02/04/2023

PENCEGAHAN DAMPAK KEBISINGAN DI

INDUSTRI

Dr. F Handoyo Kun H, MPH, SpOk (K), HIU

Perdoki
(Perhimpunan Spesialis Kedokteran Okupasi Indonesia)

MASALAH
• Bahaya kebisingan terdapat pada 50% industry di Indonesia
• Kebisingan menyebabkan noise induced hearing loss (NIHL)
• Proses terjadinya ketulian secara bertahap tanpa rasa sakit dan
kerusakannya (NIHL) bersifat permanen
• NIHL akibat pajanan kebisingan:
Ditempat kerja mengakibatkan terjadinya PAK (BPJS TK/ JAMSOSTEK)
Diluar tempat kerja tidak termasuk PAK (BPJS KESEHATAN)

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KETULIAN
• Tuli konduktive
• Tuli saraf
• Tuli campuran

Jenis bising

• Terus menerus (kontinyu)

Konstan selama 8 jam perhari, 40 jam per minggu.
• Intermittent
Pajanan bising terjadi beberapa kali sehari, tidak terus menerus.
• Impact
Pajanan terhadap bising yang bersifat “sharp burst” atau impulsive
atau impact seperti palu, pasak bumi dsb.

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Dampak Bising

• EFEK PENDENGARAN • EFEK NON-PENDENGARAN

• TEMPORARY THRESHOLD SHIFT • KOMUNIKASI
bersifat sementara, waktu recovery • SAFETY
variable
• PERFORMANCE
• PERMANENT THRESHOLD SHIFT • KELELAHAN
bersifat menetap karena iritabilitas dan kurang tidur
• NOISE INDUCED sebagai akibat bising
• OCCUPATIONAL
• PENYAKIT AKIBAT STRES
• AKIBAT BISING
• AKIBAT TRAUMA AKUSTIK
• NON-OCCUPATIONAL
• PROBLEM PENYERTA
• DIPLAKUSIS
• TINNITUS

OCCUPATIONAL HEALTH CONCEPT

“no harm to people”

“maximise gain”

Illness Wellness

Premature Death Optimum Health

Attitudes/Behaviour
Disability

“breakout and grow”

Neutral
“minimise loss” Point
LOSS CONTROL / PREVENTION OPTIMISATION OF RESOURCES
( Short Term / Immediate ) ( Medium to Long Term Investment )

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HEALTH PREVENTION
• Primary prevention
measures that prevent the onset of illness before the disease process
begins through health promotion, legislation, and immunization
against infectious disease.
• Secondary prevention
measures that reduce the impact of a disease or injury that has
already occurred, lead to early diagnosis and prompt treatment of a
disease
• Tertiary prevention
measures that soften the impact of an ongoing illness or injury that
has lasting effects.

Nilai Ambang Batas

Peraturan Menteri Ketenagakerjaan no 5 tahun 2018

• 8 jam 85 dBA
• 4 jam 88 dBA
• 2 jam 91 dBA
• 1 jam 94 dBA
• 30 menit 97 dBA
• 15 menit 100 dBA

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Hearing Conservation Program

OSHA NIOSH
1. Noise Monitoring 1. Monitoring hearing hazards
2. Audiometric testing 2. Engineering and administrative
3. Hearing Protection control
4. Training program 3. Audiometric evaluation
5. Record program 4. Personal hearing protection
device
5. Education and Motivation
6. Recordkeeping
7. Program Evaluation

STANDARD THRESHOLD SHIFT

• Definition
a change in hearing threshold, relative to the baseline audiogram for
that employee, of an average of 10 decibels (dB) or more at 2000,
3000, and 4000 hertz (Hz) in one or both ears.
• Fletcher-Munson contour showed that surrround 4000Hz is the most
sensitive frequency in human

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Fletcher and Munson contour

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Noise Induced Hearing Loss

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Presbyacusis

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OTOTOXIC

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OTOTOXIC SUBSTANCE AT WORKPLACE

• Organic solvents: Styrene, toluene, p-xylene, ethylbenzene, chlorobenzene, trichloroethylene, n-
hexane, n-heptane, carbon disulphide, solvent mixtures
• Halogenated hydrocarbons: polychlorinated biphenyls, tetrabromobisphenol a,
hexabromocyclododecane, hexachlorobenzene
• Nitriles: 3-Butenenitrile, cis-2-pentenenitrile, acrylonitrile, cis-crotononitrile, 3,3’-
iminodipropionitrile
• Bromates: Sodium bromate, potassium bromate
• Metals and compounds: Lead, mercury, organotins, germanium dioxide
• Asphyxiants: Carbon monoxide, hydrogen cyanide, acrylonitrile, 3,3'-iminodipropionitrile
• Tobacco smoke
• Pharmaceuticals: Aminoglycosidic antibiotics (e.g., streptomycin) and some other antibiotics such
as tetracyclines, loo diuretics (e.g., furosemide), certain analgesics and antipyretics (e.g.,
salicylates such as aspirin), certain antineoplastic agents such as cisplatin.
• Other substances: Pesticides (organophosphates, paraquat, pyrethroids, hexachlorobenzene),
polychlorinated biphenyls, etc.

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OTOTOXIC SUBSTANCE IN INDUSTRY

• Machinery • Solar cell
• Leather and allied product • Manufacturing of metal, fibreglass,
• Textile and apparel leather, and petroleum products
• Paper / Printing • Aircraft maintenance
• Chemicals (including paints) • Assay laboratories
• Plastics • Firefighting
• Furniture and related products • Pesticide spraying
• Transportation equipment (e.g., • Fueling aircraft and motor vehicles
ship and boat building)
• Electrical equipment, appliances,
and components (e.g., batteries)

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OTOTOXIC SUBSTANCE IN INDUSTRY

APA YANG AKAN TERJADI BILA

PEKERJA BEKERJA DITEMPAT
BISING
DAN JUGA
MENGGUNAKAN CAIRAN
KIMIA YG BERSIFAT OTOTOXIC?

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TERIMA KASIH

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