Konsep

hubungan
Learning objectives
Kesempata antara
n karier pekerjaan
dan
kesehatan

Pengendalia Konsep
n bahaya bahaya

Konsep
Monitoring Health Risk
Assessment
 Health and Occupation

HEALTH OCCUPATION
(Kesehatan) (Pekerjaan)
 Occupational Health
• addresses the two way relationship
between work and health (hubungan
timbal balik antara kesehatan dan
pekerjaan)
• Work environment
• Physical
• Social
workplace??
Penyakit Akibat Kerja di Indonesia
• Pada
Februari 2002, PT. Jamsostek membayar
kompensasi kepada beberpa pegawai PT. KPC
sebesar 1.5 Millyar rupiah karena Penyakit
Akibat Hubungan Kerja (Work related
diseases) (Tuli Akibat Kerja; Back pain, dll.)
Implikasi dimasa datang

•Claimlebih banyak;
•Penuntutan thd. perusahaan;
•premium asuransi naik?
Occupational Health
• ILO/WHO: The promotion and maintenance
of the highest degree of physical, mental
and social well-being of workers in all
occupation;
• The main emphasis is on prevention of
occupational diseases and promotion of
the worker’s health (penekanan utama
program kesehatan kerja adalah
Pencegahan dan Promosi kesehatan)
 Pilar Kesehatan Kerja
Occupational
Medicine

Industrial
Ergonomic,
Hygiene
Epidemiology
OH Team:
Occ. Health Physician
Occ. Health Nurse;
Industrial Hygienist;
Safety Officer;
HR/ Plant Manager
 Sejarah Kesehatan
Kerja
• Dimulai abad 18  Kedokteran Kerja
• Ramazzini
• Berkaitan dengan perundangan
• Factories Act
• Compensation Act

• Berkembang menjadi Kesehatan

Kerja
• Industri Rumah Sakit baru
berkembang
Work related diseases vs occupational
diseases (Koh, Chia, Jeyaratnam, 2001)
• Multifactorial • Akibat paparan factor
• Seringkali ada di bahaya
• Terkait secara dominant
masyarakat dengan factor bahaya
• Hipertensi
• Timbul (terutama) pada
• PJI pekerja yang terpapar
• Psikosomatis
• Bisa timbul di
• Pekerjaan bisa menjadi masyarakat
• Penyebab • Paparan terhadap limbah
• Pemicu
• Cause specific
• Asbestos  asbestosis
 OH Rule and Regulations
Peraturan Perundangan
 Act no 1 - 1970: Occupational Safety.
 Permenaker 02/1980: Health Examination;
 Permenaker 03/1982: Occ. Health Services;
 SE 01/Men/1997: TLV for Chemical Substance;
 Kepmenaker 051/1999: TLV-Physical Factors;
 Kepres no 22, 1993: Work Related Diseases;
 Permenaker 04/1987: OSH Committee;
 Act no 23/92: on Health (art. 23 on OH);
 Act no 3/92: Workers Insurance
 Act no 13/2003 on Manpower Resource.
 Gov’nt Reg. no 23/2000 on Radiation (ionizing)
Safety;
 Kepmenkes no 907/2002 on Water quality;
 Kepmenkes 715/2003 Canteen Hygiene.
Health Risk Assessment
•Usaha penilaian resiko yang ada di
tempat kerja yang bisa mempengaruhi
kesehatan pekerja
•Faktor bahaya
• Segala hal yang bisa mempengaruhi kualitas
hidup pekerja
Fisik
• Kebisingan
• Getaran
• Suhu ekstrim
• radiasi
Kimiawi
• Basa • Pelarut
• Asam • Pewarna
• Debu • Lem
Biologis
• Bakteri
• Virus
• Parasit
• Jamur
Ergonomi
• Posisi kerja
• Suhu ruangan
• Pencahayaan
• Jam kerja
Psikologis
• Hubungan atasan; sesama teman
• Tekanan politis
• Tekanan lingkungan luar
Pengawasan:
•lingkungan
•biologis

Pengendalian:
•Eliminasi
•Substitusi
•Rekayasa teknik
•Administratif
•APD
Hazard Measurement and Exposure
Evaluation:

• Noise & Vibration; Gas, vapor, dust;

Thermal stress; Radiation; Biological;
Ergonomic; Psycho-social;
• Environmental and Biological Monitoring.
• Threshold Limit Valuess and Biological and
Environmental Investigations
• Hazard Control (Pengendalian bahaya):

Eliminasi

Substitusi

Rekayasa Teknik

Pengaturan administrative

Alat pelindung diri

Generator yang bising Penggunaan jarum suntik
• Buang ?? • Buang ??
• Ganti yang baru; • Ganti teknologi nano
teknologi baru particle?
• Perbaiki; peredam • Rekayasa Teknik
• Pengaturan shift kerja; • SOP; no re-cap
SOPs; tanda peringatan; • Gloves; goggle
hearing protection
program
• APD: earplug, ear muff
• HIGH RISK GROUPS

• Exposure to Chemicals, eg. solvents, heavy

metals, free silica, pesticides, etc.
• Exp. to Noise & Vibration;
• Exposure to Radiation;
• Exp. to extreme temperature;
• Special Groups: Food-handlers, Drivers,
Welders, Health personnel, Fire brigade,
etc.
 Pengujian Kesehatan Terhadap Pekerja
Resiko Tinggi (contoh)

Group/Exposure: Recommended Tests:

Audiometry
• Noise
•

• Spirometry, Chest X-ray

• Dusts
• Harvard Step Test; ECG
• Heat Stress • Neurological, e.g. Swedish Q16; Renal
function, LFTs, Spirometry, Bio-
• Solvent Vapor monitoring
• Welders • Urinalysis, Bio-monitoring
• Drivers • Eye/ear testing, ECG (> 40)
Feces culture, Chest X-ray
• Canteen Personnel
•

• Serology for Hep-B, LFTs,

• Medical personnel
• Chest X ray.
• HEALTH PROMOTION
(Promosi Kesehatan)

• Healthy Life Style:

• Healthy diet;
• Physical fitness;
• Smoking;
• Drug and Alcohol;
• Safe sex, AIDS, Hep-B;
• Stress Management;

• Env. and Personal Hygiene

• Environment: TBC, DHF, Malaria; etc.
• Health Surveillance
(Surveilans Kesehatan)

• Job-related
Health Examination :
(Pemeriksaan Kesehatan-terkait
jabatan)
• Pre-employment;
• Periodic;
• Pre-placement, etc.

• Data Klinik Perusahaan;

• Data Absenteeism;
• Data Rawat Inap;
• Data Rawat Jalan.
• Sickness Monitoring
(Pemantuan Absensi Karena Sakit)

• Occupational Diseases:
−Baseline;exposure;biological plausibility;
−Reportable
• Morbidity statistics (onsite clinic):
• National Disease Registry;
• Monthly, Annually;
• Data analysis an inference:
• Medical check up data and clinic data;
• in/out patient data; Medical absenteeism.
• MEDICAL EMERGENCY RESPONSE
PLAN (MERP)

• MERP (Rencana Darurat Medik: Tertulis,

Terencana,Terlatih);
• First Aid System;
• first 5 minutes: BLS;
• Number and Distribution;

• Onsite clinic : Stabilization;

• Referral:
• Transfer & Follow up
• Regular Exercise.
 H(SE) Management
System
Leadership and Management Commitment

Management Review
Policy and Strategic
Objectives
Audit

Organization,
Health Protection Responsibilities,
Resource;
Implementation
Health Promotion
Health Risk Assessment
Planning and
Procedure
Penyakit akibat kerja di
Puskesmas
Faktor bahaya??
 Pengawasan dan Pengendalian
Bahaya
•Pengawasan:
•Angka kesakitan:
• penyakit menular
• Terkait ergonomi: LBP, strain, sprain
• DKI, DKA
•Cek rutin (?): Hepatitis B
• Promosi kesehatan
• Penyuluhan kesehatan internal Puskesmas
• Pelatihan

• Pengendalian:
• Menjaga ventilasi udara: exhaust
• Yang sakit menular harus istirahat
• Penggunaan APD yang tepat
CV
• 2002 – 2005 PT International SOS
• Freeport International
• KPC
• Newmont Minahasa, Sumbawa, Sumatera Utara
• Newcrest, Halmahera Utara
• Offshores: Riau, Luwuk, Laut Jawa

• 2005 - 2010
• PetroChina International