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

KETAHANAN LINGKUNGAN:

KESEHATAN LINGKUNGAN

Disarikan oleh: soemarno, psl ppsub 2013

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: www.sawa2006.com/.../22%20-...... 15/12/2012

http://www.sawa2006.com/.../22%20-

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: www.sawa2006.com/.../22%20-...... 15/12/2012

http://www.sawa2006.com/.../22%20-

Kita menghadapi banyak macam bahaya

• Lima tipe-utama bahaya– Biologis: pathogens– Kimiawi– Fisika– Kultural– Pilihan Gaya hidup

Sumber: Environmental Hazard and Human Health. …………. www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

http://www.bergen.edu/.../Environmental.../chapter_...diunduh



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.





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. ………….

www.bergen.edu/.../Environmental

.../chapter_...diunduh 15/12/2012

http://www.rims.edu.in/HealthCareCDACKolgksaha/Zoom-%20Infectious%20Diseases%20-%20Ringworm-Jock%20Itch-Worms-Amebas-Malaria.html





• Sejak 1950, kematian akibat penyakit infeksi telah menurun, karena :– Perawatan kesehatan lebih baik– Antibiotika– Vaksin

• Disability-adjusted life years (DALYs)


Bbrp penyakit dapat menular dari satu orang ke orang lainnya




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. ………….



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: http://linkinghub.elsevier.com/retrieve/pii/S2210909910000056?via=sd





JALUR PENYAKIT INFEKSI PADA MANUSIA





RESISTENSI GENETIK THD ANTIBIOTIK

• Bacteria: rapid reproduction, easily spread• Penggunaan antibiotika yg berlebihan• Penggunaan pesticida yang berlebihSumber: Environmental Hazard and Human Health. …………. www.bergen.edu/.../

Environmental.../chapter_...diunduh 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: http://www.beltina.org/health-dictionary/antibiotic-resistance.html _...diunduh 15/12/2012






• Methicillin-resistant Staphylococcus aureus (MRSA)– Resistant to most antibiotics– Symptoms of MRSA– How will it be controlled?

Sumber: Environmental Hazard and Human Health.

…………. www.bergen.edu/.../

Environmental.../chapter_...diunduh

15/12/2012

RESISTENSI GENETIK THD ANTIBIOTIK

Sumber: http://www.scq.ubc.ca/attack-of-the-superbugs-antibiotic-resistance/ _...diunduh 15/12/2012

Mechanisms of Antibiotic Resistance.






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





BEBERAPA PENYAKIT VIRUS SANGAT MEMATIKAN

• Influenza or flu virus– #1 Killer– Transmission

• HIV– #2 Killer– Antiviral drugs





• 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






• 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






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





Malaria— oleh NYAMUK PEMBAWA PARASIT

• Malaria– Caused by Plasmodium sp.

carried by Anopheles mosquitoes

– Penyebaran– Gejala-gejala– Siklus Malarial

• 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


Malaria— oleh NYAMUK PEMBAWA PARASIT




Mengurangi penyakit infeksi

• Good news– Vaccinations on the rise– Oral rehydration therapy

• Bad news– More money needed for medical

research in developing countries





SOLUTIONS

Infectious Diseases

Increase research on tropical diseases and vaccinesReduce povertyDecrease malnutritionImprove drinking water quality

Reduce unnecessary use of antibioticsEducate people to take all of an antibiotic prescriptionMengurangi penggunaan antibiotik

dalam budidaya unggas

Require careful hand washing by all medical personnel

Immunisasi anak-anak thd penyakit virus

Provide oral rehydration for diarrhea victimsConduct global campaign to reduce HIV/AIDS


Solusi: Penyakit Infeksi, Cara-cara untuk mencegah atau mereduksi kejadiannya

Memperbaiki kualitas air minum





MENGHADAPI BAHAN KIMIA BERBAHAYA

Managing the risks of toxic substances is an ongoing, integrated process

Sumber: http://www.oag-bvg.gc.ca/internet/English/parl_cesd_200911_02_e_33197.html

_...diunduh 15/12/2012


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...diunduh

….. 15/12/2012


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





Potential Pathways on Which Toxic Chemicals Move Through the Environment





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





• Hormonally active agents (HAAs) – Gender benders– Pengganggua kelenjar Thyroid– Bahan kimia Toksik

• Phthlates • Efek pada sistem hormonal system• Kanker


Bbrpa bahan kimia mempengaruhi sistem immune, Nervous, dan Endocrine




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


Hazard and Human Health.



15/12/2012

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 energetics3. Low (or nonexistent)

rate of internal degradation/excretion of the substance (often due to water-insolubility)

http://flyfishingconsultant.blogspot.com/2010/07/i-do-not-eat-fish-why-is-that.html






http://bp3.blogger.com/_JaDVFdQMdwc/R5eREcDJypI/AAAAAAAAFeU/Z9htnzGiZ3Y/s1600/accumulation.gif

• 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?


EFEK TOKSIK AKIBAT MERKURI




Siklus merkuri dalam lingkungan akuatik





Fig. 17-B, p. 451

SOLUTIONS

Pencemaran Merkuri

Prevention Control

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


PENYELESAIAN PENCEMARAN MERKURI

Pencegahan

Kontrol




Bisphenol A

• Menyerupai Estrogen

• Found in many common products

• Laboratory findings

• Effects on human health

• Should it be banned?




Diunduh dari: http://www.bisphenol-a.org/pdf/BPAsafe.pdf





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.





EFEK BERBAHAYA DARI BAHAN KIMIA

• Toxicology• Toksisitas tergantung pada:

– Dose – Age– Genetic makeup – Multiple chemical sensitivity (MCS) – Kelarutan dan persistensi bahan kimia– Biomagnifikasi




Diunduh dari: http://www.sciencedirect.com/science/article/pii/S0014579308001166





http://www.sciencedirect.com/science/article/pii/S0014579308001166

KECELAKAAN KIMIA

Sumber: http://www.hrdp-idrm.in/e5783/e17327/e27015/e27708/_...diunduh 15/12/2012

“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


Estimasi Paparan Manusia thd bahan kimia dan mengukur efeknya


Pengukuran &

Pemodelan Ilmiah

Ramalan kandungan toksik

dalam manusia

MetabolismeAkumulasiEkskresi




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





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?






• 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?


Estimasi toksisitas: Hewan uji di Lab dan Uji non-hewan




Kurva Hipotetis Dose-Response untuk menentukan LD50





Tingkat Toksisitas dan Rataan LD untuk manusia





Fig. 17-15, p. 456

Nonlinear dose-response

Linear dose- response

Eff

ect

Eff

ect

Threshold level

Dose Dose

No threshold Threshold


KURVA RESPON DOSIS




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






APA BAHAYA DOSIS RENDAH DARI BAHAN TOKSIK?

Sumber: http://www.sciencedirect.com/science/article/pii/S0048969711001136_...diunduh 15/12/2012

Acute-based Predicted No-effect Concentrations (PNECacute), 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).

The two red dots represent sites at which chlorfenvinphos was responsible for the TUmax.








BAHAN KIMIA BERBAHAYA DI RUMAH





Vinyl toys contain phthalates

Imported fruit may contain pesticides banned in the U.S.

Fig. 17-16, p. 458

Shampoo Teddy bear Clothing Baby bottle

Nail polish

Perfluorochemicals and phthalates

Some stuffed animals made overseas contain flame retardants and/or pesticides

Perfluorochemicals to add shine

Can contain perfluorochemicals

Can contain bisphenol-A

Mattress

Perfume

Flame retardants in stuffing

Phthalates

Hairspray

Carpet

Phthalates

Padding and carpet fibers contain flame retardants, perfluorochemicals, and pesticides

Food

Some food contains bisphenol-A

TV

MilkWiring and plastic casing contain flame retardantsFat contains

dioxins and flame retardants

Sofa

Frying pan Foam padding contains flame retardants and perfluorochemicals

Nonstick coating contains perfluorochemicals

Tile floorFruit Water bottle Computer Toys Tennis

shoes

Contains perfluorochemicals, phthalates, and pesticides

Can contain bisphenol-A

Flame retardant coatings of plastic casing and wiring

Can contain phthalates





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


Diagram illustrating dose response curve for Chemical A

Diunduh dari: … http://www.stewardshipcommunity.com/?id=339




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 removedSumber: Environmental Hazard and Human Health. …………. www.bergen.edu/.../

Environmental.../chapter_...diunduh 15/12/2012

Dose-Effect and Dose-ResponseSince 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: http://toxlearn.nlm.nih.gov/htmlversion/module1.html




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


The cycle of the ozone depletion and how its shown to be depleted.

Diunduh dari: http://optioneenvirochemblog1.wordpress.com/2012/03/28/e4-ozone-depletion/




http://optioneenvirochemblog1.files.wordpress.com/2012/03/chemistry.gif

Risiko dan Menghindari Bahayanya

We can reduce the major risks we face if we become informed, think

critically about risks, and make careful choices.




.../chapter_...diunduh

15/12/2012

The relationship between risk assessment and selection of controls

Sumber: http://security.practitioner.com/introduction/infosec_5_5.htm ... diunduh 17/12/2012





http://security.practitioner.com/introduction/infosec_5_5.htm


Risiko kesehatan datang-dari Kemiskinan, Gender dan Gaya-hidup

• Analisis Risiko• Risiko Kesehatan “terbesar”:

– Kemiskinan– Gender– Pilihan Gaya Hidup

Sumber: http://www.uic.edu/sph/prepare/courses/ph420/resources/pt2analysis.htm_...diunduh 17/12/2012

Analyzing Health Problems for Risk Factors


BAHAYA AKIBAT MEROKOK

• Most preventable major cause of suffering and premature death

• Nikotin: bahan adetif (tambahan)• Efek merokok pasif (secondhand

smoke)



www.bergen.edu/.../Environmental.../chapter_...

diunduh 15/12/2012

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: http://www.whatyoudomatters.org/Substance_Abuse/Tobacco/Secondhand_Smoke.

aspx





• Bagaimana mengurangi merokok– Pajak– Ban– Klassifikasi dan Regulasi nikotin– Pendidikan

Sumber: http://ginfomation.blogspot.com/2008/09/smohing-hazards-danger-info.html_...diunduh 17/12/2012

BAHAYA AKIBAT MEROKOK


Estimasi risiko dari teknologi Hal ini tidak mudah

Sumber:. http://www.aist.go.jp/NIRE/eco_tec_e/hyouka_e.htm…………. _...diunduh 15/12/2012

Technologies for Risk Assessment and Risk Management of Chemical Substances


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.



15/12/2012

Diunduh dari: http://www.scielo.br/scielo.php?pid=S1517-83822000000100002&script=sci_arttext

……. 17/12/2012





http://www.scielo.br/scielo.php?pid=S1517-83822000000100002&script=sci_arttext

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





Documents

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