Tesis

Efek Pajanan Asap Rokok Lingkungan terhadap Kadar Kotinin Urin dan Uji Fungsi Paru pada Anak = Effects of Enviromental Tobacco Smoke on Urinary Cotinine Level and Lung Function Test in Children.

Latar Belakang: Menurut Global Youth Tobacco Survey (GYTS) Indonesia 2014, 57,3% siswa terpajan asap rokok lingkungan. Pajanan asap rokok menyebabkan inflamasi saluran nafas dan paru, serta penurunan fungsi paru. Kotinin sebagai metabolisme nikotin dapat digunakan sebagai biomarker pajanan asap rokok. Tujuan: Mengetahui efek pajanan asap rokok lingkungan terhadap kadar kotinin urin dan uji fungsi paru pada anak. Metode: Penelitian teknik potong lintang dengan subyek siswa berusia 11-16 tahun di Jakarta. Data didapat dari kuesioner, spirometri, dan penghitungan kadar kotinin urin dengan metode ELISA. Hasil: Terdapat 92 subyek, terdiri dari 46 kelompok kasus dan 46 kelompok kontrol. Kadar kotinin urin >10 ng/ml ditemukan pada 37,0% kelompok kasus dan 4,3% kelompok kontrol; p=0,000; OR=8,50 (95% IK 2,08-34,71). Terdapat perbedaan bermakna kadar kotinin urin terhadap jumlah perokok (p=0,027) dan jumlah batang rokok per hari (p=0,037). Tidak ditemukan hubungan pajanan asap rokok dengan uji fungsi paru. Terdapat perbedaan bermakna absensi anak pada kelompok kasus dibandingkan kelompok kontrol; p=0,004; OR=6,00 (95% IK 1,42-25,33). Kesimpulan: Anak yang terpajan asap rokok memiliki kadar kotinin urin lebih tinggi dibandingkan yang tidak terpajan, yang dapat dipengaruhi oleh jumlah perokok dan jumlah batang rokok per hari.
Kata kunci: anak; pajanan asap rokok; kadar kotinin urin; uji fungsi paru


Background: Global Youth Tobacco Survey (GYTS) 2014 in Indonesia showed that 57,3% of students are exposed to enviromental tobacco smoke, which causes inflammation of respiratory tracts and decrease of lung function. Urinary cotinine can be used as biomarker for cigarette smoke exposure. Objectives: To examine effects of enviromental tobacco smoke on urinary cotinine level and lung function test in children. Methods: Subjects were students aged 11-16 years-old in Jakarta. Data were obtained from questionnaire, spirometry, and urinary cotinine test using ELISA method. Results: There were 92 subjects, consisted of 46 case group and 46 control group. Urinary cotinine level > 10 ng/ml was found in 37,0% of case group and 4,3% of control group; p=0,000; OR=8,50 (CI 95% 2,08-34,71). There were significant differences between urinary cotinine level with number of smokers (p=0,027) and number of cigarettes per day (p=0,037). No association was found between cigarette smoke exposure and lung function test. There was a significant difference in school abscence between case group and control group; p=0,004; OR=6,00 (CI 95% 1,4225,33). Conclusions: Children exposed to enviromental tobacco smoke have higher urinary cotinine level than non-exposed children. Factor such as number of smokers and number of cigarettes per day may affect urinary cotinine level.
Keywords: children; cigarette smoke exposure; urinary cotinine level; lung function test