Dampak Pajanan Aluminium Terhadap Kerusakan Oksidatif DNA dan Gangguan Kognitif pada Pekerja Industri Pengecoran Aluminium Informal di Kota Yogyakarta

NELMI SILVIA, Prof. Dr. dr. KRT. Adi Heru Husodo, M.Sc., D.Comm.Nut., DLSHTM, PKK; Dr.Med. dr. Indwiani Astuti

2022 | Disertasi | DOKTOR ILMU KEDOKTERAN DAN KESEHATAN

Latar Belakang : Pekerja industri pengecoran aluminium informal berpotensi untuk terpajan debu atau uap aluminium. Aluminium yang masuk secara inhalasi berpotensi menimbulkan gangguan kesehatan pada pekerja. Walaupun sejumlah studi menunjukkan terdapat hubungan antara pajanan aluminium di tempat kerja dengan gangguan kognitif, namun studi pada pekerja industri pengecoran aluminium informal masih sangat terbatas. Mekanisme yang tepat dari neurotoksisitas aluminium masih belum jelas. Studi yang ada menunjukkan bahwa aktivitas prooksidan aluminium dapat menimbulkan stres oksidatif. Stres oksidatif berpotensi menimbulkan kerusakan oksidatif pada beberapa atau semua target molekul, termasuk deoxyribonucleic acid (DNA). Tujuan : Penelitian ini bertujuan untuk mengetahui hubungan antara pajanan aluminium dengan kerusakan oksidatif DNA dan ganguan kognitif pada pekerja industri pengecoran aluminium informal. Metode : Studi cross sectional dilakukan pada pekerja industri pengecoran aluminium informal di Kota Yogyakarta. Sebanyak 79 pekerja industri pengecoran aluminium informal berpartisipasi sebagai subjek penelitian. Aluminium urin dianalisis menggunakan Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). Pengukuran 8-hydroxy-2'-deoxyguanosine (8-OHdG) urin sebagai biomarker kerusakan oksidatif DNA menggunakan metode ELISA. Fungsi kognitif dinilai menggunakan Montreal Cognitive Assessment-Indonesian version (MoCA-Ina). Hasil : Sebanyak 55 pekerja (69,6%) mengalami gangguan kognitif. Terdapat hubungan antara kadar aluminium urin dengan kadar 8-OHdG urin yang bermakna secara statistik. Tidak ada hubungan antara kadar 8-OHdG urin dan gangguan kognitif. Analisis regresi logistik menunjukkan bahwa kadar aluminium urin (adjusted odds ratio (ORa) = 6,550; confidence interval (CI) 95% = 1,281-33,499) dan lama pendidikan (ORa =16,885; CI 95% = 2,042-139,604) berhubungan dengan gangguan kognitif yang bermakna secara statistik. Kesimpulan : Terdapat hubungan antara kadar aluminium urin dan lama pendidikan dengan gangguan kognitif. Untuk mencegah gangguan kognitif pada pekerja industri pengecoran aluminium informal perlu dilakukan biomonitoring kadar aluminium urin pekerja secara teratur dan pengendalian bahaya aluminium secara adekuat.

Background : Informal aluminium foundry industry workers have potential risk to be exposed to aluminium dust and fume. Inhaled aluminium can potentially cause health problems for workers. Although a number of studies have shown an association between aluminium exposure in the workplace and cognitive impairment, studies on informal aluminium foundry workers are still very limited. The exact mechanism of aluminium neurotoxicity remains unclear. Existing studies show that the pro-oxidant activity of aluminium can cause oxidative stress. Oxidative stress has the potential to cause oxidative damage to some or all of the target molecules, including deoxyribonucleic acid (DNA). Aim : This study aims to determine the relationship between aluminium exposure with DNA oxidative damage and cognitive impairment in informal aluminium foundry workers. Methods : A cross sectional study was conducted on workers of informal aluminium foundry industry in Yogyakarta City. A total of 79 informal aluminium foundry industry workers participated as research subjects. Urinary aluminium was analyzed using Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). Measurement of urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) as a biomarker of oxidative DNA damage was using ELISA method. Cognitive function was assessed using the Montreal Cognitive Assessment-Indonesian version (MoCA-Ina). Results : A total of 55 workers (69.6%) experienced cognitive impairment. There was a statistically significant relationship between urinary aluminium levels and urinary 8-OHdG levels. There was no association between urinary 8-OHdG levels and cognitive impairment. Logistic regression analysis showed that urinary aluminium levels (adjusted odds ratio (ORa) = 6.550; 95% confidence interval (CI) = 1.281-33.499) and length of education (ORa = 16.885; 95% CI = 2.042 - 139.604) were associated with cognitive impairment, which is statistically significant. Conclusion : There is a relationship between urinary aluminium levels and length of education with cognitive impairment. To prevent cognitive impairment in informal aluminium foundry industry workers, it is necessary to conduct regular biomonitoring of urinary aluminium levels of workers and adequate control of aluminium hazards.

Kata Kunci : aluminium, pengecoran, informal, gangguan kognitif, kerusakan oksidatif DNA