Faktor Fisik

Faktor Risiko di
lingkungan kerja
Faktor Kimia

The National Fire Protection Association

(NFPA 30)  9 Class bahan berbahaya :
√ Explosives
√ Gases/Flammable & Non-Flammable
√ Flammable Liquids
√ Flammable Solids
√ Oxidizers & Organic Peroxides
√ Poisons
√ Radiation
√ Corrosive/ Acids
√ Miscellaneous
 Bahan Kimia

All substances are poisons; Semua Zat adalah racun;

there is none that is not a poison. Tidak ada yg bukan racun.
--------------------- ---------------------
Dosis yg tepat
The right dose
Membedakan racun dan obat
differentiates a poison and a remedy.
-------------------
-------------------
Paracelsus (1493-1541)
Paracelsus (1493-1541)
2
Faktor Fisik Permenkes no 66 thn
2016
Faktor Kimia ( Hal 51 s.d 56 )
 B3 adalah zat/energi/komponen
lain yg dpt membahayakan baik
secara langsung maupun tdk
langsung krn :
 Sifat

 Konsentrasi

 Jumlah

 Pengendalianmaksudnya untuk
mengurangi risiko tersebut.
Permenkes 66 tahun 2016 4

 APA PENDAPAT ANDA TERKAIT PELANGGARAN PASAL 3 UU

No. 1 TH. 1070 TERHADAP KECELAKAAN KERJA YG
MENGAKIBATKAN KEMATIAN ATAU KERUGIAN JIWA.
 SIAPA YG BERWENANG UNTUK MELAKUKAN PENEGAKAN
HUKUM BILA TERJADI KASUS TERSEBUT
Faktor Fisik Permenkes no 66 thn
2016
Faktor Kimia ( Hal 51 s.d 56 )
 Tergolong B3 di RS adalah :
 Infeksius

 Benda tajam
 Patologis

 Bahan kimia “expired”

 Radioaktif

 Farmasi

 Sitotoksik

 Peralatan dgn Logam Berat Tinggi

 Tabung Gas bertekanan
 Faktor Fisik
GHS. Pictogram s

Faktor Kimia
• Flammables, pyrophoric,
• Flammables, pyrophoric,
• Self-heating, emits flam
• Self-heating, emits flam
gas,
Gases under gas,
• self-reactive,
pressure Aquatic • self-reactive,
Aquatic • organic peroxides
toxicity • organic peroxides
• Explosives, toxicity
•• Explosives,
Explosives,
• self-reactives,
•• self-reactives,
self-reactives,
• organic peroxides
•• organic
organicperoxides
peroxides

Skin corrosion/burns,
Skincorrosion/burns,
Skin corrosion/burns,
eye damage
eyedamage
eye damage
corrosive to metals
corrosiveto
corrosive tometals
metals
GHS = Globally Harmonized System
oxidizers
oxidizers
!
Carcinogen, mutagenicity, Irritant, skin sensitizer,
Carcinogen, mutagenicity,
Repro toxicity, resp sensitizer, acute toxicity, narcotic
Repro toxicity, resp sensitizer,
target organ toxicity, effects, resp tract irritant,
target organ toxicity,
aspiration toxicity haz to ozone layer
aspiration toxicity
Acute toxicity,
fatal or toxic
 Potential Hazards in Hospital
Faktor FisikPotential Risk Population at risk
-- Kepmenkes 432 tahun 2007 --

Faktor Kimia
OX Oxidizing Agent
LabelsHealth
Special
- Hazard
Stability Hazard
Flammability Hazard
Hazard
W Water Reactive 4 Danger Deadly. May be fatal on short exposure.
Specialized protective equipment
G Compressed Gas required
LN2 Liquid Nitrogen 3 Warning Extreme Danger. Corrosive or toxic.
Avoid skin contact or inhalation
LHE Liquid Helium
2 Warning Dangerous. May be harmful if inhaled or
COR Corrosive absorbed
BIO Biohazards 1 Caution Slight Hazard. May be irritating
ACD Acid
0 No unusual hazard
POI Poison
ALK Alkali
RAD Radioactive
4 Danger Ignites below 73 °F. Flammable gas or
extremely flammable liquid
4 Danger May detonate. Explosive material at
room temperature 3 Warning Ignites below or Flammable liquid flash
point below 100°F
3 Danger May be explosive if shocked, heated
under confinement or mixed with water 2 Caution Ignites below 200°F. Combustible liquid
flash point of 100° to 200°F
2 Warning Unstable or may react violently if mixed
with water 1 Ignites above 200°F. Combustible if
heated
1 Caution Normally Stable. May react if heated or
mixed with water but not violently 0 Will not burn. Not combustible
0 Stable Not reactive when mixed with water
NFPA Diamond System
Efek Kesehatan
 Carcinogens

Chemical Hazards
Teratogens
Asphyxiates
Corrosives
Irritants
Sensitizers Chemical
Toxic Hazards
Target Organ Effects

Target
Explosives Physical Hazards Organ Health Hazards
Chemicals

Reactives Fire Hazards Corrosives Sensitizer Irritants

Chemicals

Water Reproductive
Reactives Pyrophorics
Pyrophorics Combustible Carcinogen Hazards

Unstable Oxidizer Flammables Mutagens Teratogens

Faktor yg
berpengaruh bahaya
B3
 Faktor yg mempengaruhi bahaya B3:
 Cara masuk kedalam tubuh :
 Inhalation  (paling umum  60 %)
 Skin absorption/contact
 Ingestion
 Injection

 Konsentrasi bahan dan lama

paparan
 Efek kombinasi
 Kerentanan individu
Spesific Chemical Hazard in
Hospital
Chemical Health Hazard in
 Diantaranya adalah :
 Chemotherapeutic Drugs.
√ IARC : provokasi tumor pd penderita.

 Formaldehyde.
√ 37% Formalin, sbg Sterilizing, Desinfecting, Fixing agent,
etc.
Hospital
 Allergic-Inducing Agents.
√ Detergents , Disinfectants, Synthetic rubber gloves, dsb.

 Desinfectants.
√ (Glutaraldehyde vs Eto).

 Latex.
√ Peralatan dari latex, mis. Kateter, dsb.

 Mercury. (Persistance, Bio-accumulative, Toxic)

√ Termometer, Tensimeter  Mutagen, Teratogen, dsb.

 Photocopying Activities.
√ Solvent, Tonner, dsb.
Health Effects

Allergy & Sensitisation

Health Effects

Chemical Burns
Caustic Burn
Health Effects

Dermatitis
( Need a Chemical resistance gloves )
Health Effects

Burns caused by lime powder Cancer causing asbestos dust

Dermatitis from contact with harmful chemical

 Desinfectants
Glutaraldehyde vs Ethylene Oxide (Eto)
Glutaraldehyde vs Ethylene
Oxide Glutaraldehyde ETO
Severe respiratory
Known Carcinogen
sensitizer

Probable
Asthmagen
Teratogen

Skin Sensitizer Neurotoxin

Low Exposure
May damage CNS
Limits

Water Pollutant Air Pollutant

Ethylene Oxide (1)
 Digunakan untuk material yg sensitive thd panas
dan kelembaban shg tdk dpt dilakukan steam
sterilized.
 Digunakan pada : Sterilisasi peralatan medis.
 Chronic exposure, dapat berakibat :
 Cancer – leukemia
 Reproductive effects : Mutagenic changes
Removing sterilized
 Neurotoxicity items
 Occupational asthma (reactive airway syndrome)
 Sensitization.
 Paparan thd petugas dapat terjadi saat :
 Unloading of sterilized or fumigated materials
 Direct handling of sterilized materials (off-gassing)
 Cylinder changing.
Ethylene Oxide (2)
 MedicalEvaluation (Evaluasi medis) yg
diperlukan :
 Pemeriksaan kesehatan pra-kerja.
 Pemeriksaan berkala tahunan  bagi mereka
yang :
 Terpapar ETO lebih dari 0,5 ppm selama 30 hari atau lebih
setahunnya.
 Terpapar ETO pada saat situasi emergency.
 Bila menunjukan gejala ggn akibat ETO.
 Bila ingin mendapatkan saran medis  reproduktive health.
Program Pengendalian (1)
 Chemical inventory, Safe Storage
 Chemical
Safety & Hygiene Plan (mis : SOP,
Pedoman) / MSDS,
 Monitoring: Air Monitoring, Health Surveilans, Bio-
Excreted
monitoring,
Chemical Exposure Absorb
In the (Inhalasi, (Dose) Metabolized Toxic Effect
workplace Ingesti, Dermal)

Health
Environmental Monitoring
Monitoring Monitoring
(MCU)
Biologis
Terima Kasih