Tesis

Hubungan kebiasaan merokok dan viskositas darah dengan hipoksia pada awak dan nonawak pesawat = Relationship between smoking habits and blood viscosity with hypoxia in aircrew and non-aircrew.

Latar belakang: Dampak hipoksia penerbangan, bergantung tempat dan lama di ketinggian, telah dialami saat ketinggian 5000 kaki, mulai dari yang ringan sampai berat. Waktu Sadar Efektif (WSE) adalah rentang waktu seseorang mampu melakukan tindakan korektif pada kondisi sadar sebelum mengalami inkapasitasi. Tujuan penelitian ini untuk mengetahui hubungan kebiasaan merokok dan viskositas darah serta faktor usia dan massa tubuh terhadap risiko hipoksia pada awak dan nonawak pesawat di simulasi Ruang Udara Bertekanan Rendah (RUBR). Metode: Para awak pesawat (pilot, navigator, Juru Mesin Udara, Load Master), dan nonawak pesawat (perawat udara dan calon pilot) yang telah melaksanakan pemeriksaan kesehatan umum, laboratorium, foto thorax, dan kesamaptaan jasmani, menjalani simulasi pengenalan hipoksia di RUBR Lakespra Saryanto. Penelitian ini menggunakan desain potong lintang dengan purposive sampling, uji regresi logistik berganda, untuk menganalisis faktor-faktor dominan yang mempengaruhi WSE. Hasil: 79 subyek (46 awak pesawat dan 33 nonawak pesawat) dari 87 subyek yang bersedia berpartisipasi, 8 drop out karena mengalami ear block/sinus block saat simulasi. Persentase awak dan nonawak pesawat yang mengalami WSE memendek sebanyak 32,9%. Faktor kebiasaan merokok kategori sedang (indeks brinkman) cenderung meningkatkan risiko hipoksia [ORa=3,08; IK 95%=0,55-17,21; p=0,201]. Kadar hematokrit tinggi cenderung mengurangi risiko hipoksia[ORa=0,21; IK 95%=0,04-1,13; p=0,070] namun keduanya bukan merupakan faktor dominan yang mempengaruhi risiko hipoksia. Kategori usia >40 tahun [OR=0,57; IK 95%=0,10-3,23; p=0,694] dan usia 30-39 tahun [OR=0,74; IK 95%=0,28-2,01; p=0,561] serta massa tubuh [OR=0,89; IK 95%=0,32-2,48; p=0,821] tidak terbukti meningkatkan risiko terjadinya hipoksia. Kesimpulan: Kebiasaan merokok kategori sedang cenderung meningkatkan risiko hipoksia. Viskositas darah cenderung mengurangi risiko hipoksia, sedangkan usia dan massa tubuh tidak mempengaruhi terjadinya hipoksia
Kata kunci: merokok; viskositas darah; waktu sadar efektif; hipoksia.


Background: The impact of flight hypoxia, ranging from mild to severe, depends on place as well as duration in altitude and will be experienced at 5000 feet. Time of Useful Consciousness (TUC) is the span of time a person is able to perform corrective actions on the conscious state before experiencing incapacitation. The purpose of this research is to know the relationship between smoking habit and blood viscosity, body mass and age as factors related to risk of hypoxia in aircrew and non-aircrew through a simulation in Hypobaric Chamber. Methods: Aircrew (pilot, navigator, flight engineer, load master) and non-aircrew (flight nurse and prospective aviator) who had undergone general medical and laboratory examinations, chest x-ray and physical fitness test, underwent a simulated hypoxia introduction in Hypobaric Chamber at Lakespra Saryanto. This study used cross sectional design with purposive sampling and multiple logistic regression test to analyze the dominant factors which affects TUC. Results: A total of 79 subjects (46 aircrews and 33 non-aircrews) from 87 subjects were willing to participate, 8 dropped out due to ear block/sinus block during simulation. Percentage of aircrew and non-aircrew with TUC shortened by 32,9%. Moderate smoking habit (Brinkman Index) tends to increase the risk of hypoxia [Ora=3.08; CI 95%=0.55-17.21; p=0.201]. High hematocrit levels tend to reduce the risk of hypoxia [Ora=0.21; CI 95%=0.04-1.13; p=0.070] but they are not dominant factors that affect the risk of hypoxia. Age category >40 years [OR=0.57; CI 95%=0.10-3.23; p=0.694], age 30-39 years [OR=0.74; CI 95%=0.28-2.01; p=0.561] and body mass [OR=0.89; CI 95%=0.32-2.48; p=0.821] does not appear to increase the risk of hypoxia. Conclusion: Moderate smoking habit tends to increase the risk of hypoxia. Blood viscosity tends to reduce the risk of hypoxia, whereas age and body mass do not affect the occurance of hypoxia.
Keywords: smoking; blood viscosity; time of useful consciousness; hypoxia