Faktor resiko keracunan timbal dan gangguan kesehatan anak balita di Desa Lilang Kecamatan Kema Kabupaten Minahasa Utara Propinsi Sulawesi Utara

JOSEPH, Woodford Baren Solaiman, Prof. Dr. dr. Adi Heru Sutomo, M.Sc

2010 | Tesis | S2 Ilmu Kesehatan Kerja

Faktor resiko paparan timbal yang ada di Desa Lilang, berpotensi mengakibatkan keracunan timbal pada anak balita. Faktor resiko paparan timbal diantaranya adalah penggunaan pipa penyalur air bersih yang mengandung timbal, cat/vernis dinding rumah, asap rokok dan air susu ibu (ASI). Keracunan timbal akan mengakibatkan gangguan kesehatan pada anak balita. Tujuan penelitian ini adalah untuk mengetahui (1) apakah kadar timbal pada air pipa di Desa Lilang memenuhi syarat air bersih, (2) pengaruh faktor resiko terhadap kadar timbal urin, (3) hubungan kadar timbal urin dengan gangguan kesehatan pada anak balita di Desa Lilang. Penelitian ini menggunakan metode survei analitik dengan rancangan cross-sectional. Sampel air diambil pada sumber dan keran umum. Subyek penelitian adalah 43 orang anak balita yang berumur 12-59 bulan. Identitas anak balita, faktor resiko dan gejala gangguan kesehatan diperoleh menggunakan kuesioner. Kadar timbal air dan urin ditentukan dengan Atomic Absorption Spectrophotometer (AAS). Status gizi ditentukan menurut standar baku WHO-NCHS. Data dianalisis menggunakan uji Fisher dan regresi logistik dengan interval kepercayaan 95% dan taraf signifikansi p<0,05. Hasil penelitian menunjukkan bahwa rerata kadar timbal air pada sumber dan keran umum berturut-turut sebesar 0,0202 mg/l dan 0,0137 mg/l. Kadar timbal urin anak balita sebagian besar meningkat (83,7%). Ada pengaruh umur (OR=5,37; CI=0,59-49,22), sumber air minum (OR=6,00; CI=0,97-37,12), anggota keluarga perokok (OR=4,65; CI=0,79- 27,30) dan dinding rumah dicat/vernis (OR=3,13; CI=0,53-18,29) terhadap kadar timbal urin, walaupun secara statistik tidak signifikan (p>0,05). Ada hubungan kadar timbal urin dengan status gizi BB/U (OR=1,71; CI=0,18- 16,40), walaupun secara statistik tidak signifikan (p>0,05). Hasil regresi logistik menunjukkan bahwa pengaruh umur, sumber air minum, anggota keluarga perokok dan dinding rumah dicat/vernis terhadap kadar timbal urin secara statistik tidak signifikan (p>0,05). Kesimpulan dari penelitian ini adalah kadar timbal pada air pipa di Desa Lilang memenuhi syarat air bersih. Ada pengaruh umur, sumber air minum, anggota keluarga perokok dan dinding rumah dicat/vernis terhadap kadar timbal urin. Anak balita yang berumur 12-35 bulan, menggunakan air pipa desa sebagai sumber air minum, memiliki anggota keluarga perokok dan dinding rumahnya dicat/vernis, mempunyai kemungkinan berturut-turut sebesar 5,37; 6,00; 4,65 dan 3,13 kali lebih besar untuk mengalami peningkatan kadar timbal urin. Ada hubungan kadar timbal urin dengan status gizi BB/U. Anak balita yang mengalami peningkatan kadar timbal urin mempunyai kemungkinan 1,71 kali lebih besar untuk mengalami gizi kurang.

Background : Risk factors of lead exposure in Lilang village potentially result lead poisoning on children of under five years old. Exposure of risk factors such as using lead pipeline on water supply sistem, walls painted house/varnish, cigarette smoke and breast milk. Lead poisoning will cause health disorders on children of under five years old. Objective : This study aims to know (1) is the lead levels of tap water on Lilang village meet to health requirements, (2) the influence of some risk factors on urine lead levels, (3) the relationship between urine lead levels and health disorders on children of under five years old in Lilang village. Method : This was an analitical survey research with cross-sectional design. Water samples were taken at the source and public’s taps water. The subjects were 43 children of under five years old age of 12-59 months. Personal identity, risk factors and symptoms of health disorders obtained using a questionnaire. Water and urine lead levels were determined by Atomic Absorption Spectrophotometer (AAS). Nutritional status were determined according to WHO-NCHS standard. Data were analyzed using Fisher's exact test and logistic regressions with 95% confidence interval and p value of <0.05 was set as a significant level. Result : Mean of water lead level from the source and public’s taps water were 0.0202 mg/l and 0.0137 mg/l, respectively. Children urine lead levels was mostly increased (83.7%). There was an influence of age (OR=5.37; CI=0.59-49.22), source of drinking water (OR=6.00; CI=0.97-37.12), a family member of smokers (OR=4.65; CI=0.79-27.30) and walls painted house/varnish (OR=3.13; CI=0.53-18.29) on urine lead level, although not statistically significant (p>0.05). There was a relationship of urine lead levels and nutritional status based on weight-for-age (OR=1.71; CI=0.18-16.40), although not statistically significant (p>0.05). Results of logistic regression showed the influenced of age, source of drinking water, a family member of smokers and walls painted house/varnish on the urine lead levels were not statistically significant (p>0.05). Conclusion : Lead levels of tap water on Lilang village meet to health requirements. There was an influenced of age, source of drinking water, a family member of smokers and walls painted house/varnish on urine lead level. Children of 12-35 months old, user of village’s tap water as source of drinking water, has a family member of smokers and lived at house with walls painted/varnish have probability to get high lead levels of urine 5.37, 6.00, 4.65 and 3.13 times higher, respectively. There was a relationship of urine lead levels and nutritional status based on weight-for-age. Children of under five years old with high lead levels of urine have probability to get less of nutrition 1.71 times higher.

Kata Kunci : Faktor resiko, Timbal, Kesehatan, Air, Lingkungan