Kesehatan Lingkungan & Managemen Risiko Kesehatan
Kesehatan Lingkungan & Managemen Risiko Kesehatan
2
Analysis Risiko Covid-19
3
Faktor Lingkungan Penularan
Corona Virus -19
• Melalui tetesan cairan (droplets) yang asalnya dari
batuk dan bersin.
• Melakukan kontak dekat dengan carrier atau
pembawa virus misalnya bersalamans dan
menyentuh mulut
• Menyentuh benda atau permukaan yang di atasnya
ada virus. Kemudian, tanpa mencuci tangan
menyentuh mulut, hidung, atau mata
• Kontaminasi tinja, namun penularan ini jarang
terjadi
• Studi baru menemukan, ada potensi penularan
terjadi melalui udara dan Air.
4
• Studi menunjukkan, pasien terinfeksi
Covid-19 berpotensi besar menularkan
virus corona ke banyak orang pada saat
pertama kali mereka merasa tidak sehat.
5
Group Yang Berisiko
Siapa saja bisa tertular dan menularkan
virus corona.
- Laki-laki dan perempuan,
- orang dewasa,
- anak-anak hingga lansia bisa berpotensi
terpapar.
Namun, ada beberapa kelompok yang
cenderung lebih rentan
- mereka penyakit diabetes,
- kanker,
- HIV,
- Penderita Asma dan gangguan pernapasan
lainnya.
6
Manajement Risiko agar tidak Tertular Covid 19
7
Agar Terhindar COVID-19
9
FOKUS Management and Risks Assessment MRA
Chemical Risks Assessment Microbial Risks Assessment
11
2. MRA/QMRA
• Penilaian Risiko Mikroba Kuantitatif
adalah metodologi yang digunakan
untuk mengatur dan menganalisis
informasi ilmiah dlm memperkirakan
probabilitas dan tingkat keparahan
suatu peristiwa yang merugikan
akibat mikroba.
• Metodologi ini juga dapat
membantu mengidentifikasi tahap-
tahap dalam Pertumbuhan virus ,
penularan, penanganan, dan akibat /
Risiko yg berkontribusi peningkatan
risiko penyakit
12
Tools & Data Needs for
Microbial Risk Assessment
• Disease surveillance
• Clinical studies
• Epidemiological studies
• Methods for detection of microbial
• Transport models
• Regrowth and die-off models
• Development of occurrence data bases
• Dose-response models
13
Environmental & Health Effects
• Virulensi mikroba dan faktor
patogenisitas
• Infeksi simtomatik dan simtomatik
Keparahan (durasi, perawatan medis &
rawat inap)
• Mortality
• Status kekebalan tubuh inang
Populasi rentan
14
Acute and Chronic Outcome Associated with
Microbial infections
Acute disease Chronic disease
16
Exposure Assessment
and Risk Characterization
17
Occurrence Analysis for the Exposure Process
• Concentrations
• Frequency
• Transport
18
New Environmental Microbiological Methods
to Inform Risk Assessment during Exposure
• Alternative Indicators
• Pathogen Monitoring
• Source Tracking
19
Criteria to Consider
Several criteria to consider for identifying a candidate Microbial risk
assessment (MRA)
a) Characteristics and importance of the hazard(s) of concern;
b) Magnitude (e.g., presence, prevalence, concentration of hazards) and
severity (e.g., impact on public health) of the risk;
c) Urgency of the situation;
d) Populations of concern;
e) Other factors associated with specific hazards (e.g., water treatment
processes, food processing, cooking, cross contamination);
f) Availability of resources (e.g., time, money, staff).
20
PROBLEM FORMULATION
ANALYSIS
CHARACTERIZATION
of Exposure of Human
Health Effects
RISK CHARACTERIZATION
21
22
23
24
Percentage of Disease Due to
Transmission Route
Animal to Person to
Human Person
?% ?% Aerosols
Drinking ?%
Water ?%
?% ?% ?%
Food
Fomite Recreation
25
Factors Important in
Assessing Exposure
• Route of Exposure
• Duration of exposure
• Seconds, hours, minutes
• Number of exposures
• How many times in a day, month, year
• Degree of exposure
• Liters of water ingested
• Liters of air inhaled
• Grams of food ingested
26
How Important is the Environment in Disease
Transmission?
• Most other infections are acquired from insect bites and direct
personal contact (e.g. sex, hand shaking, kissing)
27
Factors that influence Enteric Virus and Bacteria
Survival in Surface Waters
• Temperature • Longer survival at lower temperatures
• UV Light • Related to amount of sunshine
• Organic Matter • Longer survival in presence of organic
matter
• Seawater vs.
Freshwater • Shorter survival in seawater
• Sediments
• Prolonged survival in sediments; regrowth
of enteric bacteria possible in sediments
• Antagonistic • Certain marine microbes prey on bacteria
Microflora or are antagonistic to virus survival;
survival is reduced in the presence of non- 28
29
Factors that influence Enteric Virus and Bacteria
Survival at/near Soil Surface
• Temperature • Longer survival at lower temperatures
• Infected animal
• Cross contamination
• Cutting board to produce (vegetables)
• Irrigation water
31
Transport and fate of enteric viruses
in the marine environment
Aerosolization
by breaking waves
Sewage outfall
Resuspension by rain,
wave action, tides,
dredging, etc.
Accumulation in sediments
(viruses occur in higher concentrations Uptake by crustacea 88
32
in sediment than the overlaying water) and bottom feeding fish
Derivation of Beta-Poisson Model (assumptions)
33
A farm-to-fork model in MRA
Should consider :
a) How many viable pathogens (or indicators) are present in the source (e.g.,
infected chicken, contaminated carcass) at time zero?
b) How many pathogens are released from the source and/or what is the
prevalence of infection in the source?
c) Over what period are the pathogens released?
1) Continuously
2) Batchwise
d) At what rate are the pathogens released?
1) Counts/unit time (e.g., cfu, pfu, genomes per minutes, seconds, hours, days)
34
A farm-to-fork model in MRA
e) What is the form of the release?
1) Fomites
2) Spray equipment
3) Offgases from a fermentor
4) Waste water
5) Animal slaughter
35
A farm-to-fork model in MRA
f) To what medium are they released?
1) Food
2) Surface water
3) Soil
4) Air
5) Other surfaces
36
Point Estimate
37
Example: Anthrax
−
38
Thank you
39