Hubungan antara tingkat paparan asap rokok dengan fungsi paru pada perokok pasif di Kabupaten Gunung Kidul Propinsi DIY

PAHIMAH, dr. Nawi Ng., MPH.,Ph.D

2007 | Tesis | S2 Ilmu Kesehatan Masyarakat (Epidemiologi Lapanga

Latar Belakang: Asap tembakau lingkungan (ETS) mengandung bahan karsinogenik dan iritan yang menyebabkan penyakit pada saluran pernapasan dan penurunan fungsi paru. Prevalensi perokok dalam rumah tangga di Kabupaten Gunungkidul 18,35% dengan kepadatan jiwa per rumah tangga sebesar 5 sehingga diperkirakan jumlah perokok pasif tinggi. Di California perokok pasif usia dewasa mengalami penurunan fungsi paru obstruktif sebesar 12%. Meskipun demikian penelitian paparan asap rokok dengan penurunan fungsi paru pada perokok pasif dewasa masih memberikan hasil kontradiksi. Tujuan: mengetahui prevalensi penurunan fungsi paru pada perokok pasif dan mengetahui hubungan antara tingkat paparan asap rokok dengan fungsi paru pada perokok pasif. Metode: Penelitian analitik observasional menggunakan rancangan cross sectional. Populasi penelitian adalah semua perokok pasif di Kabupaten Gunungkidul. Sampel adalah perokok pasif di atas usia sekolah (>18 tahun), dengan besar sampel 127 subjek. Pemilihan sampel menggunakan Multistage sampling dimana cluster kecamatan ditentukan dengan teknik proportional probability to size. Paparan asap rokok diukur menggunakan kuesioner dan fungsi paru diukur menggunakan spirometer oleh petugas kesehatan dari Balai Pengobatan Penyakit Paru-paru Yogyakarta. Hasil pengukuran fungsi paru diinterpretasi oleh dokter spesialis paru. Hasil: Dari 127 subjek ditemukan prevalensi gangguan restriksi sebesar 14,2% dan prevalensi gangguan obstruksi paru sebesar 15,7%. Pada analisis multivariat jam bulan terakhir paparan asap rokok di rumah berhubungan dengan gangguan obstruksi setelah mengendalikan kepadatan hunian rumah, jumlah perokok di rumah, tingkat paparan asap rokok, meskipun tidak bermakna secara statistik [OR 1,02; 95%CI 0,98-1,06]. Kesimpulan: Prevalensi ganguan obstruksi pada perokok pasif wanita ditemukan tidak berhubungan secara statistik dengan lama dan intensitas paparan asap rokok disebabkan penelitian ini mempunyai banyak kelemahan.

Background: Environmental Tobacco Smoke (ETS) contains carcinogenic and irritant substances which cause diseases of respiratory tract and decrease of lung function. Prevalence of smokers in the household of Gunungkidul District is 18.35% with population density per household as many as 5 people so that it is presumed that the number of passive smokers is high. In California 12% of adult passive smokers undergo decreasing obstructive lung function. However, research on cigarette smoke exposure and decrease of lung function among adult passive smokers bring contradictory results. Objective: To identify the prevalence of lung function decrease among passive smokers and relationship between cigarette smoke exposure and lung function among passive smokers. Method: This was an observational analytical study with cross sectional design. Population of the study were all passive smokers at District of Gunungkidul. Samples consisted of 127 passive smokers over 18 years old selected using multistage sampling whereby clusters of subdistrict were determined using proportional probability to size technique. Exposure to cigarette smoke was measured through questionnaire and lung function was measured using spirometer by health staff of Lung Disease Medication Clinic of Yogyakarta. The result of lung function measurement was interpreted by lung specialist. Result: The prevalence of lung restriction disorder was 14.2% and obstruction disorder was 15.7% out of as many as 127 subjects. In multivariable analysis, hours of latest months of having cigarette smoke exposure in the house were related to obstruction disorder after being controlled with house occupancy density, number of smokers in the house, exposure to cigarette smoke, but the relationship was statistically insignificant (OR 1.02; 95%CI 0.98-1.06). Conclusion: The prevalence of obstruction disorder among women passive smokers statistically did not have relationship with length and intensity of cigarette smoke exposure because the study had some weaknesses.

Kata Kunci : Fungsi Paru,Perokok Pasif, environmental tobacco smoke, lung function, adult women passive smokers