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KETAHANAN LINGKUNGAN: KESEHATAN LINGKUNGAN Disarikan oleh: soemarno, psl ppsub 2013.

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Presentation on theme: "KETAHANAN LINGKUNGAN: KESEHATAN LINGKUNGAN Disarikan oleh: soemarno, psl ppsub 2013."— Presentation transcript:

1 KETAHANAN LINGKUNGAN: KESEHATAN LINGKUNGAN Disarikan oleh: soemarno, psl ppsub 2013

2 PENGENALAN DAN KONTROL BAHAYA DI HUNIAN Determine if personnel have potential occupational exposure to environmental hazards. Obtain training. Voluntarily notify supervisor or OMC of any pre-disposition to environmental hazards that can create medical emergencies. Use personal protective equipment, administrative controls, and engineering controls when exposed to environmental hazards. Sumber: Environmental Health Hazard. Atallah Z. Rabi …. Diunduh dari: 15/12/2012

3 MENGURANGI / KONTROL BAHAYA LINGKUNGAN Prevent the creation of a hazard in the first place Reduce the amount of hazard brought into being Prevent the release of existing hazard Modify the rate or spatial distribution of release of hazard from its source Separate, in time or in place, the hazard and that which is to be protected. Separate the hazard and that which is to be protected by interaction of a material barrier. Modify the basic qualities of the hazard. Make that which is to be protected more resistant to damage from the hazard Counter damage already done by the environmental hazard Stabilize, repair, and provide rehabilitative corrective measures Sumber: Environmental Health Hazard. Atallah Z. Rabi …. Diunduh dari: 15/12/2012

4 Kita menghadapi banyak macam bahaya Lima tipe-utama bahaya –Biologis: pathogens –Kimiawi –Fisika –Kultural –Pilihan Gaya hidup Sumber: Environmental Hazard and Human Health. …………. 15/12/2012

5 JENIS-JENIS BAHAYA BIOLOGIS Do We Face? In terms of death rates, the most serious infectious diseases are flu, AIDS, diarrheal diseases, malaria, and tuberculosis; most of these deaths occur in developing countries. Sumber: Environmental Hazard and Human Health. …………. 15/12/2012

6 Bbrp penyakit dapat menular dari satu orang ke orang lainnya 1.Nontransmissible disease 2. Infectious disease 3.Transmissible disease (contagious or communicable disease) Sumber: Environmental Hazard and Human Health. …………. nvironmental.../chap ter_...diunduh 15/12/2012 nvironmental.../chap ter_...diunduh %20Ringworm-Jock%20Itch-Worms-Amebas-Malaria.html

7 Sejak 1950, kematian akibat penyakit infeksi telah menurun, karena : –Perawatan kesehatan lebih baik –Antibiotika –Vaksin Disability-adjusted life years (DALYs) Sumber: Environmental Hazard and Human Health. …………. 15/12/2012 Bbrp penyakit dapat menular dari satu orang ke orang lainnya

8 Penyakit infeksi masih menjadi ancaman utama Penyakit infeksi menyebar melalui: –Udara –Air –Makanan –Cairan tubuh Epidemik dan Pandemik Resistensi bacteri dan serangga Sumber: Environmental Hazard and Human Health. …………. ronmental.../chapter_... diunduh 15/12/2012 ronmental.../chapter_... diunduh Global warming has various effects on human health. The main indirect effects are on infectious diseases. Although the effects on infectious diseases will be detected worldwide, the degree and types of the effect are different, depending on the location of the respective countries and socioeconomical situations. Diunduh dari:

9 JALUR PENYAKIT INFEKSI PADA MANUSIA Sumber: Environmental Hazard and Human Health. …………. 15/12/2012

10 RESISTENSI GENETIK THD ANTIBIOTIK Bacteria: rapid reproduction, easily spread Penggunaan antibiotika yg berlebihan Penggunaan pesticida yang berlebih Sumber: Environmental Hazard and Human Health. …………. 15/12/2012 Antibiotic Resistance is the adaptation of bacterial strains to certain of the ANTIBIOTIC MEDICATIONS doctors prescribe to treat infections the BACTERIA cause, rendering the antibiotic ineffective. Sumber: _...diunduh 15/12/2012 _...diunduh

11 Methicillin-resistant Staphylococcus aureus (MRSA) –Resistant to most antibiotics –Symptoms of MRSA –How will it be controlled? Sumber: Environmental Hazard and Human Health. …………. nmental.../chapter_...diund uh 15/12/2012 nmental.../chapter_...diund uh RESISTENSI GENETIK THD ANTIBIOTIK Sumber: _...diunduh 15/12/2012 _...diunduh Mechanisms of Antibiotic Resistance.

12 ANCAMAN GLOBAL AKIBAT TUBERCULOSIS Why is tuberculosis on the rise? –Not enough screening and control programs –Genetic resistance to a majority of effective antibiotics –Person-to-person contact has increased –AIDS individuals are very susceptible to TB Sumber: Environmental Hazard and Human Health. …………. 15/12/2012

13 BEBERAPA PENYAKIT VIRUS SANGAT MEMATIKAN Influenza or flu virus –#1 Killer –Transmission HIV –#2 Killer –Antiviral drugs Sumber: Environmental Hazard and Human Health. …………. 15/12/2012

14 Global strategy to slow down the spread of HIV –Reduce the number of new infections –Concentrate on those most likely to spread HIV –Free testing –Education for prevention –Provide free or low-cost drugs –Research Sumber: Environmental Hazard and Human Health. …………. 15/12/2012 BEBERAPA PENYAKIT VIRUS SANGAT MEMATIKAN

15 Hepatitis B virus (HBV) –#3 Killer –Mode of transmission Viruses that move form animals to humans –West Nile virus –Severe acute respiratory syndrome (SARS) Reduce chances of infection: Wash your hands Sumber: Environmental Hazard and Human Health. …………. 15/12/2012 BEBERAPA PENYAKIT VIRUS SANGAT MEMATIKAN

16 PENYEBARAN PENYAKIT INFEKSI DARI BINATANG KE MANUSIA Ecological medicine Human practices that encourage the spread of diseases from animals to humans Emerging infections –HIV –SARS –West Nile virus –Lyme virus Sumber: Environmental Hazard and Human Health. …………. 15/12/2012

17 Malaria— oleh NYAMUK PEMBAWA PARASIT Malaria –Caused by Plasmodium sp. carried by Anopheles mosquitoes –Penyebaran –Gejala-gejala –Siklus Malarial

18 Malaria on the rise since 1970 –Drug resistant Plasmodium –Insecticide resistant mosquitoes –Effect of global warming –AIDS patients particularly vulnerable Prevention of spread and current research Sumber: Environmental Hazard and Human Health. …………. 15/12/2012 Malaria— oleh NYAMUK PEMBAWA PARASIT

19 Mengurangi penyakit infeksi Good news –Vaccinations on the rise –Oral rehydration therapy Bad news –More money needed for medical research in developing countries Sumber: Environmental Hazard and Human Health. …………. 15/12/2012

20 SOLUTIO NS Infectious Diseases Increase research on tropical diseases and vaccines Reduce poverty Decrease malnutrition Improve drinking water quality Reduce unnecessary use of antibiotics Educate people to take all of an antibiotic prescription Mengurangi penggunaan antibiotik dalam budidaya unggas Require careful hand washing by all medical personnel Immunisasi anak-anak thd penyakit virus Provide oral rehydration for diarrhea victims Conduct global campaign to reduce HIV/AIDS Sumber: Environmental Hazard and Human Health. …………. 15/12/2012 Solusi: Penyakit Infeksi, Cara-cara untuk mencegah atau mereduksi kejadiannya Memperbaiki kualitas air minum

21 MENGHADAPI BAHAN KIMIA BERBAHAYA Managing the risks of toxic substances is an ongoing, integrated process Sumber: bvg.gc.ca/internet/English/parl_cesd_200911_02_e_33197.html_...diunduh 15/12/2012_...diunduh

22 BEBERAPA BAHAN KIMIA DAPAT MENYEBABKAN KANKER, MUTASI, DAN GANGGUAN JANIN Bahan kimia toksik: Carcinogens Mutagens Teratogens Sumber:_http://risk.arizona.edu/healthandsafety/chemicalsafetyinfo/index.shtml...diu nduh ….. 15/12/2012_http://risk.arizona.edu/healthandsafety/chemicalsafetyinfo/index.shtml...diu nduh

23 PCB ADA DI BERBAGAI TEMPAT Kelompok senyawa kimia yang mengandung khlor: –Sangat stabil –Nonflammable –Break down slowly in the environment –Travel long distances in the air –Larut dalam lemak –Biomagnifikasi –Food chains and webs Banned, but found everywhere Sumber: Environmental Hazard and Human Health. …………. 15/12/2012

24 Potential Pathways on Which Toxic Chemicals Move Through the Environment Sumber: Environmental Hazard and Human Health. …………. 15/12/2012

25 Bbrpa bahan kimia mempengaruhi sistem immune, Nervous, dan Endocrine Some natural and synthetic chemicals in the environment can weaken and harm –Sistem Kekebalan –Sistem Syaraf –Sistem Hormonal Sumber: Environmental Hazard and Human Health. …………. 15/12/2012

26 Hormonally active agents (HAAs) – Gender benders –Pengganggua kelenjar Thyroid – Bahan kimia Toksik Phthlates Efek pada sistem hormonal system Kanker Sumber: Environmental Hazard and Human Health. …………. 15/12/2012 Bbrpa bahan kimia mempengaruhi sistem immune, Nervous, dan Endocrine

27 EFEK TOKSIK AKIBAT MERKURI Hg: teratogen and potent neurotoxin –Once airborne, persistent and not degradable –1/3 from natural sources –2/3 from human activities –Enters the food chain: biomagnification Sumber: Environmental Hazard and Human Health. …………. /chapter_...diundu h 15/12/2012 /chapter_...diundu h Biomagnification, also known as bioamplification or biological magnification, is the increase in concentration of a substance that occurs in a food chain as a consequence of: 1.Persistence (can't be broken down by environmental processes) 2.Food chain energetics 3.Low (or nonexistent) rate of internal degradation/excretion of the substance (often due to water- insolubility)

28 2007: Hg hotspots identified How are humans exposed? –Inhalation: vaporized Hg or particulates of inorganic salts –Eating fish with high levels of methylmercury Effects of Hg on humans Who is most at risk? Sumber: Environmental Hazard and Human Health. …………. 15/12/2012 EFEK TOKSIK AKIBAT MERKURI

29 Siklus merkuri dalam lingkungan akuatik Sumber: Environmental Hazard and Human Health. …………. 15/12/2012

30 Fig. 17-B, p. 451 SOLUTIO NS Pencemaran Merkuri PreventionControl Phase out waste incineration Sharply reduce mercury emissions from coal-burning plants and incinerators Remove mercury from coal before it is burned Tax each unit of mercury emitted by coal-burning plants and incinerators Switch from coal to natural gas and renewable energy resources such as wind, solar cells, and hydrogen Require labels on all products containing mercury Convert coal to liquid or gaseous fuel Phase out use of mercury in batteries, TVs, compact fluorescent lightbulbs, and all other products unless they are recycled Collect and recycle mercury-containing electric switches, relays, and dry-cell batteries Sumber: Environmental Hazard and Human Health. …………. 15/12/2012 PENYELESAIAN PENCEMARAN MERKURI Pencega han Kontrol

31 Bisphenol A Menyerupai Estrogen Found in many common products Laboratory findings Effects on human health Should it be banned? Sumber: Environmental Hazard and Human Health. …………. ronmental.../chapter_... diunduh 15/12/2012 ronmental.../chapter_... diunduh Diunduh dari: a.org/pdf/BPAsafe.pdf

32 Bagaimana Evaluasi dan Menangani Bahaya Kimia ? Scientists use live laboratory animals, non- animal tests, case reports of poisonings, and epidemiological studies to estimate the toxicity of chemicals, but these methods have limitations. Many health scientists call for much greater emphasis on pollution prevention to reduce our exposure to potentially harmful candidates. Sumber: Environmental Hazard and Human Health. …………. 15/12/2012

33 EFEK BERBAHAYA DARI BAHAN KIMIA Toxicology Toksisitas tergantung pada: –Dose –Age –Genetic makeup –Multiple chemical sensitivity (MCS) –Kelarutan dan persistensi bahan kimia –Biomagnifikasi Sumber: Environmental Hazard and Human Health. …………. ronmental.../chapter_... diunduh 15/12/2012 ronmental.../chapter_... diunduh Diunduh dari:

34 KECELAKAAN KIMIA Sumber: 15/12/2012_...diunduh “Chemical accident" means an accident involving a fortuitous, or sudden or unintended occurrence while handling any hazardous chemicals resulting in continuous, intermittent or repeated exposure to death, or injury to, any person or damage to any property but does not include an accident by reason only of war or radio-activity

35 Estimasi Paparan Manusia thd bahan kimia dan mengukur efeknya Sumber: Environmental Hazard and Human Health. …………. 15/12/2012 Pengukura n & Pemodela n Ilmiah Ramalan kandungan toksik dalam manusia Metabolisme Akumulasi Ekskresi

36 Studi Kasus: Melindungi anak-anak dari bahan kimia toksik Analysis of umbilical cord blood: significance Infants and children more susceptible to the toxic effects of chemicals than adults –Eat, drink water, and breathe more per unit of body weight than adults –Put their fingers in their mouths –Less well-developed immune systems and body detoxification processes Sumber: Environmental Hazard and Human Health. …………. 15/12/2012

37 Estimasi toksisitas: Hewan uji di Lab dan Uji non-hewan Dose-response curve: median lethal dose (LD50) –Nonthreshold dose-response model –Threshold dose-response model Can the data be extrapolated to humans? Sumber: Environmental Hazard and Human Health. …………. 15/12/2012

38 More humane methods using animals Replace animals with other models –Computer simulations –Tissue culture and individual animal cells –Chicken egg membranes What are the effects of mixtures of potentially toxic chemicals? Sumber: Environmental Hazard and Human Health. …………. 15/12/2012 Estimasi toksisitas: Hewan uji di Lab dan Uji non-hewan

39 Kurva Hipotetis Dose-Response untuk menentukan LD50 Sumber: Environmental Hazard and Human Health. …………. 15/12/2012

40 Tingkat Toksisitas dan Rataan LD untuk manusia Sumber: Environmental Hazard and Human Health. …………. 15/12/2012

41 Fig , p. 456 Nonlinear dose- response Linear dose- response Effect Threshold level Dose No thresholdThreshold Sumber: Environmental Hazard and Human Health. …………. 15/12/2012 KURVA RESPON DOSIS

42 ESTIMASI EFEK BERBAHAYA BAHAN KIMIA Case reports and epidemiological studies Limitations of epidemiological studies –Too few people tested –Length of time –Can you link the result with the chemical? –Can not be used for new hazards Sumber: Environmental Hazard and Human Health. …………. 15/12/2012

43 APA BAHAYA DOSIS RENDAH DARI BAHAN TOKSIK? Sumber: 15/12/2012_...diunduh Acute-based Predicted No-effect Concentrations (PNEC acute ), as well as two existing EQSs for the pesticides chlorpyrifos and chlorfenvinphos compared to a correlation of observed effects on community structure of aquatic macroinvertebrate communities, expressed as SPEAR index (SPEAR[%]) and a measure of toxic stress, calculated as Toxic Units (TU) for the most toxic compound (based on data from von der Ohe et al., 2009).von der Ohe et al., 2009 The two red dots represent sites at which chlorfenvinphos was responsible for the TU max.

44 BAHAN KIMIA BERBAHAYA DI RUMAH Sumber: Environmental Hazard and Human Health. …………. 15/12/2012

45 Vinyl toys contain phthalat es Imported fruit may contain pesticides banned in the U.S. Fig , p. 458 Shampoo Teddy bear Clothing Baby bottle Nail polish Perfluorochemica ls and phthalates Some stuffed animals made overseas contain flame retardants and/or pesticides Perfluorochemic als to add shine Can contain perfluorochemic als Can contain bisphenol -A Mattress Perfume Flame retardants in stuffing Phthalates Hairspray Carpet Phthalates Padding and carpet fibers contain flame retardants, perfluorochemic als, and pesticides Food Some food contains bisphenol-A TV Milk Wiring and plastic casing contain flame retardants Fat contains dioxins and flame retardants Sofa Frying pan Foam padding contains flame retardants and perfluorochemic als Nonstick coating contains perfluorochemic als Tile floor Fruit Water bottle Computer Toys Tennis shoes Contains perfluorochemic als, phthalates, and pesticides Can contain bisphenol- A Flame retardant coatings of plastic casing and wiring Can contain phthalate s Sumber: Environmental Hazard and Human Health. …………. 15/12/2012

46 EFEK BERBAHAYA DARI BAHAN KIMIA Severe limitations estimating toxicity levels and risks Acceptable levels vary between 1/100 and 1/1000 of the estimated harmful levels Sumber: Environmental Hazard and Human Health. …………. 15/12/2012 Diagram illustrating dose response curve for Chemical A Diunduh dari: …

47 PENCEGAHAN Polusi & Prinsip Ke-hati- hatian Those introducing a new chemical or new technology would have to follow new strategies –A new product is considered harmful until it can be proved to be safe –Existing chemicals and technologies that appear to cause significant harm must be removed Sumber: Environmental Hazard and Human Health. …………. 15/12/2012 Dose-Effect and Dose-Response Since the basic question in toxicology is how dose is related to toxicity, most toxicology studies are designed to investigate how living creatures react as doses vary incrementally, from low to high levels. Diunduh dari:

48 Individuals Matter: Ray Turner and His Refrigerator 1974: Ozone layer being depleted by chlorofluorocarbons (CFCs) 1992: International agreement to phase out CFCs and other ozone-destroying chemicals Ray Turner: citrus-based solvents to clean circuit boards Sumber: Environmental Hazard and Human Health. …………. 15/12/2012 The cycle of the ozone depletion and how its shown to be depleted. Diunduh dari: depletion/

49 Risiko dan Menghindari Bahayanya We can reduce the major risks we face if we become informed, think critically about risks, and make careful choices. Sumber: Environmental Hazard and Human Health. …………. Environmental.../ch apter_...diunduh 15/12/2012 Environmental.../ch apter_...diunduh The relationship between risk assessment and selection of controls Sumber: diunduh 17/12/2012http://security.practitioner.com/introduction/infosec_5_5.htmdiunduh

50 Risiko kesehatan datang-dari Kemiskinan, Gender dan Gaya-hidup Analisis Risiko Risiko Kesehatan “terbesar”: –Kemiskinan –Gender –Pilihan Gaya Hidup Sumber: 17/12/2012_...diunduh Analyzing Health Problems for Risk Factors

51 BAHAYA AKIBAT MEROKOK Most preventable major cause of suffering and premature death Nikotin: bahan adetif (tambahan) Efek merokok pasif (secondhand smoke) Sumber: Environmental Hazard and Human Health. …………. Environmental.../ch apter_...diunduh 15/12/2012 Environmental.../ch apter_...diunduh Secondhand smoke is a complex mixture of gases and particulates containing as many as 4800 chemicals including formaldehyde, carbon monoxide, nicotine, carcinogenic tars and others. Of the chemicals identified in secondhand smoke, more than 50 have been found to cause cancer. Diunduh dari: spx

52 Bagaimana mengurangi merokok –Pajak –Ban –Klassifikasi dan Regulasi nikotin –Pendidikan Sumber: info.html_...diunduh 17/12/2012_...diunduh BAHAYA AKIBAT MEROKOK

53 Estimasi risiko dari teknologi Hal ini tidak mudah Sumber:. _...diunduh 15/12/2012 _...diunduh Technologies for Risk Assessment and Risk Management of Chemical Substances

54 Banyak orang tidak mengerti bagaimana Evaluasi Risiko? Fear Degree of control Whether a risk is catastrophic Optimism bias Unfair distribution of risks Sumber: Environmental Hazard and Human Health. …………. vironmental.../chapter _...diunduh 15/12/2012 vironmental.../chapter _...diunduh Diunduh dari: &script=sci_arttext ……. 17/12/2012http://www.scielo.br/scielo.php?pid=S &script=sci_arttext

55 Beberapa prinsip Evaluasi dan Reduksi Risiko Membandingkan Risiko Determine how much you are willing to accept Determine the actual risk involved Concentrate on evaluating and carefully making important lifestyle choices Sumber: Environmental Hazard and Human Health. …………. 15/12/2012


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