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Results in Journal The Indonesian Journal of Community and Occupational Medicine: 27

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Arriz Akbar Sukadi, Muhammad Ilyas
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 189-98; https://doi.org/10.53773/ijcom.v1i3.38.189-98

Abstract:
Introduction: Naphthalene is one of the chemicals that are widely used throughout the world, such as aircraft fuel, camphor, insecticides, and colouring agents in cosmetics. Exposure to naphthalene can cause health problems ranging from dermatitis and haemolytic anaemia to even the possibility of cancer of the respiratory tract, therefore it is necessary to carry out biological monitoring of workers at risk. The aim of this study is to find out which is the simplest and most reliable biomonitoring to use based on an evidence-based literature review. Methods: Literature search was conducted through electronic databases from PubMed, ProQuest, and Cochrane. The keywords used are worker, naphthalene, and biomonitoring. Initially, 273 articles were obtained, but after going through a selection process and manual search, seven articles were examined. Results: Based on the selected evidence-based literature, it was found that there was an increase in the level of naphthol in the urine in workers exposed to naphthalene who were examined during pre-shift and post-shift. Conclusion: Naphthol concentration in urine can be a non-invasive, easy, and reliable biomonitoring exposure of naphthalene. Although it is currently not possible to do this in Indonesia, this study shows the importance of biomonitoring to prevent occupational diseases due to this exposure.
Bernath Siagian, Ambar W Roestam, Dewi S Soemarko, Sudadi Hirawan, Indah S Widyahening, Suryo Wibowo
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 154-61; https://doi.org/10.53773/ijcom.v1i3.30.154-61

Abstract:
Background: Lower back pain (LBP) complaints are a health issue that may lead to restrictions on work activities. Motorcycles vibrations and long sitting duration on the motorcycles can cause chronic lower back pain complaints. Base motorcycles drivers receive motorcycles vibration exposure while riding a motorcycle. With the large number of base motorcycles drivers in Indonesia, the specific health problems (LBP complaints) in this group need to be examined. Methods: This research method uses a cross sectional study design to examine the relationship of motor vibration exposure and length of sitting to chronic low back pain with sampling technique used is Consecutive sampling. Consecutive sampling is a way of taking samples by selecting samples that meet the inclusion criteria until a certain time period so that the number of samples is met. The sampling period in this study is 2 days. The variables that measured were chronic lower back pain complaints, vibration, long sitting time, age, IMT, smoking, and working time. Data analysis using SPSS Statistics version 25.0. Results: A total of 95 subjects were included in this study. Based on Fisher’s test, the result of the correlation of chronic lower back pain complaints with motor vibrations > 0.5 m/s2 was obtained p = 0.102; OR = N / A). While for long sitting time of >4 hours result in p = 0.717; OR 0.85; CI 95% = 0.34-2.09. There is no difference in age-related chronic lower back pain complaints. At age> 35 years of age p = 0.722; OR 1.57; CI 95% = 0.31-7,9. No significant association between IMT and chronic lower back pain was found. In the IMT group> 25, p = 0.103 was obtained; OR 2.14; 95% CI = 0.85-5.36. There was no significant difference in chronic lower back pain complaints based on smoking status, where smoking group had p = 0.451; OR 1,45; CI 95% = 0.55-3.78. According to the Fisher test, there was no difference in chronic lower back pain complaints based on working age, where groups with> 4 years of work had a p = 0.908 value; OR 1.07; CI 95% = 0.31-3.91. Conclusion: In this study the hypothesis was rejected. There is no association between motorcycles vibration exposure and the occurrence of chronic lower back pain complaints in the base motorcycles driver in Bekasi city. There is no association long sitting time with the occurrence of chronic lower back pain complaints in the base motorcycles driver in Bekasi city.
Felicia Erika Jahja, Muhammad Ilyas
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 179-88; https://doi.org/10.53773/ijcom.v1i3.28.179-88

Abstract:
Introduction: Cancer is a disease with a high mortality rate in Indonesia. One of the chemical exposures that can cause cancer is perfluorooctanesulfonyl fluoride/perfluoro octane sulphonate (PFOS). PFOS is a chemical that is widely used due to its diverse functions, including use in fire extinguishers, waterproof materials in food boxes and furniture, and household hygiene products. Long-term exposure to workers affected by PFOS is suspected to be one of the risk factors for cancer. Methods: The author conducted a literature search of online search engines in 3 sources PubMed, Google Scholar, and JSTOR databases. The inclusion criteria in this study are articles in English, full text available, and conducted on the working population. The author has not restricted search within the last 5 years due to the limited reference of the topic. Results: Out of a total of 5 articles examined, the authors found the incidence of bladder cancer in workers as much as 1.28 times, there was even a death rate of 12.77 times in workers with PFOS exposure due to bladder cancer, although the results did not statistically significantly. Other studies have shown increased levels of PFOS in the blood but were not associated with changes in other laboratory examinations associated with health problems in workers. Conclusions: The results of the literature study found no significant association in cancer occurrence based on the length of PFOS exposure in workers. The literature search results also found no direct association between PFOS exposure to possible health problems.
Tenny Sutarto, Dewi S Soemarko, Slamet Ichsan
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 146-53; https://doi.org/10.53773/ijcom.v1i3.33.146-53

Abstract:
Background: Hot work environment can cause various subjective and objective complaints for workers. When workers perform activities under hot work environment, their body will react by balancing the amount of heat received by the body from outside the body and the loss of water in the body. Hydration status is the condition achieving the balance between water intake and water discharge from the body. Bad hydration status or de-hydration can cause various changes in the body physiological functions. This study was intended to see the association between heat exposure and hydration among production workers in Fish Processing Company Sawangan, Depok. Method : A cross sectional study with 88 respondents, selected as a total sampling. The study was conducted on November 2017 until January 2018. Data analysis were used by SPSS version 20.0. Result: There is no significant difference between the specific gravity of urine before and after working (p=0.076). However, 37.5% of the workers had dehydration. There is a significant association between the work environment temperature and hydration status (p=0.002), and also between water intake and status of hydration (p=0.013). Work environment temperature is the most dominant risk factor to influence dehydration (p=0.000; OR= 9.305; 95%CI=2.727-31.748) Conclusions: There is a significant association between heat exposure and hydration status (p=0.000; OR=9.305). The number of workers that were exposed to heat and experienced dehydration is 33 people (37.5%). Water intake turns to be the individual factor that influences the status of hydration of the workers exposed to heat. The work factor that influences the hydration status of the workers is the work environment temperature.
Francoise Cardoso, Erika Wasito, Tonny Sundjaya, Ray Wagiu Basrowi, Mikhael Yosia
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 162-73; https://doi.org/10.53773/ijcom.v1i3.40.162-73

Abstract:
Breastfeeding is undoubtedly the best nutrition for infants. Even throughout the COVID-19 pandemic, more pregnant mothers intend to breastfeed their babies. Despite this desire, not all of them succeed in initiating breastfeeding. One of the overlooked challenges in breastfeeding is that working mothers need to return to work, increasing hesitancy to continue breastfeeding due to numerous inconveniences, leading to full breastfeeding cessation. Systematic changes are needed following simple and practical changes: giving access to knowledge on breastfeeding while working, sharing advice and support from employers and colleagues, and providing a breastfeeding-friendly workplace, all of which can increase breastfeeding rates in many countries. Improvement in breastfeeding habits would also bring greater impact as increases in working mothers’ wellbeing will increase their work performance. Danone has done several breastfeeding initiatives and post-natal support in workplaces which has shown a positive impact through preliminary evaluation included in this study. The corporate world has not fully supported breastfeeding, but some best practices and learning points shed from this study could become an example that would lead to better commitments from other companies.
Ayu Munawaroh, Herqutanto, Khamelia Malik, Ambar W. Roestam, Astrid B. Sulistomo
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 129-36; https://doi.org/10.53773/ijcom.v1i3.34.129-36

Abstract:
Introduction: Occupational stress is known to be one of the factors that are often found in nursing professionals. Occupational stress can affect a person both physically and mentally. Moreover, the COVID-19 pandemic has brought additional workload for healthcare professionals, including nurses. This study aimed to analyze the association between occupational stress and psychopathological symptoms among nurses in Cardiovascular Hospital during the Covid-19 pandemic. Methods: This cross-sectional study involved 108 nurses in Cardiovascular Hospital X. Samples were taken by simple random sampling based on inclusion and exclusion criteria. Occupational stress was assessed by Expanded Nursing Stress Scale (ENSS) and psychopathological symptoms were assessed by Symptom Checklist 90 (SCL-90). Results: The mean ENSS total score was 88,17 ± 32,24 (maximum score of ENSS was 228). 19,4% of nurses had psychopathological symptoms. Somatization, obsessive-compulsive, and psychoticism had higher t-score values than other SCL-90 subscales. There was a strongly significant association between occupational stress and psychopathological symptoms (p<0,001). Conclusion: Its highly recommend early diagnosis and prompt treatment for psychopathological symptoms among nurses. Monitor and evaluation of occupational stress and psychopathology in nurses are recommended as periodic medical check-up program in hospital.
Boy Hidayat, Nuri Purwito Adi, Cinthya Yuanita
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 174-8; https://doi.org/10.53773/ijcom.v1i3.32.174-8

Abstract:
Background: The COVID-19 pandemic is first and foremost a human tragedy that has played out across the globe. People are experiencing unprecedented levels of disruption in their homes and communities, as well as in their jobs. Office worker of an international oil and gas company located in Jakarta was also had the impact of COVID-19 pandemic. The company must establish system to protect their worker to perform their work safely and avoid COVID-19 exposure. Objective: To describe COVID-19 statistic period 2020 – November 2021 and how company address the system to prevent outbreak and the re-occurrence. Methods: A case study based on company record and performance on tackling COVID-19 problem during 2020 – 2021. Result: Two cases started in March 2020 and total were up to 111 of 800’s workers until Nov 2021. 56% were asymptomatic, 39% were 50 yo or above. 74% did not have co morbid. 46% were domestic cluster. Cases trend were like local and national cases statistic trend. Conclusion: COVID-19 had also impact to corporate office workers which potentially lead to business disruption. The company set dedicated health system to prevent and control COVID-19 system. Principally, it must be set higher than local government standard other than 3M as follows: WFH policy, lowered body temperature identification to min 370C for COVID-19 testing, applied mobile application for health monitoring and tracing, biweekly COVID-19 screening test prior to work at office and included COVID-19 prevention behavior into individual key performance indicator.
Eva Suarthana, Mikhael Yosia
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 125-8; https://doi.org/10.53773/ijcom.v1i3.39.125-8

Abstract:
Predictive models have long been used to assist clinical decision-making in medicine. Predictive models are made to estimate how likely a person is to have a disease (diagnostic model) or will experience a disease (prognostic model). In the field of occupational health, for example, diagnostic models can be used to increase the efficiency of surveillance programs by identifying groups of workers with occupational diseases without using complex and expensive diagnostic tests.Work-related asthma (WRA) is the most common occupational lung disease in industrialized countries and the second most common in developing countries. Around the world, especially in developing countries, diagnosing WRA is still difficult due to the limitations of available diagnostic tests. Specific inhalation challenge (SIC), the best test for diagnosing occupational asthma, is only available in several research centres worldwide.Several questionnaire-based models have been developed to diagnose work-related asthma at both the primary (general practitioner) and secondary (specialist) levels of care. A recent model for diagnosing occupational asthma was developed using data from Canada and has been validated using data from several European countries. A collaboration has been initiated to assess the application of this model among Indonesian workers.
Caroline Thomas, Catherine Thomas, Claudius Novchovick Mone Iye
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 137-45; https://doi.org/10.53773/ijcom.v1i3.27.137-45

Abstract:
Background: HIV cases are still increasing in Indonesia. With the spread of COVID-19, HIV key populations are experiencing undesirable outcomes in social, financial, access to health and food resources. The study aimed to assess the impact of COVID-19 among key populations & PLHIV in Indonesia. Method: Yayasan Peduli Hati Bangsa conducted a participatory research in October to December 2020 to capture and assess the impact of Covid-19, combining and adapting the formats of a ‘Citizen’s report card’, a ‘Community assessment’, and a qualitative survey. Results: Out of 15 participants who were PLHIV and key populations, mostly perceived that COVID-19 had impacted them financially, especially for those who work in informal sectors. Food assistance from the Government was provided at least once a month and the nutritional value was perceived as substandard. Having said that, participants did not consider the nutrition as crucial, as long as they had something to eat. Most of the participants observed that mental health issues were related to their physical health and financial adequacy. Additionally, sources of anxiety arose from the uncertainty in financial income. Lastly, the government was perceived as overly prioritizing COVID-19 while neglecting other health services. Conclusion: Participants in this study wished that government would improve the healthcare and assistance programs for the vulnerable ones affected by COVID-19. Equal and well-targeted distribution of assistance, as well as provision of access to jobs, were the ones that need to be majorly improved by the government.
Spadini Putri, Muhammad Ilyas
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 107-13; https://doi.org/10.53773/ijcom.v1i2.10.107-13

Abstract:
Background: One of the health problems that can be caused by Perfluorooctanoic acid (PFOA) is Diabetes mellitus (DM). However, the causal relationship between Perfluorooctanoic acid and DM is still unclear, so it is necessary to look for some evidence regarding this relationship. The search for evidence is also equipped with a seven-step assessment of occupational diseases therefore it can assist occupational health doctors who find patients with DM and have a history of exposure to glutaraldehyde. Methods: Literature search using Pubmed, Cochrane and JSTOR databases. The keywords used are “PFOA” OR “perfluoroalkyl substances” OR “perfluorooctanoic acid” AND “diabetes mellitus”. Article selection was performed using the defined inclusion and exclusion criteria. Selected articles will be critically reviewed based on etiological studies from the Oxford Center of Evidence-Based Medicine. Result: It was in 5 selected articles that met the inclusion and exclusion criteria. The main finding after a critical review was that PFOA may increase the risk of DM. Conclusion: There is a relationship between PFOA and the incidence of DM in health workers. To establish the diagnosis of occupational diseases in health workers who are exposed to PFOA, seven steps of diagnosis of occupational diseases are used.
Ade Mutiara, Dewi S Soemarko, Indah S Widyahening
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 72-7; https://doi.org/10.53773/ijcom.v1i2.14.72-7

Abstract:
Background: Graves’ disease is an autoimmune thyroid gland disease that causes increased activity of the thyroid hormones. But, the mechanism by which the autoantibodies are generated is still unclear. Some theory suggests that daily life stress may be a risk factor that triggers Graves’ disease. The aim of this report is to enrol a systematically searching in order to get an answer about the risk factor of the Grave’s disease and the prevention measure.Methods: In this case report, a 47-year-old career woman with prominent occupational stress was diagnosed with Graves’ disease. Literature searching was done on database such as Pubmed, Cochrane Library, and Science Direct with occupational stress, stressful life event, and Graves’ disease as the keywords. One article was selected and critically appraised. Results: One case-control study showed that patients with Graves’ disease had odds ratio (OR) of having stressful life events as big as 8.59; 95%CI = 2.35-20.80, and the number needed to harm (NNH) is 2.35.Conclusion: Occupational stress is a prominent risk factor for developing Graves’ disease. However, this is based on one article
Firly Ratsmita, Dewi S. Soemarko
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 84-8; https://doi.org/10.53773/ijcom.v1i2.22.84-8

Abstract:
Background: One of the risk factors for Chronic Lymphocytic Leukemia (CLL) is chemical exposure at work. The aim is to determine the relationship between patient who work as a farmer and vegetable seller with the incidence of CLL.Case presentation: A-69-year-old man who has been working as a vegetable seller since 15 years and a chili farmer since 4 years ago. The patient was diagnosed with CLL. In his work as a vegetable seller and chili farmer, the patient gets five hazards ranging from physical, chemical, biological, ergonomic and psychosocial hazards so it is necessary to analyze whether there is a relationship between the patient’s work and the current CLL disease.Discussion: There are seven steps needed in the enforcement of occupational diseases. In addition, additional examinations are needed to determine the biomarkers of pesticides that can cause disease. This requires control for farmers and vegetable sellers who may be exposed to pesticides found in vegetables and chilies. Conclusion: Vegetable seller and farmer have potential hazards, especially chemicals contained in pesticides which have a risk relationship with the incidence of CLL. However, to cause CLL, sufficient doses are required which are influenced by occupation, intensity of use and the type of specific chemical without the need for a long duration of exposure.
Ari Fahrial Syam
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 41-3; https://doi.org/10.53773/ijcom.v1i2.25.41-3

Abstract:
Burnout in health workers causes physical and emotional fatigue; it is a condition of a long-term affective state and is an outcome of cumulative and chronic exposure to stress, particularly work stress. Burnout was especially evident in hospitals with limited availability of medical staff. Mental burdens are higher because they face more patients infected by the coronavirus, followed by the trauma of witnessing deaths among patients. These conditions may weaken the immune system, increasing vulnerability to COVID-19 and higher risk of severe symptoms that can cause death. When talking out of context of the pandemic, burnout can also be associated with various other diseases, including IBS.4 Burnout was associated with a 2.41-fold elevated prevalence of IBS after adjusting for potential confounding variables, including job strain.
Vera, Muhammad Ilyas
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 114-9; https://doi.org/10.53773/ijcom.v1i2.12.114-9

Abstract:
Background: Perfluorooctanoic Acid (PFOA) is one of the Perfluoroalkyl acids family that can affect human health. It can act as an endocrine disruptors which interfered the hypothalamus–pituitary–thyroid (HPT) axis and targeted the biosynthesis and secretion of thyroid hormones, which can caused thyroid diseases. To determine the causal relationship between PFOA and thyroid diseases, it is necessary to look for some evidence regarding this relationship. The search for evidence is also complemented by a seven-step occupational disease assessment to establish occupational diseases.Methods: The literature searching using the electronic database “PubMed”, “Cochrane”, and “Scopus” search engine. The keyword is “PFOA” “perfluoroalkyl substances” “perfluorooctanoic acid” “perfluorooctanoate” AND “thyroid disease” “thyroid function” “thyroid parameters” combined with MeSH and Title/Abstract terms. The inclusion criteria are research on humans, English language, free full article and the exclusion is duplicate articles.Result: From the five literature obtained, there are differences in results. Four articles stated that there are association between PFOA and thyroid diseases but one articles stated PFOA concentrations measured in this study were not associated with thyroid hormones.Conclusion: Althought most articles stated there are associations between PFOA and thyroid disease but it does not mean that PFOA can caused thyroid disease so it is still not clear the causal relationship between PFOA and thyroid disease especially in occupational setting.
Mikhael Yosia, Ray Wagiu Basrowi
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 89-93; https://doi.org/10.53773/ijcom.v1i2.15.89-93

Abstract:
Nearing the end of the second year of the COVID-19 pandemic, businesses and companies had decided to continue their operations and strive forwards, posing superfluous challenges to occupational health (OH) professionals in keeping workers safe against the continuous threat of infections. The novelty of COVID-19 results in a myriad of medical questions, all of which needs to be answered promptly and reliably through medical research followed by dissemination of answer through publications. Making the knowledge accessible through publications ensures that OH professionals and other relevant parties can collectively develop new policies, determine preventive action, the standard of procedures and care, and administer medical procedures – all of which eases the fight against pandemics in the workplace. Despite its complications and challenges, the author hoped that OH professionals realized the importance of research and publishing in the fight against this pandemic.
Muchtar, Ray Wagiu Basrowi
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 120-4; https://doi.org/10.53773/ijcom.v1i2.23.120-4

Abstract:
Introduction: During the COVID-19 pandemic, healthcare workers have physical and psychosocial pressure in carrying out their work. The requirement for healthcare workers in dealing with the pandemic is so high, the identification process for the resilience of healthcare workers is not going well. The purpose of this article is to review about how to optimize the resilience of healthcare workers exposed to COVID-19 outbreak working conditions. Methods: This literature review is conducted in October 2021. Research related to the resilience of healthcare workers during COVID-19 Pandemic by using valid keywords, including resilience, healthcare workers, COVID-19 through ProQuest, ScienceDirect and SpingerLink. Results: A total of 10 articles were selected for the literature review. The process of self-reflection is one of the important things for healthcare workers. Optimizing relisience of healthcare workers by carrying out an efficient division of tasks to reduce workloads, give more attention to their needs, provide training and knowledge about digital applications to increase capacity in carrying out their work, provide mental health support for healthcare workers and creating a safe and comfortable work environment for them. Conclusions: Maintaining health during the COVID-19 pandemic is an important thing that needs to be done by healthcare workers. Stress management is an important factor in dealing with a pandemic. Create an assessment of the resilience of healthcare workers by detecting gaps, determining priorities, developing plans to prevent psychosocial hazards at all levels both individual and organizational levels.
Iwan Susilo Joko, Dewi S Soemarko, Nuri Purwito Adi
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 63-71; https://doi.org/10.53773/ijcom.v1i2.7.63-71

Abstract:
Background: One of the risk factors for Chronic Lymphocytic Leukemia (CLL) is chemical exposure at work. The aim is to determine the relationship between patient who work as a farmer and vegetable seller with the incidence of CLL.Case presentation: A-69-year-old man who has been working as a vegetable seller since 15 years and a chili farmer since 4 years ago. The patient was diagnosed with CLL. In his work as a vegetable seller and chili farmer, the patient gets five hazards ranging from physical, chemical, biological, ergonomic and psychosocial hazards so it is necessary to analyze whether there is a relationship between the patient’s work and the current CLL disease.Discussion: There are seven steps needed in the enforcement of occupational diseases. In addition, additional examinations are needed to determine the biomarkers of pesticides that can cause disease. This requires control for farmers and vegetable sellers who may be exposed to pesticides found in vegetables and chilies. Conclusion: Vegetable seller and farmer have potential hazards, especially chemicals contained in pesticides which have a risk relationship with the incidence of CLL. However, to cause CLL, sufficient doses are required which are influenced by occupation, intensity of use and the type of specific chemical without the need for a long duration of exposure.
Rita I Wijaya, Muhammad Ilyas
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 94-100; https://doi.org/10.53773/ijcom.v1i2.8.94-100

Abstract:
Background: One of the health problems that can be caused by glutaralaldehyde is allergic contact dermatitis (ACD). However, the causal relationship between glutaraldehyde and DKA is still unclear, so it is necessary to look for some evidence regarding this relationship. The search for evidence is also equipped with a seven-step assessment of occupational diseases therefore it can assist occupational medicine doctors who find patients with ACD and have a history of exposure to glutaraldehyde. Methods: Literature search using Pubmed, Scopus and JSTOR databases. The keywords used are ‘healthcare worker OR healthcare personnel’, ‘glutaraldehyde’ and ‘allergic contact dermatitis. Article selection was performed using the defined inclusion and exclusion criteria. Selected articles will be critically reviewed based on etiological studies from the Oxford Center of Evidence-Based Medicine. Result: It was in six selected articles that met the inclusion and exclusion criteria. The main finding after a critical review was that glutaraldehyde may increase the risk of ACD. Conclusion: There is a relationship between 1% glutaraldehyde exposure and the incidence of ACD in health workers. To establish the diagnosis of occupational diseases in health workers who are exposed to glutaraldehyde, seven steps of diagnosis of occupational diseases are used.
Tine Alliet, Thomas Gestels, Siel Daelemans, Levi Hoste
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 44-55; https://doi.org/10.53773/ijcom.v1i2.21.44-55

Abstract:
Background and objectives: The COVID-19 pandemic has put strain on the activities and well-being of health care workers. We aimed to measure the direct and indirect impact on a personal and professional level for paediatric trainees in Flanders, Belgium.Study design: Junior representatives of the Flemish Society for Paediatrics (Jong VVK) conducted a longitudinal study among their fellow paediatric trainees. The impact of COVID-19 on daily tasks, education and emotional well-being for the first (March-April 2020) and second wave (October-November 2020) of the pandemic were studied.Results: One hundred and nineteen surveys were completed in the first wave, representing data of 51% (119/233) of the total number of paediatric trainees in Flanders. Eighty surveys were completed in the second wave. Educational program changes occurred in 25% (30/119) of trainees and more than half (61%; 72/119) described the pandemic as an impediment for their educational progress. The perception of impaired education persisted for 30% of the responders (24/80) during the second wave. One out of three (30%; 35/119) felt their job was more exhausting than usual and 38% (45/119) perceived more stress at work. These numbers were comparable at both time points. Increases in stress paralleled with increased irritability in daily life and poorer sleep quality. Conclusions: COVID-19 had an important impact on the daily tasks, education and emotional well-being of the paediatric trainees. Medical training centres should be aware that there is a perception of impediment on the educational program of the paediatric trainee.
Arriz Akbar Sukadi, Dewi Sumaryani Soemarko, Faisal Yunus
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 56-62; https://doi.org/10.53773/ijcom.v1i2.6.56-62

Abstract:
Objective: To determine the prevalence of asthma and its corelation with ammonia exposure among informal workers of poultry farmers.Method: This study design was a cross-sectional analytic to 69 respondents using questionnaires, field observation, physical examination, spirometry measurement, and peak flowmeter test to diagnose work-related asthma and measurement of ammonia level in air environment of farm. All variable were bivariate tested by using Chi-square test or Fischer test. The variables which have p value <0,25 were included into multivariate analysis by using binary logistic regression.Results: The prevalence of asthma in poultry farmers was 21,74%. In bivariate analysis, there was a significant corelation between working periode (p = 0,035 with OR = 7,00) and smoking habit (p = 0,018 with OR = 5,603) with asthma. There was no significant corelation between age, sex, nutritional status, work location, education level and marital status with asthma. The result of measurement of ammonia level in the poultry farm enclosure on average is 2,329 ppm. Multivariate analysis was performed on several risk factors that fulfilled the requirement p <0,25 ie working periode, smoking habit, nutritional status, and work location. From the results of mutivariate found that workers with a history of smoking habits have the strongest corelation p = 0,013 with OR 17,305.Conclusion: The prevalence of asthma in poultry farmers was 21,74%. There was no significant corelation between ammonia exposure in the work environment with asthma. But there was a significant corelation between working periode and smoking habit with asthma.
Muhammad Ilyas, Andreas Kresna
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 101-6; https://doi.org/10.53773/ijcom.v1i2.9.101-6

Abstract:
Background: Perfluorooctanoic acid (PFOA), a class of perfluorocarbons, are synthetic environmental contaminants. Their long biological half-lives and their poor ability to metabolize likely add to any chronic health effects they may pose, such as chronic kidney disease (CKD). The causal relationship between PFOA and CKD is still unclear, so it is necessary to look for some evidence regarding this relationship. The search for evidence is also complemented by a seven-step occupational disease assessment to establish occupational diseases. Aim: This study aims to justify chronic kidney disease of workers exposed to perfluorooctanoic acid can be diagnosed as occupational diseases. Methods: Searching literature for the evidence-based has been conducted with a clinical question through “PICO” method. Then continued with literature searching using the electronic database “PubMed”, “JSTOR”, and “Scopus” search engine. The keyword is “PFOA” “perfluoroalkyl substances” “perfluorooctanoic acid” “chronic kidney” “chronic kidney disease” “CKD” and combined with MeSH terms and Boolean operation. The inclusion criteria are research on humans, English language, and the exclusion is retracted articles. Result: From the five literatures obtained, there are differences in results. A study of workers exposed to perfluorooctanoic acid in a DuPont chemical plant with chronic kidney disease was (Standardized Mortality Ratios (SMR) = 3.11, 95% CI: 1.66, 5.32). Study in China found that perfluorooctanoic acid is not associated with renal function and higher risk of CKD (OR = 0.73, 95% CI: 0.57, 0.95; p=0.019). Conclusion: There are insignificant associations between perfluorooctanoic acid and chronic kidney disease.
Dewi Sumaryani Soemarko, Aditya Agung Prasetyo
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 78-83; https://doi.org/10.53773/ijcom.v1i2.11.78-83

Abstract:
Background: Liver cirrhosis is the final pathological result of various chronic liver diseases that characterized by the formation of regenerative nodules and fibrotic tissue. The etiology of liver cirrhosis are hepatitis C, hepatitis B, alcohol, nonalcoholic fatty liver disease, and can also be caused by chemicals in the workplace. The occupational diagnosis of Liver Cirrhosis that exposed by vinyl chloride superimposed with hepatitis B infection with was performed by using The Seven Steps of Occupational Diagnosis, a method that issued by PERDOKI (Indonesian Occupational Medicine Association-IOMA). The aim of this case report is to determine whether liver cirrhosis in this patient is an occupational disease or not.Case Presentation: Fifty years old man came to Emergency Room with complaints of vomiting black blood since 4 hours. Vomiting blood as much as 5 times with a volume of about 200 cc each time. One day before, patient admitted that his defecation is black, watery, and smell bloody. Volume of defecation was unknown. Three months before, patient complainted that the stomach often felt bloated, enlarged, and got full quickly. There was no icteric in eyes and body.This complaints (vomiting black blood and black stools) were often occured since 2017. In 2017, 2018 and 2020, this patient was hospitalized once while in 2019, the patient was hospitalized twice for this complaint. In 2017, when the complaint first appeared, the patient was declared to have hepatitis B and in 2019, the patient underwent an endoscopy and was said to have enlarged blood vessels in the esophagus, and an abdominal ultrasound was performed and was said to be suspected of liver cirrhosis.This patient works as a family owned chemical industry. The chemical produced is called zamitex, a mixture for paints. These chemicals contain formaldehyde, Vinyl Chloride, and CMC (Carboxymethyl Cellulose). This patient had worked in this field for 21 years, and was exposed to these chemicals. In addition, there are also dangers of heat, awkward positions, and psychosocial.Conclusion: Based on The Seven Steps of Occupational Diagnosis, Liver cirrhosis in this patient can be categorized as an occupational disease superimposed with hepatitis B infection. Liver cirrhosis in this patient can be caused by prolonged exposure to Vinyl Chloride. Vinyl Chloride is known to cause damage to the liver, especially to cause carcinoma of the liver. There is a synergistic effect between exposure to Vinyl Chloride and hepatitis B infection, exacerbating the condition of liver damage. However, because the exposure to Vinyl Chloride has been going on for a longer time, compared to hepatitis B infection, the condition of liver cirrhosis in this patient is still categorized as an occupational disease.
Arnold Fernando, Muhammad Ilyas, Indah Suci Widyahening
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 15-22; https://doi.org/10.53773/ijcom.v1i1.3.15-22

Abstract:
Background. Breast cancer is the most common cancer among women worldwide. 80% of breast cancer that has been identified in Indonesia has progressed into an advanced stage of malignancy. In 2007, the International Agency for Research on Cancer concluded: shift-work that involves circadian disruption is probably carcinogenic to humans (Group 2A) Aim. This study aims to justify the association between night shift work and breast cancer. Methods. Searching literature for the evidence-based has been conducted with a clinical question through "PICO" method. Then continued with literature searching using the electronic database "PubMed" and "google scholar" search engine. The keyword is "shift work" "night shift" "breast cancer" and combined with MeSH terms and Boolean operation. The inclusion criteria are research on humans, and the exclusion is inaccessible studies, case report studies, and retracted articles. Result. All of the ten prospective studies that have been combined, the weighted average RR was 0.99 (95% CI = 0.95 to 1.03) for any night shift work compared with none. There was no statistically significant heterogeneity across studies (P = .052). ). But if based on a study of more than 20 years, the RR was 1.01 (95% CI = 0.93 to 1.10). And if based on a study of more than 30 years, the combined RR was 1.00 (95% CI = 0.87 to 1.14, P heterogeneity = 0.067. Confidence intervals for the incidence rate ratios on this study are narrow, even for 20 or more years of night shift work (RR = 1.01, 95% CI = 0.93 to 1.10), so these findings exclude a moderate association of breast cancer incidence with long duration night shift work Conclusion. There are insignificant associations between night shift work and breast cancer.
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 3-14; https://doi.org/10.53773/ijcom.v1i1.1.3-14

Abstract:
Introduction: According to medical check up results of the hand-rolled cigarette factory PT. X in 2018, a hemorrhoid prevalence of 33% was found. Several studies have tried to show an association between individual factors such as age, family history, constipation, obesity, pregnancy, fiber consumption, and defecation position in research subjects in clinics and hospitals. Nevertheless, the effects of sitting work position and sitting time on the risk of hemorrhoid is yet to be revealed. This study aims to prove the effect of these factors on the increased risk of hemorrhoids. Methods: An observational study with a 1:1 unmatched case control design with 300 female workers as subjects. The risk factors related with hemorrhoids were obtained from primary and secondary data. Cases were workers diagnosed with hemorrhoids and controls were workers who were not diagnosed with hemorrhoids during a medical check-up 2018. Data analysis was performed using univariate and bivariate analysis. Results: The mean ages of the subjects were 42.49±3.05 years old (cases) and 42.83±3.02 years old (controls), with most education level was a junior high school in both groups. Bivariate analysis pointed out that sitting work position and sitting time did not have a significant relationship with the incidence of hemorrhoids. Meanwhile, consumption of less fruit (OR=3.84;95%CI 1.87-7.91) and less vegetable (OR=2.41;95%CI 1.36-4.28) increased the risk of hemorrhoid compared to sufficient vegetables and fruit consumption. Conclusion: Sitting work position and sitting time were not associated with an increased risk of hemorrhoids. Meanwhile, consumption of less vegetable and fruit increased the risk of hemorrhoids.
Irwan Suhadi, Indah Widyahening, Muhammad Ilyas
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 23-31; https://doi.org/10.53773/ijcom.v1i1.4.23-31

Abstract:
Prostate cancer has been associated with jobs that involve some degree of work at night. In 2007, the International Agency for Research on Cancer (IARC) concluded that shift work involving circadian disruption was probably carcinogenic in humans. Exposure to artificial LAN (Light at Night) suppresses pineal melatonin secretion and subsequently leads to an increase of sex hormones, which in turn could increase the susceptibility to hormone-dependent cancers. Disruption of the circadian rhythm regulated by several clock genes controlling apoptosis and cell proliferation, repeated phase shifting leading to internal desynchronisation and defects in the regulation of the circadian cell cycle, and also sleep deprivation alters immune function. In this case, the authors assessed the relationship between workers in a manufacture company who had worked shift work for 30 years and an increased risk of prostate cancer. This case takes evidence base from several journals that support this hypothesis while doing a critical appraisal to determine its validity and applicability.
Denta Aditya Episana, Aria Kekalih, Liem Jen Fuk
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 32-40; https://doi.org/10.53773/ijcom.v1i1.5.32-40

Abstract:
Background: Shoe manufacturing factory workers in developing countries are daily exposed to complex mixtures of organic solvents. Chemical exposure occurs through inhalation / respiration and skin which can affect many physiological systems. The main chemical exposure to organic solvents in shoe manufacturing comes from the process of gluing and cleaning process by using organic solvents on footwear in the assembling section. Methyl ethyl ketone is one type of organic solvent which, when entering into the body through inhalation routes can cause irritation of the nose, throat, lungs and chest becomes congested. Acute neurotoxicity is a collection of symptoms in the central nervous system (central nervous system depression, psychomotor disorders, narcosis, drowsiness, headache, dizziness, dyspepsia, and nausea). Method: The research design was a prospective cohort research consisting of 45 people for each high MEK exposed group and low exposed to MEK. Data collection was done by interview, physical examination, MEK level measurement of pre-shift urine and end-shift work, and filling out questionnaires Form Acute symptoms rating questionnaire at the beginning of work shift (07.00), 2 hours after work (09.00), break (12.00), 2 hours after break (15.00), and end of work shift (16.00). Result: The incidence of acute neurotoxicity symptoms in the MEK-high exposed group based on the Acute Symptoms questionnaire was 51.1%. Age factor with symptoms of acute neurotoxicity in workers at PT. X with p value = 0.432, gender factor with p value = 0.162, education factor with p value = 0.897, nutritional status factor with p value = 0.865, alcohol habit factor with p value = 0.181, coffee drinking habit factor with p value = 0.265, and smoking habit factor with p value = 0.968, work duration factor with symptoms of acute neurotoxicity at worker in PT. X with p value = 0.533, and the use factor of personal protective equipment (PPE) with p value = 0.470. In this research, symptoms of acute neurotoxicity were dominant are fatigue (80%), headache (77.8%), nausea (71.1%), dizziness (66.7%), and feeling of intoxication (53.3%). Conclusion: There are no subject and occupational factors that have a significant effect to the symptoms of acute neurotoxicity. Conducting isolation of other work areas for workers exposed to chemicals that because of high potential to harm other workers in the vicinity. Reassessing the hazard risk of using MEK substitutes with other chemicals that are of lower risk or replace with water-based solvents. Provide PPE eligible to all workers exposed to chemicals and workers around them. A PPE fit test is used for workers to feel comfortable while wearing it, giving strict sanctions to workers who do not consistently use personal protective equipment.
The Indonesian Journal of Community and Occupational Medicine, Volume 1, pp 1-2; https://doi.org/10.53773/ijcom.v1i1.2.1-2

Abstract:
Research in community and occupational medicine field has grown rapidly in the last decade. In European countries such as Netherland, the contribution of authors in occupational health journal has even doubles in the past five years.1 Knowledge of community and occupational health medicine; which includes community, and occupational health and medicine, epidemiology, community nutrition, and health economics, is constantly growing, hence increase the need of journal submissions and reference searches. In this digital era, the role of web has greatly reduced the barriers for publishing and communicating scientific and research works outcome.2 Journals online in open access (OA) platform is one of many strategic methods with high impact and relevancy. With peer-reviewed method prior of publication, this model of publishing can be freely accessed.3 In Indonesia, there are still only few of open accessed journal publications in the field of community and occupational medicine. We understand the urge and importance of providing publication platform in this field, therefore The Association of Alumni of Occupational Medicine Magister Faculty of Medicine Universitas Indonesia (ILUNI MKK FKUI) launches The Indonesian Journal of Community and Occupational Medicine (IJCOM) as an open access journal for the expansion of community and occupational medicine-related knowledge and acts as a media for authors to publish their researches. IJCOM is the peer-reviewed, world scale scientific journal of community, occupational clinical, and epidemiology, community nutrition, and health economics. As the official journal of ILUNI MKK FKUI we committed to facilitate authors, academicians, students and health care professionals to share their science work in community and occupational medicine, as well as other related field includes epidemiology, community nutrition, family medicine, health economics and other public health research works. This Journal also act as the platform to provide learnings and recommendations in community and occupational medicine and related data for the development of good health practice for Indonesian community and the world. We do realize that this first issue is a baby step for a greater future. We will definitely put our utmost effort and energy to develop and grow this journal to meet all the requirements of national accredited journal and ultimately a reputable international journal standard.
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