Dewi Sumaryani Soemarko
Occupational Medicine Division, Departement Of Community Medicine, Faculty Of Medicine, Universitas Indonesia

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Lymphocyte chromosome breakage in low benzene exposure among Indonesian workers Mansyur, Muchtaruddin; Soemarko, Dewi S.
Medical Journal of Indonesia Vol 23, No 4 (2014): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (394.206 KB) | DOI: 10.13181/mji.v23i4.740

Abstract

Background: Benzene has been used in industry since long time and its level in environment should be controled. Although environmental benzene level has been controlled to less than 1 ppm, negative effect of benzene exposure is still observed, such as chromosome breakage. This study aimed to know the prevalence of lymphocyte chromosome breakage and the influencing factors among workers in low level benzene exposure.Methods: This was a cross sectional study in oil & gas industry T, conducted between September 2007 and April 2010. The study subjects consisted of 115 workers from production section and head office. Data on type of work, duration of benzene exposure, and antioxidant consumption were collected by interview as well as observation of working process. Lymphocyte chromosome breakage was examined by banding method. Analysis of relationship between chromosome breakage and risk factors was performed by chi-square and odd ratio, whereas the role of determinant risk factors was analyzed by multivariate forward stepwise.Results: Overall lymphocyte chromosome breakage was experieced by 72 out of 115 subjects (62.61%). The prevalence among workers at production section was 68.9%, while among administration workers was 40% (p > 0.05). Low antioxidant intake increases the risk of chromosome breakage (p = 0.035; ORadjusted = 2.90; 95%CI 1.08-7.78). Other influencing factors are: type of work (p = 0,10; ORcrude = 3.32; 95% CI 1.33-8.3) and chronic benzene exposure at workplace (p = 0.014; ORcrude = 2.61; 95% CI 1.2-5.67), while the work practice-behavior decreases the lymphocyte chromosome breakage (p = 0.007; ORadjusted = 0.30; 95% CI 0.15-0.76).Conclusion: The prevalence of lymphocyte chromosome breakage in the environment with low benzene exposure is quite high especially in production workers. Chronic benzene exposure in the workplace, type of work, and low antioxidant consumption is related to lymphocyte chromosome breakage. Thus, benzene in the workplace should be controlled to less than 1 ppm, and the habit of high antioxidant consumption is recommended.
Past antihypertensive drugs, obesity, daily light working load and risk of hypertension: An Indonesian 2001 rural study Amri, Zarni; Soemarko, Dewi S.; Basuki, Bastaman; Ibrahim, Ermita I.
Medical Journal of Indonesia Vol 10, No 4 (2001): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (725.11 KB) | DOI: 10.13181/mji.v10i4.38

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This study aims to identify some risk factors related to hypeertension in rural areas. The data for this study is a part af the result of the field study done by the second year medical students of the Faculty of Medicine, University of Indonesia, Jakarta, on June 27h , 2001, at Cijeruk subdistrict in Bogor regency. The subjects were seleccted randomly using neighborhood cluster which was diffirent from the previous study in 2000. Interviews and blood pressure were taken at the houses of the subjects from 1:00 PM to 4:00 PM. The results of this study showed that people aged 40 years or over had an increase risk to suffer hypertension compared to the 18-39 year old group, and the risk was most prominent among the 55-59 year group [adjusted odds ratio (OR)= 17.7; 95% confidence intervals (CI)=6.26-59.2). Compared to the subjects with normal body posture,those who were obese had more than two-fold increase in the risk to be hypertensive (adjusted OR= 0.87; 95% CI= 0.87-4.17; P= 0.109). In addition, those who discontinued antihypertensive drugs had almost 14-fold increase in the risk to be hypertensive relative to subjects who never take antihypertensive drugs (adjusted OR= 14.16; 95% CI= 7.14- 28.05). In general, the results of this study is similar with our last year study which used different subjects. This study concluded that special attention should be taken to the elderly aged 40 years and over, to some one who discontinued antihypertensive drugs; andwhom had light daily working load to prevent hypertension. (Med J Indones 2001; 10: 224-9)Keywords: hypertensive, risk factor, adjusted odds ratio, elderly.
Hallux Valgus as an Occupational Disease among Indonesian Female Workers:A Study Using Seven Steps of Occupational Diagnosis Approach Dewi Sumaryani Soemarko; Fita Rahmasari; Dewi Yunia Fitriani
eJournal Kedokteran Indonesia Vol 7, No 3 (2019): Vol 7, No. 3 (2019): December
Publisher : Faculty of Medicine Universitas Indonesia

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Abstract

Shoes are a necessity for female workers. Not only they are used as footwear, they also play role in workers’ appearance. Company policies sometimes require female workers to use high heels, which could consequently lead to frequent foot problems such as hallux valgus (HV). This cross-sectional study was conducted to determine the prevalence of HV as an occupational disease among female workers at M department store, in Bekasi City West Java on May to June 2018, using a seven steps of occupational diagnosis approach. Female workers with HV were included as study subjects and were given questionnaires. Data was analyzed using the seven steps of occupational diagnosis method to establish the diagnosis of HV as an occupational disease or work-related disease or non-occupational disease. A total of 35 subjects were diagnosed with HV by the orthopedic specialist, 19 subjects of whom had an occupational disease and 8 subjects of work-related HV and 8 subjects of non-occupational HV. The majority of HV cases among the female workers at the department store was an occupational disease. Keywords: occupational disease, seven steps of occupational diagnosis, female workers, hallux valgus. Hallux Valgus Akibat Kerja di Pekerja Perempuan Indonesia: Suatu Studi Menggunakan 7 Langkah Diagnosis Okupasi Abstrak Sepatu sangat penting untuk pekerja perempuan, selain sebagai alas kaki, sepatu juga menambah penampilan. Kebijakan perusahaan kadang menghendaki pekerja perempuan menggunakan sepatu berhak tinggi sehingga menimbulkan masalah kaki antara lain hallux valgus (HV). Studi potong lintang ini bertujuan mengetahui prevalensi HV akibat kerja di M departemen store, di Kota Bekasi Jawa Barat pada bulan Mei sampai Juni 2018, menggunakan tujuh langkah diagnosis okupasi. Pekerja perempuan dengan HV dikumpulkan sebagai subjek, diberikan kuesioner dan dikaji dengan metode tujuh langkah diagnosis okupasi untuk menentukan HV akibat kerja atau HV berhubungan dengan pekerjaan atau HV bukan akibat kerja. Terdapat 35 subjek didiagnosis HV oleh spesialis ortopedi; 19 subjek termasuk HV akibat kerja dan 8 subjek masing-masing untuk HV berhubungan dengan pekerjaan dan HV bukan akibat kerja. Sebagian besar HV yang timbul di pekerja perempuan yang bekerja di department store adalah HV akibat kerja. Kata kunci: penyakit akibat kerja, tujuh langkah diagnosis okupasi, pekerja perempuan, hallux valgus.
Correlation of noise level exposure on the reaction time of workers at a manufacturing company in Bandung, Indonesia Herqutanto Herqutanto; Irwan Suhadi; Imron Khazim; Dewi S. Soemarko; Retno A. Werdhani
Health Science Journal of Indonesia Vol 11 No 1 (2020)
Publisher : Sekretariat Badan Penelitian dan Pengembangan Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22435/hsji.v11i1.2447

Abstract

Latar Belakang: Para pekerja sering kali terpaksa berhadapan dengan kebisingan tinggi ditempat kerja. Kebisingan mengganggu perhatian yang diperlukan terus-menerus dan menurunkan produktivitas kerja, oleh sebab itu pekerja yang melakukan pengamatan dan pengawasan terhadap satu proses produksi atau hasilnya, dapat membuat kesalahan akibat dari terganggunya konsentrasi dan kurang fokusnya perhatian. Pada penelitian ini dilakukan pengukuran waktu reaksi cahaya dan suara untuk menilai fokus perhatian/konsentrasi. Metode: Studi analitik dengan desain komparatif cross sectional. Penelitian ini dilakukan pada perusahaan manufaktur yang memproduksi benang nylon sintetik. Membandingkan rerata selisih waktu reaksi cahaya dan suara sebelum dan setelah bekerja dengan pajanan kebisingan pada kelompok subjek yang bekerja pada intensitas kebisingan di atas NAB (area braiding) dibandingkan dengan yang di bawah NAB (area waring), dimana sebelumnya dilakukan pengukuran intensitas tingkat kebisingan di kedua area tersebut. Hasil Penelitian: Perbedaan bermakna waktu reaksi cahaya yang melambat pada subjek yang bekerja dengan pajanan kebisingan di atas NAB sebelum dan setelah bekerja (p=0.007), namun tidak dengan waktu reaksi suara. Tidak terdapat perbedaan bermakna waktu reaksi cahaya dan suara pada subjek yang bekerja dengan pajanan kebisingan di bawah NAB sebelum dan setelah bekerja. Terdapat perbedaan bermakna rerata selisih waktu reaksi cahaya yang melambat pada subjek yang bekerja pada pajanan kebisingan di atas NAB dengan di bawah NAB, p=0,017, namun tidak bermakna terhadap rerata selisih waktu reaksi suara. Kesimpulan: Terdapat perbedaan rerata selisih waktu reaksi cahaya pada pekerja yang bekerja dengan pajanan kebisingan di atas NAB dibandingkan dengan pekerja yang bekerja dengan pajanan kebisingan di bawah NAB, sehingga tingkat intensitas kebisingan tinggi (di atas NAB) mempengaruhi waktu reaksi cahaya dan menjadi lebih lambat. Kata Kunci: waktu reaksi cahaya; waktu reaksi suara; kebisingan Abstract Background: Workers are often exposed to high noise level at their workplaces. Noise can disrupt the worker’s concentration and focus and in the end, may cause lower productivity. Thus, workers whose main job descriptions are to supervise workflow from one phase to another are prone to mistakes due to the loss of concentration and focus. In this research, we used reaction timer with light and sound stimuli to assess attention or concentration. Methods: The study was an analytical study with comparative cross sectional design, comparing a mean difference between light and sound reaction time before and after work. This research was conducted at a manufacturing company that produces synthetic nylon fibers. The subjects were divided into two groups; the workers with noise intensity above TLV (braiding’s area) and with noise intensity below TLV (waring’s area). Prior to the study, the research has measured the intensity of the noise level in the workplace area. Result: A significant difference was found in the light’s reaction time who work with noise exposure above TLV (p= 0.007) and it was found to be slower after work with the workers who are exposed to noise above TLV. There was also a significant mean difference for the light’s reaction time between the above TLV noise group and below TLV noise group (p = 0.017). There was no significant difference in sound reaction time. Conclusion: There was a significant mean difference in light reaction time for the workers who work with noise exposure above TLV compare with the workers who work in below TLV, so that high intensity of noise level is found to affect and decrease the light reaction time of the workers. Keywords: light’s reaction time, sound’s reaction time, noise.
Occupational skin cancer and precancerous lesions Fifinela Raissa; Githa Rahmayunita; Sri Linuwih Menaldi; Dewi Soemarko
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 1, No 3 (2016): December
Publisher : Universitas Indonesia

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Abstract

Occupational skin cancer and precancerous lesions are skin disorders caused by exposure to chemical carcinogens such as polycyclic hydrocarbons and arsenic, or radiation, such as ultraviolet light and ionizing light in the workplace. Annual increase in skin cancer incidence is believed to be related to various factors such as frequent intense sunlight exposure (i.e. at work, recreational activities, and sun-tanning habit), ozone depletion, an increase in number of geriatric population, and an increase of public awareness in skin cancer. The most common occupational skin cancers are basal cell carcinoma, squamous cell carcinoma, and melanoma. Examples of occupational precancerous lesion of the skin are actinic keratosis and Bowen’s disease. Particular diagnostic criteria to diagnose occupational diseases has been developed. Early detection of occupational skin cancer and precancerous lesion is necessary. An effective prevention program consists of primary prevention such as prevention of hazardous material exposure, secondary prevention such as early detection of disease for early intervention, and tertiary prevention such as minimizing long-term impact of the disease. Keywords: occupational, skin cancer, precancerous lesion, radiation, carcinogen
The Role of CYP4502E1 Genetic Polymorphism on Benzene Metabolism Dewi Sumaryani Soemarko; Muchtaruddin Mansyur; Septelia Inawati Wanandi; Novi Silvia Hardiany
eJournal Kedokteran Indonesia Vol 5, No 2 (2017): Vol 5, No. 2 (2017): Agustus
Publisher : Faculty of Medicine Universitas Indonesia

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Abstract

The carcinogenic effect of benzene is associated with metabolites produced in benzene metabolism such as phenol, catechol, quinones, muconic acid (tt-MA), and phenyl mercapturic acid (s-PMA). The role of CYP4502E1 enzyme in benzene metabolism is very important, which is determined by its genetic polymorphism. This cross-sectional study is aimed to obtain the distribution of frequency of s-PMA concentration in workers who had been low exposure of benzene based on CYP4502E1 genetic polymorphism. The study was conducted between September 2007 and April 2010. Data were collected by methods of interviews, physical examinations, laboratory examinations, and direct observation on the work place. The variables studied were CYP4502E1, benzene exposure at the work place, age, type of work, history of work, length of work, body mass index (BMI), antioxidants intake, behavior and management, and s-PMA concentration in the urine. The distribution of CYP4502E1 genetic polymorphism in workers is 87.8% wild type homozygote, 11.3% heterozygote and 0.9% mutant homozygote. There was no significant difference in the proportion of s-PMA concentration based on CYP4502E1 genetic polymorphism (p=0.595; ORraw=0.98; 95% CI=0.95-1.01). There were also no differences of age, type of work, length of work, BMI, antioxidants consumptions, behavior and management of subjects with s-PMA. Further study should be conducted on CYP4502E1 genetic polymorphism in various Indonesian races at different workplace with low-level benzene.
Upper extremity deep vein thrombosis in an informal porter Dewi S. Soemarko; Herlinah Herlinah
Universa Medicina Vol. 39 No. 3 (2020)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2020.v39.207-211

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BackgroundUpper extremity deep vein thrombosis (UEDVT) is a rare condition, in which job-related arm movements and repetitive, forceful or overhead arm activities have been recognized as the predisposing factor for this condition. UEDVT can occur among informal porters. This report describes a case of UEDVT in an informal porter due to manual lifting of heavy goods and reviews the literature for occupational reports of this condition.Case descriptionA 35-year-old male informal porter presented with marked swelling, pain, and numbness of his right arm 3 days after a prolonged episode of lifting heavy goods. A Doppler ultrasound showed thrombosis in the right subclavian and axillary veins and laboratory tests found elevated D-dimer. Patient was diagnosed as having axillo-subclavian thrombosis and treated with low molecular-weight heparin. One month after the last follow-up, patient returned to work with modified capacity and after 3 months of return to work, patient was able to resume his regular duties without impairment or disability.ConclusionThe occupation of informal porter should be considered a risk factor for upper extremity deep vein thrombosis (UEDVT), thus the occupational medicine physician should be aware of this condition in the context of manual workers. Detailed occupational history to aid the diagnosis and future risk assessment are needed, and education for preventing UEDVT should be provided to porters.
Effectiveness of PPE For Prevention of Occupational Ocular Injury Iwan Susilo Joko; Dewi S Soemarko; Nuri Purwito Adi
The Indonesian Journal of Community and Occupational Medicine Vol. 1 No. 2 (2021): ijcom
Publisher : ILUNI MKK FKUI and PRODI MKK FKUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (157.747 KB) | DOI: 10.53773/ijcom.v1i2.7.63-71

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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.
Determination of Occupational Disease in Worker with Liver Cirrhosis That Exposed by Vinyl Chloride Superimposed with Hepatitis B Infection Dewi Sumaryani Soemarko; Aditya Agung Prasetyo
The Indonesian Journal of Community and Occupational Medicine Vol. 1 No. 2 (2021): ijcom
Publisher : ILUNI MKK FKUI and PRODI MKK FKUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (305.183 KB) | DOI: 10.53773/ijcom.v1i2.11.78-83

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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.
The Association between Heat Exposure and Hydration Status Among Production Workers in Fish Processing Company Tenny Sutarto; Dewi S Soemarko; Slamet Ichsan
The Indonesian Journal of Community and Occupational Medicine Vol. 1 No. 3 (2022): ijcom
Publisher : ILUNI MKK FKUI and PRODI MKK FKUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53773/ijcom.v1i3.33.146-53

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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.