Tesis

Hubungan Penurunan Diameter Pupil Dengan Persentase Penurunan Aktivitas Asetilkolinesterase Plasma Sesudah Pajanan Organofosfat Pada Petani Penyemprot Padi Laki-Laki = The Association of Decreased of Pupillary Diameter With Percentage of Plasma Acetylcholine Esterase Activity Decrease After Organophosphate Exposure Among Male Pesticide-Spraying Rice Farmers.

Latar Belakang. Pajanan pestisida organofosfat terhadap mata dapat melalui pernafasan, pencernaan, absorbsi melalui kulit dan pajanan langsung pada mata. Efek toksik organofosfat akut yang utama pada mata adalah konstriksi pupil (miosis) melalui mekanisme menghambat aktivitas enzim kolinesterase di neuromuscular junction. Penelitian ini bertujuan untuk mengetahui hubungan penurunan diameter pupil dengan persentase penurunan aktivitas asetilkolinesterase plasma sesudah pajanan organofosfat pada petani penyemprot padi laki-laki. Metode. Penelitian ini menggunakan disain cross sectional dengan dua kali pengukuran sebelum dan sesudah penyemprotan pestisida di Desa X, Jawa Barat. Pengambilan sampel menggunakan metode cluster random sampling pada tingkat RT. Pengumpulan data dilakukan dengan wawancara menggunakan kuesioner, pemeriksaan fisis, pemriksaan darah dan pengamatan cara kerja. Pemeriksaan diameter pupil dan AChE plasma dilakukan sebelum dan sesudah penyemprotan. Hasil. Dari 72 responden penelitian sebesar 64 responden (88,89%) mengalami penurunan diameter pupil baik secara unilateral maupun bilateral sesudah melakukan penyemprotan pestisida organofosfat. Nilai median perubahan aktivitas AChE plasma adalah 2,2 % dengan nilai minimum -4,26% dan maksimum 9,75%. Penurunan diameter pupil dan penurunan aktivitas asetilkolinesterase plasma secara statistik bermakna (paired t-test; p < 0,001). Tidak ditemukan hubungan bermakna antara penurunan diameter pupil dengan persentase perubahan aktivitas asetilkolinesterase plasma (p = 0,052). Kesimpulan. Pada penelitian ini tidak ditemukan hubungan antara penurunan diameter pupil dengan persentase perubahan asetilkolinesterase plasma dan faktor resiko lainnya seperti usia, IMT, masa kerja dan lama waktu penyemprotan pestisida.
Kata kunci. Diameter pupil, asetilkolinesterase, petani, pestisida, organofosfat.


Background. Organophosphate (OP) pesticides exposure to the eye can be through respiration, digestion, absorption through the skin and directly the eyes. A major ocular manifestation of acute OP toxicity is pupil constriction (miosis) through a mechanism inhibiting the activity of the cholinesterase enzyme at the neuromuscular junction. This study aims to determine the association of pupillary diameter decrease with percentage of plasma acetylcholine esterase activity decrease after organophosphate exposure among male pesticides-spraying rice farmers. Method. The design of study is cross-sectional with two measurements pre- and postspraying at a village in West Java. Sample were selected by cluster random sampling method at the neighborhood level. Data were collected using face to face interviews, physical examination, blood examination and observation of working process. Acetylcholine esterase plasma and pupillary diameter examination was conducted before and after spraying. Results. From 72 subjects, 64 subjects (88.89%) had decreased pupil diameter either unilaterally or bilaterally after organophosphate (OP) pesticides exposure. The median of percentage plasma AChE activity decrease was 2.2% (-4.26 – 9.75). Decreased of pupil diameter and plasma AChE activity decrease after OP exposure were statistically significant (paired t-test; p < 0.001). There is no significant association between pupillary diameter decease with percentage of plasma AChE activity decrease (p = 0.052). Conclusion. The pupillary diameter decreases were not significantly associated with percentage of plasma AChE activity decrease and other risk factors (age, BMI, duration time as farmer and spraying duration time).
Keywords. Pupil diameter, acetylcholine esterase, farmers, pesticides, organophosphates.