Tesis

Hubungan polusi udara terhadap gangguan fungsi respiratori pada remaja yang diukur dengan spirometri = Air pollution and respiratory dysfunction in adolescents that measured by spirometry.

Latar belakang: Polusi udara merupakan salah satu ancaman kesehatan (terutama kesehatan sistem respiratori) masyarakat dunia, termasuk remaja. Setiap tahun kualitas udara di Indonesia terus memburuk, puncaknya pada bulan Agustus tahun 2023 Jakarta sempat menjadi kota dengan polusi udara terburuk di dunia. Spirometri merupakan salah satu alat ukur untuk mengetahui gangguan aliran dan volume udara yang keluar masuk paru-paru. Hingga saat ini belum banyak penelitian di Indonesia mengenai dampak polusi udara terhadap uji fungsi ventilasi respiratori pada remaja yang bersekolah di area dengan polusi udara yang tinggi. Tujuan: Mengetahui karakteristik hasil uji spirometri pada remaja di Jakarta yang bersekolah pada area dengan pajanan polusi udara yang tinggi (terutama PM2.5) serta faktor-faktor yang berhubungan yaitu indeks massa tubuh (IMT), jenis kelamin, riwayat penyakit respiratori, karakteristik lingkungan rumah, pajanan rokok, lama pajanan polusi udara, opsi transportasi, jenis polutan (PM2.5), dan pengunaan masker. Metode: Dilakukan studi potong lintang terhadap remaja berusia 16-18 tahun yang bersekolah di SMAN DKI Jakarta yang terdampak pajanan polusi udara PM2.5 paling tinggi. Dilakukan pemeriksaan spirometri dan pengisian kuesioner. Pengukuran kadar PM2.5 saat hari pemeriksaan spirometri menggunakan alat particulate counter. Kriteria eksklusi antara lain memiliki kontraindikasi spirometri, sakit berat, atau domisili >5km dari sekolah. Hasil: Terdapat total 195 subjek yang menyelesaikan penelitian. Perokok aktif didapatkan sebanyak 45 subjek (23,1%). Sebanyak 26 subjek (13,3%) memiliki hasil spirometri abnormal, yaitu 8 subjek (4,1%) obstruksi, 16 subjek (8,2%) restriksi, dan 2 subjek (1%) campuran. Terdapat hubungan bermakna antara kadar PM2.5 yang diukur saat hari pemeriksaan terhadap hasil spirometri abnormal (p=0,005; PR 95%IK 2,755:1,358–5,590). Uji korelasi antara kadar PM2.5 dengan parameter spirometri menunjukkan nilai negatif yang berarti semakin meningkatnya kadar PM2.5 berhubungan dengan semakin turunnya nilai FEV1, FEV1/FVC, FEF25-75, dan PEF. Kesimpulan: Terdapat hubungan bermakna antara tingginya kadar polutan PM2.5 saat hari pemeriksaan terhadap hasil uji spirometri remaja. Tidak terbukti adanya hubungan antara IMT, jenis kelamin, riwayat penyakit, karakteristik lingkungan rumah, pajanan rokok aktif/pasif, lama pajanan polusi udara, opsi transportasi saat bepergian, dan penggunaan masker dengan hasil uji spirometri remaja.
Kata kunci: polusi udara, fungsi respiratori, remaja, spirometri, PM2.5


Background: Air pollution poses a significant health threat, particularly to the respiratory system, affecting populations worldwide, including adolescents. In Indonesia, air quality continues to deteriorate annually. Jakarta becoming the city with the world's worst air pollution in August 2023. Spirometry is a tool used to assess airflow and lung volume abnormalities. However, there is limited research in Indonesia regarding the impact of air pollution on ventilatory respiratory function tests among adolescents attending schools in highly polluted areas. Objective: This study aims to evaluate the characteristics of spirometry results in adolescents in Jakarta exposed to high air pollution levels (primarily PM2.5) and examine related factors, including body mass index (BMI), sex, history of respiratory diseases, household environment, exposure to smoking, duration of air pollution exposure, transportation options, pollutant type (PM2.5), and mask usage. Methods: A cross-sectional study was conducted on adolescents aged 16–18 years attending high schools in Jakarta exposed to the highest levels of PM2.5 pollution. Spirometry tests and questionnaires were administered, and PM2.5 levels were measured on the examination day using portable particulate counter. Exclusion criteria included contraindications for spirometry, severe illness, or residence >5 km from the school. Results: A total of 195 subjects completed the study, with 45 active smokers (23.1%) identified. Abnormal spirometry results were found in 26 subjects (13.3%), including 8 subjects (4.1%) with obstruction, 16 subjects (8.2%) with restriction, and 2 subjects (1%) with mixed patterns. A significant association was observed between PM2.5 levels measured on the examination day and abnormal spirometry results (p=0.005; PR 95%CI 2.755:1.358–5.590). Correlation analysis between PM2.5 level and spirometry parameters showed a negative relationship, indicating that higher PM2.5 levels were associated with decreased FEV1, FEV1/FVC, FEF25-75, and PEF values. Conclusion: A significant relationship was found between elevated PM2.5 levels on the examination day and abnormal spirometry results in adolescents. However, no significant associations were observed between BMI, sex, medical history, household environment, active/passive smoking exposure, duration of air pollution exposure, transportation options, or mask usage and spirometry outcomes in adolescents.
Keywords: air pollution, respiratory function, adolescents, spirometry, PM2.5