K4.2013 Dermatitis Industri - 2 Dari golongan zat kimia organik dan anorganik Zat organik kebanyakan

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Text of K4.2013 Dermatitis Industri - 2 Dari golongan zat kimia organik dan anorganik Zat organik kebanyakan

10/16/2013

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Digunakan untuk kelainan pada kulit akibat eksposur terhadap iritan di lingkungan kerja

Efek dapat berupa kemerahan saja sampai pada gatal, kulit melepuh, terbakar dan tumor

Kulit merupakan organ terbesar dari tubuh, dengan p g gfungsi: daya tahan pertama thd iritan, bakteri, fungi, dll. menerima sensasi panas, dingin, tekstur, dll. mengatur temperatur tubuh: menguapkan gas,

uap, sekresi minyak, asam pelindung, membuat pigmen thd matahari

luasnya: 2 m2, tebal dari 0,5mm sampai 3-4 mm

Zat kimia

Tenaga mekanis

Zat fisis

Racun tumbuhan

Zat biologis

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Dari golongan zat kimia organik dan anorganik Zat organik kebanyakan merupakan sensitizers Zat anorganik kebanyakan merupakan primary iritan

Kontak langsung dengan kulit Oral

immersing hands (sometimes legs) into chemicals

direct handling of contaminated workpieces

contact with contaminated surfaces (eg workbench, tools, clothing and containers)

splashing (eg when liquid or powdery chemicals are mixed or handled

in deposits in the air (eg cement dust)

Iritan primer

Penyumbat pori

Sensitiser

Menyebabkan dermatitis karena kontak langsung dermatitis kontak

80% dari kasus di industri Contoh:

HNO3, H2SO4, NaOH: cepat membakar kulit Deterjen sabun kuat pelarut sedang: iritasi ringan Deterjen, sabun kuat, pelarut sedang : iritasi ringan,

eksposur berulang iritasi berat karet, plastik, lem, resin (terutama epoxy resin),

pelumas: melekat pada kulit menyebabkan iritasi primer atau sensitisasi selain melekat, mengeras pada kulit kulit jadi peka terhadap iritan/radang

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Berupa minyak, wax black heads/acne yang disebut dermatitis kulit

Sering terbawa pakaian kerja dan terbawa ke rumah dapat mengena keluarga pekerja

Zat kimia yang menyebabkan kelainan kulit seperti alergi timbul setelah beberapa kali eksposur reaksi delayed dan multiple

Disebut dermatitis sensitisasi Sekali orang tersensitisasi eksposur sedikit juga

sudah menyebabkan efek parah dan kelainan dapatsudah menyebabkan efek parah dan kelainan dapat menjalar ke seluruh tubuh orang tidak dapat bekerja di tempat yang sama

Contoh: epoxy resin hardener, pewarna azo, derivat coal tar, pollen, antibiotik, dll.

Zat kimia yang menstimulir sel kulit tumbuh berlebih: epitelioma, papilioma, polip, dan kanker coal tar dan minyak mentah

Iritasi

Skin Sensitizer

Kanker

Friksi, tekanan kulit melepuh Sumbatan oleh glass wool dan rockwool Iritasi atau alergi gatal-gatal, terluka, melepuh

Melepuh

Kulit mengeras

Suhu ekstrim Sinar matahari, UV, IM, sinar-X, dll. Efek yang timbul: iritasi/sensitisasi, perubahan warna,

gatal, pedih, luka bakar, melepuh, dan kanker

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Tanaman beracun: poison ivy alergi

Bunga beracun Efek: kulit memerah dan

gatalgatal

Bakteri, jamur, parasit dan tungau Didapat di daerah pertanian, bakery,

sayur, dan buah-buahan

BEDAKAN DERMATITIS INDUSTRIAL DENGAN BUKAN INDUSTRIAL SEPERTI AKIBAT KOSMETIKA, OBAT, INSEKTISIDA, DLL.

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Deterjen dan pelarut keratin Desikator, zat higroskopis, anhidrida Protein precipitants Hidrolitik, elektrolitik PengoksidasiPengoksidasi Derivatif nitro yang toksik Keratogenik, neoplastik Agent biologis Alergi, protein anafilaktik Pereduksi

Deterjen dan pelarut keratin minyak alami kulit dan sel kulit larut kulit menjadi kering dan

mudah terinfeksi contoh:alkali,terpentin,alkohol,dan sabun

Desikator,zat higroskopis,anhidridag p

menyerap airdari kulit kulit kering dan panas contoh:SO2=,PO4=,H2SO4,dll.

Proteinprecipitants

menyebabkan koagulasi protein,kulit mengeras contoh:garam logam berat,HgCl,asam tanat,asam pikrik,fenol,UV,

formaldehid,dll.

Hidrolitik,elektrolitik bereaksidenganairdikulit,terjadiiritasi,panaskeluarselamareaksiberlangsung contoh:gasmustard,NH4NO3

Pengoksidasi Pengoksidasi bereaksidenganhidrogen Oterbebas oksidasi

contoh:FeCl2,H2O2,As,chromat,permanganat,ozon,danamonia

Derivatifnitroyangtoksik melarutkankulit

contoh:TNT,DNT,fenol,kresol,tetryl,asampikrat

Keratogenik,neoplastik selkulittumbuhberlebih kanker

As,tar,naftilamin,dll.

Agentbiologis mikroba,parasit infeksi

Alergi proteinanafilaktikAlergi,proteinanafilaktik reaksiantigenantibodidenganmembentukhistamin alergi

contoh:tepung,pollen,dll.

Pereduksi membentukhidrogenbebas reduksi

contoh:asamsalisilat,asamoksalat,hidrokarbonalifatik,fenol,naftol,hidrokarbonaromatik

sub-acute dermatitis from the rubber accelerator, mercaptoben zothiazole

contact dermatitis form exposure to the strong irritant, ethylene oxide

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Theskincontactwithanirritantresultsinitchyrashwithinminutestoanhour.

Theydisappearwithintwentyfourhours,usuallywithinafewhours.

Contacturticariaisalsoknownasnettlerashorhives.Itistypifiedbythewheal(swellings)andflareatthesiteofyp y ( g )contact.

Theaffectedpersonmaysufferfromitching,tinglingorburningsensations.

Thereareothertypesofurticaria.Thisincludesimmunesensitisedreactionandhappensinpeoplewhohavepreviouslybecomesensitisedtoacausativeagent(eglatexproteininrubbergloves).ThistypeofreactionisalsocalledACD.

Acne is an inflammatory disorder of the sebaceous glands. The skin eruptions from acne may be mild, involving exposed areas of the body, or severe covering of all the body.

Occupational acne includes oil acne, coal-tar acne, and chloracne.

Others types are related to cosmetics, heat/cold and mechanical forces.

Theincidenceofoilacnehasdeclinedinrecentyearsbecauseofdecreaseduseofneatcuttingoils.Betterperformingoilsandimprovedhealthandsafetystandardsintheworkplacehelpedthisdeclinefurther.

Theeruptionsresultingfromoilacnearecalledoilboils.Whentheexposureisprolonged,skincancer,suchascancerofthescrotum,maydevelop.

Oilacneamongstoilworkersisrarebecausetherearefeweropportunitiesforprolongedcontactwithcrudeoilortheheavieroilfractions.

Chloracne results from exposure to certain halogenated aromatic hydrocarbons (eg polychlorinated biphenyles (PCBc)).

Individual lesions of chloracne consist primarily of blackheads, whiteheads and cysts.

Choracne occurs mainly on exposed areas of the skin, but Choracne occurs mainly on exposed areas of the skin, but following regular exposure, lesions may appear in other regions especially the genital, groin and axillae areas of the body.

Chloracne usually begins several weeks or months after the exposure and new lesions may appear even when exposure stops, because there may still be traces of the contaminants in the follicular areas of the skin.

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Coal-tar acne is associated with coal tar-based products and may be aggravated by light/UV.

Skin and eyes are vulnerable and it will cause increased pigmentation as well as acne-related symptoms (eg skin eruptions blackheads)eruptions, blackheads).

Skin pigmentation disorders cause the skin to appear lighter or darker than normal.

Pigmentary disorders can be due to hazardous agents found in the workplace (eg: UV, X-rays), environment (eg Sun rays) or ones genetic makeup or reaction to medicines and food. A b f h i l d t k d i t i A number of chemicals used at work can cause depigmentaion

Hyperpigmentation by kerosene

Exposure to radiation can lead to skin cancer, most commonly this comes from exposure to the sun. Therefore outside workers are particularly at risk.

People who are exposed ionising and non-ionising radiationmay be susceptible to work related cancersmay be susceptible to work related cancers.

Some chemicals can cause cancer on the skin, others may contribute to cancers found in other parts of the body.

The use of unrefined mineral oils has in the past led to skin cancer affecting the exposed skin of the hands and forearms.

Oil-soaked clothing and oily rags kept in overalls caused scrotal cancer.

The use of refined oils together with changes in work practice and improved personal hygiene have reduced this risk.

Chemicals like Mobca is used in the manufacture of polyurethane products. It can get through the skin and may cause cancer in other parts of the body.

Penyebab zat kimia, konsentrasi pekat, temperatur

ekstrim tinggi, lama kontak dengan kulit Klasifikasi luka bakar: tingkat I (first degree burn): merah panas tingkat I (first degree burn): merah, panas,

gatal, sakit, rasa terbakar tingkat II (second degree burn): sangat sakit,

melepuh, merah, basah (terbakar lebih dalam) mudah kena infeksi

tingkat III (third degree burn): kulit dan karingan bawah kulit habis terbakar

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Burn degree

1

2

3

agriculture/horticulture; catering and food processing; chemicals; cleaning; construction;

i i engineering; hairdressing/beauty care; health care; offshore; printing; rubber.

AGENT/IRITANT

1'RY

IRRITANT

SENSITIZER

MANIFESTATIONS OF IRRITATING ACTION ON THE SKIN TYPICAL OCCUPATION

ACIDS

acetic X Dermatitis & ulcersmanufacturing acetat rayon, printing, dying, hat makers

nitric X Severe skin burn & ulcers

nitric acid worker, ekectroplaters, metal refineries, acid dippers, nitrators, soda makers

sulfuric Xcorrosiv