The Indonesian Journal of Community and Occupational Medicine

Journal Information
EISSN : 2798-723X
Total articles ≅ 37

Latest articles in this journal

Dwitya Solihati, Muhammad Ilyas
The Indonesian Journal of Community and Occupational Medicine, Volume 2, pp 17-25;

Background: Ammonia is colorless gaseous compound, lucid and irritating material that is water soluble with a distinctly pungent odor. About 80% of the total usage of ammonia is mainly used to produce synthetic fertilizers. One of the health problems caused by ammonia is bronchial asthma. Ammonia can act as sensitizer or irritant asthmagen depend on their properties, which increased complex interaction of inflammation, airway hyperresponsiveness, and airflow obstruction. However, the causal relationship between ammonia and bronchial asthma is still unclear, so it is necessary to look for some evidence regarding this relationship. The search for evidence also included the seven-step assessment of occupational diagnosis of diseases. Therefore, it can assist occupational medicine doctors who treat patients with bronchial asthma and with a history of ammonia exposure. Methods: The literature searching using the electronic database “PubMed”, “Scopus”, and “Cochrane” search engine. Keywords used were worker, ammonia, and bronchial asthma, ventilatory disorder, respiratory disorder. The articles were selected using the defined inclusion and exclusion criteria. The selected articles were then be critically reviewed based on etiological studies from the Oxford Center of Evidence-Based Medicine. Result: From the five literature obtained, there are differences in results. One article stated that ammonia can increase prevalence risk of bronchial asthma, and other four articles found significant associations between ammonia and reduction in the parameters of pulmonary function. Conclusion: There is a relationship between ammonia exposure and the prevalence of bronchial asthma and reduction of pulmonary function in synthetic fertilizer factory worker. But it is uncertain whether the diagnosis is occupational asthma.
Agus Sugiharto, Damar P. Susilaradeya, Reza Haryo Yudanto, Rasyad Khalifah, Anastasia Asmoro, Dian Aris Priyanti, Julietta Tantri
The Indonesian Journal of Community and Occupational Medicine, Volume 2, pp 3-10;

Background: The spread of COVID-19 in Indonesia was happening rapidly. The DKI Jakarta Province was the province with the highest prevalence of COVID-19. Thus, all areas in DKI Jakarta Province require special attention in the spread of COVID-19, one of which is Koja District, North Jakarta. This study was conducted to find out community diagnoses related to knowledge, attitudes, and practices regarding COVID-19 prevention. Methods: This study uses community diagnostic steps and quantitative analysis with a cross-sectional approach. The study was conducted from May 26 until June 5, 2020. The population was 115 people who seek treatment at the Koja Health Center, North Jakarta. Socio-demographic characteristics, as well as knowledge, attitudes, and practices related to COVID-19 prevention, were collected through a self-reported questionnaire. Data analysis were used by IBM SPSS version 26.0. Results: Among 115 respondents, 58.3% had good knowledge, 64.3% had a positive attitude, and 55% had positive practices related to COVID-19 prevention. The median values of knowledge, attitudes, and practices are 8, 24, and 25. The median value of knowledge is higher than the mean value, and others are almost the same as the mean value. The percentage of correct knowledge is above 90%, except for knowledge about people infected with COVID-19 who are asymptomatic (64.3%) and children who cannot be seriously ill/die if exposed to COVID-19 (33.9%). More than half of the participants had positive attitudes and practices towards the preventive measures in question, except attitudes about family members at home having to keep their distance and wearing masks inside the house (48.7%) and practices about continuing to travel outside the house (36.5%). Conclusion: Community diagnosis in Koja District, North Jakarta, more than half of the community has a sufficient level of knowledge, positive attitudes, and practices towards COVID-19 prevention. These findings still require further intervention, so that people’s knowledge, attitudes, and practices regarding COVID-19 prevention are better, especially regarding children infected with COVID-19, the importance of keeping a distance and using masks at home, and traveling outside the home. So that the provision of education and counseling to the community is essential.
Joseph Haddad
The Indonesian Journal of Community and Occupational Medicine, Volume 2, pp 1-2;

Though have seems to reach the beginning of the end of the COVID-19 pandemic, there are still looming problems on the horizon. There are necessary adjustments needed with an end goal of supporting the ongoing COVID-19 response while at the same time strengthening our resilience and capacity to respond to public health emergencies in the future. The safety of health care workers (HCW) is an utmost priority and needs to be sustained; WHO has continuously called on governments and health care leaders to address the persistent threats to the health and safety of health workers and patients since the beginning of the pandemic. “The COVID-19 pandemic has reminded all of us of the vital role health workers play to relieve suffering and save lives,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “No country, hospital or clinic can keep its patients safe unless it keeps its health workers safe and ensuring that health workers have the safe working conditions, the training, the pay and the respect they deserve."1 The pandemic has also highlighted the extent to which protecting health workers is key to ensuring a functioning health system and society. There are five critical mandatory actions to better protect health workers. These include protecting health workers from violence, improving their mental health, protecting them from physical and biological hazards, advancing national health worker safety programmes, and connecting health worker safety policies to existing patient safety policies. COVID-19 has exposed health workers and their families to unprecedented levels of risk. Although not representative, data from many countries across WHO regions indicate that COVID-19 infections among health workers are far greater than those in the general population. While health workers represent less than 3% of the population in most countries and less than 2% in nearly all low- and middle-income countries, around 14% of COVID-19 cases reported to WHO are among health workers. In some countries, the proportion can be as high as 35%. However, data availability and quality are limited, and it is impossible to establish whether health workers were infected in the workplace or their community.2 Regardless, thousands of health workers infected with COVID-19 have lost their lives worldwide. In addition to physical risks, the pandemic has placed extraordinary levels of psychological stress on health workers, who are exposed to highly demanding settings for long hours, constantly fearing disease exposure while separated from family and facing social stigmatization. Before COVID-19 hit, medical professionals were already at higher risk of suicide in all parts of the world. A recent review of health care professionals found that one in four reported depression and anxiety, and one in three suffered insomnia during COVID-19. WHO recently highlighted an alarming rise in reports of verbal harassment, discrimination and physical violence among health workers in the wake of COVID-19.3 At the same time, it should be noted that the role and responsibilities of HCW are still the same before, during, and after the pandemic. Responsibilities of Health Care Workers involve a range of efforts relating to the diagnosis, response, and treatment of COVID-19 and supporting solutions to bring an end to this crisis, especially in maintaining the ongoing vaccination campaign.4,5 As the frontline in this fight against the pandemic, it is wise to involve HCW and their opinions in developing new treatments, vaccines and accurate diagnostic tests, streamlining processes where needed and appropriate, without compromising the scientific validity and reliability of proper research conduct. The involvement of HCW in the aforementioned process would ensure that treatments for patients would be realistic and practical in an actual clinical setting. It would be helpful to involve HCW in assuring adequate supplies of essential medical equipment such as ventilators. HCW has a vital role in this area because of the ability to identify and track patients who take illegitimate or black-market drugs. With widespread fear, anxiety, and panic surrounding the pandemic, there are countless snake oil salesman and quacksalver promising quick remedies to COVID-19 (and, without a doubt, any other subsequent pandemic in the future), which might pose more danger rather than benefits to the patients. HCW has the power to inform patients about dangerous products and unscrupulous marketers who may be selling products with false or misleading claims. There should be no rest to avoid further misfortune in this pandemic. Challenges are still ahead, but we must move forward and proceed to a new normal.
Betharia Sonata Butarbutar, Nuri Purwito Adi, Levina Chandra Khoe, Marsen Isbayu Putra, Aria Kekalih
The Indonesian Journal of Community and Occupational Medicine, Volume 2, pp 11-6;

Background: Despite the COVID-19 pandemic, the workers in food manufacturing continue to work. The Government of Indonesia issued a regulation of 10-day isolation for those asymptomatic patients. This regulation implies long sick leave for workers with asymptomatic COVID-19 infection, leading to possible disruption in fulfilling target production. This study aims to understand the factors associated with the length of sick leave due to COVID-19 among food manufacturing workers. Methods: The design of this study was cross-sectional, used 205 workers’ data of confirmed COVID-19 infection, and returned to work from March 2020 – to August 2021. The data were obtained by the company medical team from medical resumes at the companies’ clinics and then sent to Ikatan Dokter Kesehatan Kerja Indonesia (IDKI) Banten. The data was screened as inclusion and exclusion criteria and then analyzed by descriptive test. unpaired T-test and linear regression. Results: The mean length of sick leave of 205 data was 19.3 (± 4,8) days. Treatment facilities, work shifts, and smoking were associated with the length of sick leave (p<0.05). Home Self-isolating, shift, and non-smoking workers had longer sick leave than workers treated at COVID center, non-shift, and smoking workers Conclusion: The mean length of sick leave among food workers in Cilegon is 19.3 (±4,8) days. There is a significant relationship between the length of sick leave with treatment facilities, shift work, and smoking. Treatment facilities were the most dominant factor.
Yohanes Edwin Jonatan, Andreas Kresna
The Indonesian Journal of Community and Occupational Medicine, Volume 2, pp 26-31;

Background: Acrylamide (ACR) are used in many chemical and industrial process. They exposure to human pose some health risk, while some effects are proven, the causal relationship between ACR and neurotoxicity is still unclear, so we would like to look for some evidence regarding this issue. The search for evidence is also complemented with a seven-step occupational disease assessment in order to establish occupational disease diagnosis. Methods: Searching literature for the evidence-based has been conducted with a clinical question through “PICO” method. Then we continued the searching using electronic databases: “PubMed”, “Google Scholar”, and “Cochrane Library” search engine. The keyword is Acrylamide” “2-Propenamide; Ethylenecarboxamide” “Neurotoxic” combined with Boolean operation. The inclusion criteria are research in human, publication last ten years, and English full text article, while our exclusion criteria are duplicate or not relevant study. Results: From the three literatures obtained, we could obtain the description of neurotoxicity symptoms induced by acrylamide, the diagnosis and treatment, and also the mechanism how acrylamide could induce neurotoxicity in human. Conclusion: Acrylamide exposure in workers can cause neurotoxicity depend on the duration and concentration of exposure.
Freade Akbar, Ray Wagiu Basrowi
The Indonesian Journal of Community and Occupational Medicine, Volume 2, pp 40-7;

Introduction: Informed consent is a concrete form of moral and ethical values that urgently needs to be emphasized, especially in research that requires the role of humans as subjects and is commonly associated with experimental research. Informed consent itself consists of two forms of print and digital, along with the times many parties began to examine how the role of informed consent, the advantages and disadvantages between print and digital, the application of good digital informed consent, and how information about research should be conveyed to the research subject so that it is easy to understand and in accordance with moral and ethical standards. The purpose of this article is to address issues related to digital informed consent in clinical research. Methods: We conducted a search on the SpingerLink database in March 2022 to see various publications in the last 2 years related to electronic informed consent using keywords: digital, informed consent, research. Results: Total 4 articles as source of literature review. Recent research shows the tendency of research subjects to choose digital informed consent because content is easier to personalize, makes it easier to understand content that is only needed by the subject, and the ease of adding digital content in certain forms of media such as audio, and video into digital formats. From the researcher’s side will increase the active participation and number of study subjects, making it easier for long-term interaction, especially follow-up research. There are 4 types of informed consent based on utilization for research and 5 informed consent processes that must be carried out in clinical research, which is attempted using language that is easily understood by the research subject and dynamic for further research. Conclusions: Informed consent in any form constitutes the autonomy right of the subject. Digital formats provide better prospects in facilitating communication to research subjects. But this ease must be accompanied by the consistency of the application of the standard informed consent process, even in intervention studies with biological samples this is more stringent. Informed consent given to the subject must use language that is easy to understand, and transparent. The subject of the study is given the right at any time to exit the research. In the future, the issue of morals and ethics of research will grow, and more dynamic informed consent is needed, especially for interventional clinical research.
Rakhmi Savitri Hoesein, Indah S. Widyahening, Dewi S. Soemarko
The Indonesian Journal of Community and Occupational Medicine, Volume 2, pp 32-9;

Background: Psoriasis is a chronic, painful, destructive, and disabling disease that has no cure, with a large negative impact on a patient’s quality of life. Sick leave is one of common challenges for people with psoriasis. Aim: To know the absenteeism risk of workers with psoriasis. Method: A literature search using search engine PubMed and Google Scholar was conducted. The inclusion criteria are systematic review, cohort, or case control studies; the subjects of studies are workers; the indicator listed in the title is psoriasis that is not differentiated in any form or type of psoriasis; and the outcome is absenteeism and its synonyms. The exclusion criteria are the articles not written in English, full text is not available, the articles have been used in the recent systematic review, the subjects are blue collar worker or non-office worker, and not relevant according to PICO. Critical appraisal was conducted using standard validity criteria for etiologic/harm/risk studies. Result: A retrospective matched case control analysis was selected with the level of evidence 3b –. Psoriasis patients were significantly more likely than controls to skip working hours (OR = 1.37; 95% CI 1.00 - 1.89; p <0.05) and days (OR = 1.21; 95% CI 0.72 - 2.05) at the previous week due to health reasons. Conclusion: Psoriasis increases the risk of sick leave/absenteeism due to illness than those without psoriasis.
Fredy Christianto, Nuri Purwito Adi
The Indonesian Journal of Community and Occupational Medicine, Volume 2, pp 66-72;

Background: Dry eye disease (DED) is a group of tear film disturbances that are caused by a decrease in tear production or tear film instability. One of the causes of DED is reduced tear secretion, which often happens in visual display terminal (VDT) workers. Blinking therapy is one of the therapies that can be given to DED workers to increase blink rate and reduce the number of incomplete blinks. Methods: Literature searching was done on database such as Pubmed, Cochrane Library, and Google Scholar. The keywords used in the literature search were dry eye disease, blinking therapy, and ocular surface disease index. Three articles were chosen and critically appraised. Results: Blinking therapy can be done using conventional methods, using animation software on a computer, or by using specifically designed wink glass. Blinking therapy showed statistically significant changes in OSDI scores, with therapy duration ranging from 20 minutes to 4 weeks. Conclusion: Blinking therapy can be done as a treatment for DED workers to improve dry eye symptoms as measured in OSDI.
Arriz Akbar Sukadi, Dewi Yunia Fitriani, Levina Chandra Khoe
The Indonesian Journal of Community and Occupational Medicine, Volume 2, pp 58-65;

Many studies have been carried out to assess the safety of the widespread use of pesticides in agriculture with diseases in farmers. A 52-year-old female farmer suffered Parkinson’s after working 27 years using paraquat herbicide. This study was conducted to obtain answers about the impact of paraquat exposure on the incidence of Parkinson’s in farmers through evidence-based case reports (EBCR) derived from a literature review.The review was conducted through the search and selection method of articles in PubMed, ProQuest, and Cochrane Library to answer research questions. The article search process used the keywords “paraquat AND Parkinson AND farmer”. Article selection was carried out using predetermined inclusion and exclusion criteria. In the initial search, 35 articles were retrieved and through the selection process three articles of the meta-analysis systematic review were selected.Selected articles from Tangamornsuksan and Vaccari show a statistically significant association between paraquat exposure and the incidence of Parkinson’s disease (PD) in workers, with a pooled OR of 1.70 and 1.24. Meanwhile, Yan’s study shows that duration of exposure to pesticides increases the risk of PD. The result showed a 5 and 10 years of duration exposure to pesticide were associated with a 5% and 11% augment in the risk of PD. All studies applied validation to reduce bias and heterogeneity effects or inadequate statistical methods.Based on the results of this evidence-based case report, it shows that the epidemiological studies taken can prove the possibility that Parkinson’s disease in this farmer is caused by exposure to paraquat.
Denta Aditya Episana, Dewi Sumaryani Soemarko, Indah Suci Widyahening
The Indonesian Journal of Community and Occupational Medicine, Volume 2, pp 48-57;

Background: Skin disorders or abnormalities occur in more than 35% of all occupational disorders. Contact dermatitis is the most recognized occupational disease in many countries (with irritant contact dermatitis accounting for 80% of the cases), yet these cases are often not reported. One of the causes of irritant contact dermatitis is Cyclohexanone, a chemical recognized as an oxidizing agent that can irritate the skin. This evidence-based case report aims to gather evidence about the effect of cyclohexanone exposure on the incidence of irritant contact dermatitis. Method: The case in this study is about a 37-year-old woman who worked as a logo printing operator in a shoe manufacturing company that is exposed to cyclohexanone and was diagnosed with irritant contact dermatitis. A literature search was conducted through PubMed, Scopus, and ProQuest and performed with the hand searching method. The inclusion criteria included systematic review study, cohort study, case-control study, cross-sectional study, irritant contact dermatitis, cyclohexanone, and occupational. Then, critically appraised using relevant criteria by the Oxford Center for Evidence-Based Medicine. Result: Three relevant cross-sectional studies were found through literature searching and are critically appraised. The estimate’s magnitude and precision regarding the association between the exposure and outcome in the first study cannot be assessed; the study only stated no statistically significant p-value in the prevalence of occupational skin dermatitis between departments and the examination between departments. The second study showed that workers with solvent chemical mixture exposure, including cyclohexane, are correlated with skin symptoms, dry or itchy skin on the hands or arms, POR 1.46 (95% CI 1.06-2.01), and redness on hands or arms, POR 1.50 (95% CI 1.09-2.70). In comparison, the third study showed that workers with a high dermal single exposure to cyclohexane have a higher risk for the incidence of hand dermatitis OR 2.15 (95% CI 0.59-7.95) without any statistical significance. Conclusion: The available evidence from cross-sectional studies did not prove an association between cyclohexanone exposure and irritant contact dermatitis in workers; only one study shows a significant association statistically. However, it is recommended to provide tools to prevent direct contact with the chemical; workers should also wear appropriate protective gloves to avoid occupational irritant contact dermatitis. A better study design such as cohort or case-control is needed to provide substantial evidence that cyclohexanone exposure can cause irritant contact dermatitis in workers.
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