kesimpulan:Prevalensi Rinosinusitis Kronis Akibat Kerja adalah 43,8%. Variabel pendidikan, perokok dan prosesus unsinatus bcrmakna untuk terjadinya Rinosinusitis Kronis Akibat Kcrja. Variabel yang paling dominan untuk terjadinya Rinosinusitis Kronis Akibat Kerja adalah prosesus unsinatus.

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Background:

Nose. the upper organ of respiratory tract system suffered directly from flour dust exposure. Deposit of flour dust particles during inhalation and exhalation accumulated mostly in the nose, acted as stimulator as well as generating inflammatory effect on nasal and paranasal sinus mucosa.

Method:

This research design was cross sectional carried out in flour factory Jakarta. Duration of study from August 2005 until July 2006. The subjects were from flour packing workers department and were diagnosed occupational rhinitis before.

Result:

The level of personal dust exposure exceeded threshold limit, value of 4 mglm3. The total subjects was 80 workers, in which 35 workers were being as diagnosed occupational chronic _rhinosinusitis, i:e is demographic, occupational and rhinogenic factors. Using bivariate statistical analysis, education (p = 0,037), smoking (p = 0,045) and procesus uncinatus (p =0,000) were identified as having significant relationship. In the logistic regression function analyses only procesus uncinatus was identified as the determinant of occupational chronic rhinosinusitis.

Conclusion:

The prevalence of occupational chronic rhinosinusitis is 43,8%. While education, smoking and procesus uncinatus are the variables identified as major risk factors. Procesus uncinatus in the logistic regression then identified as the determinant of having occupational chronic rhinosinusitis."

"ABSTRAK Prevalensi Rinitis Akibat Kerja (RAK) berkisar antara 5-48%. Penyebab RAKantara lain adalah partikulat debu yang beterbangan di lingkungan kerja. Hal iniakan meningkatkan beban pembiayaan baik terhadap pekerja itu sendiri maupunperusahaan tempat ia bekerja. Penelitian ini bertujuan untuk mengetahuiprevalensi RAK serta hubungan antara kadar partikulat debu dengan kejadianRAK dengan populasi pekerja parkir basement di sebuah Hotel dan RSUD diJakarta dengan waktu pengumpulan sampel dilakukan selama bulan Desember 2014 hingga Maret 2015. Sampel penelitian adalah yang memenuhi kriteria inklusi yakni area kerja di parkir basement, usia 20-40 tahun, masa kerja lebihdari 1 tahun dan bersedia mengikuti prosedur penelitian. Subyek penelitian diwawancara dan diperiksa kadar eosinofil kerokan mukosa hidung sebelum dansesudah bekerja. RAK positif apabila terdapat gejala rinitis, memberat ketikabekerja dan ada peningkatan eosinofil kerokan mukosa hidung. Analisa penelitiandilakukan berdasarkan karakteristik usia, jenis kelamin, masa kerja, kebiasaanmerokok dan bagian kerja (terpapar langsung atau tidak dengan partikulat debu).Dari 57 subyek penelitian, 6 orang (10.5%) mengalami peningkatan eosinofildengan karakterisktik sebagai berikut: 4 orang memiliki masa kerja > 4 tahun; 4orang memiliki kebiasaan merokok; dan 3 orang bekerja di bagian kerja yangterpapar langsung dengan partikulat debu. Dari 6 orang tersebut terdapat 3 orang(5.2%) yang memenuhi kriteria RAK dengan karakteristik sebagai berikut: 2orang berusia 30-40 tahun, 2 orang adalah laki-laki, 2 orang mempunyai masakerja ≤ 4 tahun, dan 2 orang berasal dari bagian kerja yang terpapar tidaklangsung dengan partikulat debu. Terdapat hubungan bermakna antara riwayatatopi dengan peningkatan eosinofil (OR 23.33 dan 95%CI 2.40-224.62). Namuntidak ditemukan hubungan antara kadar partikulat debu dan masa kerja dengan RAK yang bermakna. ABSTRACT The prevalence of occupational rhinitis ranges between 5-48%. It is caused byparticulate dust in the workplace. It will increase financial burden both for theworkers themselves and the company. This study aims to determine theprevalence of OR and the relation between the levels of particulate dust with ORincident among workers who work in a hotel or hospital basement parking lot inJakarta, during December 2014 to March 2015. The sample inclusion criteriawere: age 20-40 years, working period of more than one year and are willing toparticipate in the study. The subjects were interviewed and nasal mucosal scrapings eosinophil levels were measured before and after work. OR was defined as has symptoms of rhinitis, increase during work and there is anincrease in eosinophils nasal mucosal scrapings. Analysis of the research carriedout based on the characteristics of age, sex, years of smoking and workingdirectly or indirectly exposed to dust particulates. Of the 57 subjects of the study,6 (10.5%) experienced an increase in eosinophils with the followingcharacteristics: 4 people has a work period > 4 years; 4 people smoke; and 3people work directly exposed to particulate dust. Three subjects (5.2%) meet allthe OR criteria with the following characteristics: 2 were aged 30-40 years, 2were male, 2 have a working period of ≤ 4 years and 2 were indirectly exposed toparticulate dust. There is a very significant association between history of atopywith increased eosinophils (, OR 23.3 and 95% CI 2.40-224.62). However, no association was found between levels of particulate dust and working period.;The prevalence of occupational rhinitis ranges between 5-48%. It is caused byparticulate dust in the workplace. It will increase financial burden both for theworkers themselves and the company. This study aims to determine theprevalence of OR and the relation between the levels of particulate dust with ORincident among workers who work in a hotel or hospital basement parking lot inJakarta, during December 2014 to March 2015. The sample inclusion criteriawere: age 20-40 years, working period of more than one year and are willing toparticipate in the study. The subjects were interviewed and nasal mucosal scrapings eosinophil levels were measured before and after work. OR was defined as has symptoms of rhinitis, increase during work and there is anincrease in eosinophils nasal mucosal scrapings. Analysis of the research carriedout based on the characteristics of age, sex, years of smoking and workingdirectly or indirectly exposed to dust particulates. Of the 57 subjects of the study,6 (10.5%) experienced an increase in eosinophils with the followingcharacteristics: 4 people has a work period > 4 years; 4 people smoke; and 3people work directly exposed to particulate dust. Three subjects (5.2%) meet allthe OR criteria with the following characteristics: 2 were aged 30-40 years, 2were male, 2 have a working period of ≤ 4 years and 2 were indirectly exposed toparticulate dust. There is a very significant association between history of atopywith increased eosinophils (, OR 23.3 and 95% CI 2.40-224.62). However, no association was found between levels of particulate dust and working period.;The prevalence of occupational rhinitis ranges between 5-48%. It is caused byparticulate dust in the workplace. It will increase financial burden both for theworkers themselves and the company. This study aims to determine theprevalence of OR and the relation between the levels of particulate dust with ORincident among workers who work in a hotel or hospital basement parking lot inJakarta, during December 2014 to March 2015. The sample inclusion criteriawere: age 20-40 years, working period of more than one year and are willing toparticipate in the study. The subjects were interviewed and nasal mucosal scrapings eosinophil levels were measured before and after work. OR was defined as has symptoms of rhinitis, increase during work and there is anincrease in eosinophils nasal mucosal scrapings. Analysis of the research carriedout based on the characteristics of age, sex, years of smoking and workingdirectly or indirectly exposed to dust particulates. Of the 57 subjects of the study,6 (10.5%) experienced an increase in eosinophils with the followingcharacteristics: 4 people has a work period > 4 years; 4 people smoke; and 3people work directly exposed to particulate dust. Three subjects (5.2%) meet allthe OR criteria with the following characteristics: 2 were aged 30-40 years, 2were male, 2 have a working period of ≤ 4 years and 2 were indirectly exposed toparticulate dust. There is a very significant association between history of atopywith increased eosinophils (, OR 23.3 and 95% CI 2.40-224.62). However, no association was found between levels of particulate dust and working period.;The prevalence of occupational rhinitis ranges between 5-48%. It is caused byparticulate dust in the workplace. It will increase financial burden both for theworkers themselves and the company. This study aims to determine theprevalence of OR and the relation between the levels of particulate dust with ORincident among workers who work in a hotel or hospital basement parking lot inJakarta, during December 2014 to March 2015. The sample inclusion criteriawere: age 20-40 years, working period of more than one year and are willing toparticipate in the study. The subjects were interviewed and nasal mucosal scrapings eosinophil levels were measured before and after work. OR was defined as has symptoms of rhinitis, increase during work and there is anincrease in eosinophils nasal mucosal scrapings. Analysis of the research carriedout based on the characteristics of age, sex, years of smoking and workingdirectly or indirectly exposed to dust particulates. Of the 57 subjects of the study,6 (10.5%) experienced an increase in eosinophils with the followingcharacteristics: 4 people has a work period > 4 years; 4 people smoke; and 3people work directly exposed to particulate dust. Three subjects (5.2%) meet allthe OR criteria with the following characteristics: 2 were aged 30-40 years, 2were male, 2 have a working period of ≤ 4 years and 2 were indirectly exposed toparticulate dust. There is a very significant association between history of atopywith increased eosinophils (, OR 23.3 and 95% CI 2.40-224.62). However, no association was found between levels of particulate dust and working period."

"AbstrakPURPOSE:Chinese herbal medicine (CHM) has been widely used in China to treat allergic rhinitis (AR). However, several studies have produced conflicting data with regard to the efficacy of the medicine. Our aim was to perform a meta-analysis of randomized clinical trials (RCTs) to evaluate the relative efficacy of CHM.METHODS:We systematically searched the PubMed, Medline, and Springer electronic databases up to March 2017 for RCTs comparing the efficacy of CHM versus placebo for the treatment of patients with AR. Total nasal symptoms and quality of life were assessed through pooling mean difference (MD) with its 95% confidence interval (CI). Moreover, sensitivity and subgroup analyses according to control design and quality of life assessment were performed to evaluate the source of heterogeneity.RESULTS:Eleven RCTs were enrolled in the meta-analysis. Assessment of overall heterogeneity indicated significant heterogeneity among the individual studies (I²=100%, P<0.00001), and thus ransomed effects model was used to pool data. CHM was found to significantly enhance quality of life compared with placebo (MD=-0.88, (95% CI: -1.55, -0.21); P=0.01). The symptom of itchy nose, sneezing or total nasal symptoms scores were not significantly improved after CHM treatment, although the improvement in itchy nose just failed to reach significance (MD=0.09, (95% CI: 0.00, 0.18); P=0.06).CONCLUSIONS:This study suggests that CHM appears to improve the quality of life of AR patients. However, these findings, as well as the findings for the effect of CHM on sneezing, total nasal symptoms, and the symptom of itchy nose, need to be substantiated in larger cohorts of AR patients by further well-designed studies."

"Perubahan gaya hidup seiring perkembangan zaman membuat kronotipe manusia semakin bervariasi. Kronotipe malam diketahui banyak dijumpai pada kalangan remaja akhir. Pola irama sirkadian memiliki hubungan dengan sistem imun dan penyakit alergi. Rinitis alergi merupakan penyakit alergi yang paling banyak dijumpai pada kalangan remaja dan dapat menurunkan kualitas hidup penderitanya. Penelitian ini bertujuan untuk mengetahui hubungan kronotipe dan rinitis alergi pada pelajar sekolah menengah atas.

Metode: Pada penelitian potong lintang ini, analisis dilakukan pada 196 pelajar sekolah menengah atas yang telah menjawab empat kuesioner: International Study of Asthma and Allergy in Childhood Core Questionnaire, Reduced Version Morningness-Eveningness Questionnaire, Epworth Sleepiness Scale dan Kuesioner Studi Kohort Faktor Risiko PTM Tahun 2011 Bagian Penggunaan Tembakau dan Kebiasaan Merokok. Data dianalisis menggunakan uji chi square dan analisis regresi logistik.

Hasil: Lebih banyak pelajar berkronotipe pagi (64,8%) dibandingkan tipe malam (35,2%). Sebanyak 28,1% pelajar mengalami rinitis alergi dalam 12 bulan terakhir. Kronotipe berhubungan signifikan dengan rinitis alergi (p<0,05; OR=2,273; CI 95% 1,198-4,311). Terdapat perbedaan proporsi rinitis alergi yang signifikan antara pelajar dengan kronotipe malam (39.1%) dan pelajar dengan kronotipe pagi (22%).

Kesimpulan: Terdapat perbedaan proporsi rinitis alergi yang signifikan antara pelajar sekolah menengah atas dengan kronotipe malam dan pelajar dengan kronotipe pagi.

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Changes in lifestyle over the times make human chronotypes more varied. The evening type are known to be frequently found among late adolescents. Circadian rhythm has a relationship with the immune system and allergic disease. Allergic rhinitis is the most common allergic disease among adolescents and can reduce the patient's quality of life. This study aims to determine the relationship between chronotype and allergic rhinitis in high school students.

Method: In this cross-sectional study, 196 high school students answered four different questionnaires: the International Study of Asthma and Allergy in Childhood Core Questionnaire, the Reduced Version Morningness-Eveningness Questionnaire, Epworth Sleepiness Scale and Kuesioner Studi Kohort Faktor Risiko Penyakit Tidak Menular Tahun 2011 Bagian Penggunaan Tembakau dan Kebiasaan Merokok. The data was analyzed using chi-square test and logistic regression.

Result: More students were morning type (64,8%) compared to evening type (35,2%). As many as 28.1% of students experienced allergic rhinitis in the last 12 months. Chronotype was significantly associated with allergic rhinitis (p<0,05; OR=2,273; CI 95% 1,198-4,311). There was a significant difference in the proportion of allergic rhinitis between high school students with evening chronotype (39,1%) and high school students with morning chronotype (22%).

Conclusion: There was a significant difference in the proportion of allergic rhinitis between high school students with evening chronotype and students with morning chronotype."

"AbstrakPURPOSE:House dust mites (HDM) are major allergens that cause allergic rhinitis (AR). Allergen-specific subcutaneous immunotherapy (SCIT) has been shown to be clinically beneficial in many clinical trials. Such trials, however, are not reflective of all patient populations. The aim of this study was to describe the efficacy and safety of SCIT in routine clinical practice in Korean adults with AR sensitized to HDM.METHODS:We reviewed medical records of 304 patients with AR treated at an allergy clinic of a tertiary hospital using SCIT with aluminum hydroxide-adsorbed allergen extract targeting HDM alone or with pollens for at least 1 year from 2000 to 2012. Patients with asthma were excluded. Rates of remission, defined as no further requirement of maintenance medication, over time were determined by means of life tables and extension of survival analysis. Specific immunoglobulin E (IgE) levels to HDM were categorized into 6 classes.RESULTS:The mean time until achieving remission was 4.9±0.1 years, and the cumulative incidence of remission from AR was 76.6%. Severe AR (odds ratio [OR], 0.40; 95% confidence interval [CI], 0.23-0.69; P=0.001), specific IgE levels to HDM ≥17.5 kU/L (OR, 1.85; 95% CI, 1.01-3.37; P=0.045), and duration of immunotherapy ≥3 years (OR, 7.37; 95% CI, 3.50-15.51; P<0.001) were identified as significant predictors of clinical remission during SCIT for patients with AR sensitized to HDM. Overall, 73 patients (24.0%) experienced adverse reactions to SCIT, and only 1 case of anaphylaxis (0.3%) developed.CONCLUSIONS:SCIT with HDM was found to be effective and safe for patients with AR. Specific IgE levels to HDM and a duration of SCIT ≥3 years may be predictors of clinical responses to SCIT in AR patients."