Disertasi

Faktor Risiko Terjadinya Patahan Kromosom Limfosit pada Pekerja dengan Pajanan Benzena Rendah. = Risk Factors of Lymphocyte Chromosome Breakage Among Workers Exposed to Low Level Benzene.

Latar Belakang: Penggunaan benzena dalam sektor industri sudah diketahui sejak lama, dan dari tahun ke tahun cenderung semakin meningkat. Pengendalian pajanan benzena di lingkungan kerja terus diupayakan, tetapi disadari bahwa benzene tersebut tidak dapat dihilangkan di alam ini. Oleh karena itu penelitian pada saat ini lebih dititik-beratkan pada efek pajanan benzena rendah di lingkungan kerja. Penelitian ini bertujuan mencari prevalensi patahan kromosom limfosit dan faktor-faktor yang berhubungan serta sebaran polimorfisme gen CYP4502E1. Metode: Disain studi yang digunakan adalah potong lintang. Penelitian dilakukan di industri migas T, bulan September 2007 - April 2010. Populasi adalah pekerja tetap bagian produksi dan kantor pusat dengan jumlah responden adalah 115 orang. Pengumpulan data di1akukan dengan wawancara, pemeriksaan fisik, pemeriksaan laboratorium dan pengamatan cara kerja di masing-masing temp at kerja. Hasil: Prevalensi patahan kromosom limfosit 62,61 %. Patahan kromosom limfosit terbanyak di nomor 3 dan 6. Faktor yang berhubungan dengan terjadinya patahan kromosom adalah asupan sumber antioksidan rendah (p=0,033; ORsuaian=3,09; IK95%=1,10-8,56), jenis pekerjaan (p=O,Ol; ORkasar= 3,32; IK95%=1,33-8,3) dan pajanan benzena kronik di temp at kerja (p=0,014; ORkasar=2,61; IK95%=1,2-5,67), serta perilaku dan manajemen (p=0,008; OR kasar=0,33; IK95% 0,15-0,76). Faktor pajanan selain benzena, pajanan benzena di luar temp at kerja, umur, riwayat pekerjaan, penambah risiko patahan kromosom, polimorfisme gen CYP4502E1 dan metabolit s-PMA tidak berhubungan bermakna dengan terjadinya patahan kromosom limfosit. gambaran ekspresi gen CYP4502E1 ditemukan tipe wild 87,8%, heterozygot 11,3% dan homozygot mutan 0,9%. Prediksi terjadinya patahan kromosom limfosit adalah 74,8% dari variabel asupan sumber antioksidan, perilaku dan manajemen, pajanan benzena kronik di tempat kerja serta variabellainnya. Kesimpulan dan Saran: Prevalensi patahan kromosom limfosit 62,61 %. Pajanan benzena kronik di tempat kerja, jenis pekerjaan, asupan sumber antioksidan berhubungan dengan patahan kromosom limfosit dan telah dibuat rumusan prediksi patahan kromosom limfosit dari variabel tersebut. Perlu adanya pengendalian- lingkungan agar kadar benzena serendah mungkin dan meningkatkan kebiasaan makanlminum sumber antioksidan minimal sesuai kebutuhan manusia setiap harinya.
Kata Kunci: patahan kromosom limfosit, pajanan benzena rendah, asupan sumber antioksidan.
Kata Kunci: patahan kromosom limfosit, pajanan benzena rendah, asupan sumber antioksidan.



Background: Many Oil and Gas Industries are producing benzene, even though exposure to the workers are limited to low levels compared to other industries. It is well known that benzene is a carcinogen. This study's objective is to know the prevalence- and risk factors of Lymphocyte Chromosome Breakage among workers who are exposed to low levels benzene at the workplace. Method: The design of this study was cross sectional. The study was conducted in a Gas and Oil Company from September 2007 to April 2010. The population of this study was all permanent workers from the production department and the head office. The sample size was 115. Data collection was conducted by interview, physical examination, laboratory exam and observation of work practices. Variables incuded in this study were level of benzene exposure from the workplace, age, workperiod, type of work, history of work, increasing risk factors, anti-oxidant consumption, behaviour and management, health status, levels of urine s-PMA, passive sampler, CYP4502E1, and other exposures. Results: The prevalence of lymphocyte chromosome breakage was 62.61%, almost in number 3 and 6. Type of work (p=0.010; Crude OR=3.32; 95% CJ.=1.33-8.30), low antioxidant consumption (p=O.033; Adjusted OR=3.07; 95% C.1.=1.10-8.56), work practices and management ((P=0.008; Crude OR=0.33; 95% CJ.= 0.16-0.76) and benzene exposure at the workplace (p=0.018; Crude OR=2.53; 95% CJ.=1.16-5.49) had significant relationships with lymphocyte chromosome breakage. While age, work history, lifestyle, CYP4502E1 polymorphism, s-PMA urine levels, other benzene exposure and other exposures, showed no significant relationship, The CYP4502E1 enzyme expressions are 87.8% homozygote wild type, 11.3% heterozygote and 0.9% homozygote mutant. A prediction model for lymphocyte chromosome breakage was developed, including 3 variables antioxidant consumption, behavior and management and benzene exposure in the workplace. Conclusion and Recommendation: The prevalence of lymphocyte chromosome breakage was 62.61%. Benzene exposure in the workplace, occupation, and antioxidant intake resources related to lymphocyte chromosome breakage ,Low Antioxidant consumption is an increasing risk factor. It is recommended that benzene exposure should be further controlled to minimal levels and consumption of antioxidants should be encouraged.
Keywords: lymphocyte chromosome breakage, low exposure benzene, antioxidant sources.