KORELASI KADAR PLUMBUM DALAM DARAH DENGAN GANGGUAN KOGNITIF PADA PETUGAS STASIUN PENGISIAN BAHAN BAKAR UMUM KOTAMADYA YOGYAKARTA

Noegroho Harbani, Prof. Dr. dr. Sri Sutarni, SpS(K)

2013 | Tesis | S2 Ked.Klinik/MS-PPDS

Pajanan Pb bersifat neurotoksik, paling peka adalah hipokampus.. Di plasma sel hipokampus, Pb mempengaruhi proses penyimpanan memori jangka pendek, di inti sel mempengaruhi proses penyimpanan memori jangka penjang. Konsentrasi rendah Pb dapat mengganggu homeostasis Ca intrasel dan pelepasan neurotransmitter baik di sistim saraf pusat maupun parifer, antara lain dopamine, asetilkolin, dan GABA. Asetilkoin di perifer mempengaruhi otot, di SSP berkaitan dengan proses memori dan kognisi. Tujuan penelitian ini adalah untuk mengetahui korelasi antara kadar Pb dalam darah dengan gangguan kognitif. Penelitian dengan rancangan cross sectional. Responden diambil secara pencuplikan purposive pada petugas Stasiun Pengisian Bahan Bakar untuk Umum (SPBU) Kotamadya Yogyakarta. Dilakukan pemeriksaan kadar Pb dalam darah dan gangguan kognitif dengan Mini-Mental State Examination (MMSE). Korelasi kadar Pb dalam darah dengan gangguan kognitif dianalisis secara statistik. Total sampel sebanyak 55 petugas. Rerata kadar Pb darah 8.6±9.7μg/dl. Didapatkan 9 petugas (16,3%) dengan kadar Pb lebih dari normal( >20μg/dl). Responden yang mengalami gangguan kognitif MMSE tidak normal 37 orang (67,3%), gangguan orientasi 22 orang (40%), registrasi 0 orang (0%), atensi 31 orang (56,4%), recall 27 orang (49,1%), bahasa 1 orang (1,8%) dan visuospasial 0 orang (0%). Hasil analisis korelasi spearman didapatkan korelasi negatif kadar Pb dalam darah dengan gangguan kognitif dengan kekuatan lemah (r=-0,301; p=0,025). Domain yang berkorelasi secara statistik orientasi, atensi dan recall (p<0.05). Disimpulkan bahwa terdapat korelasi negatif dengan kekuatan lemah antara kadar Pb dalam darah dengan gangguan kognitif.

Lead exposure is neurotoxic, especially to hypocampus. Lead is affecting retention of short-term memory in cell cytoplasm and storage of long-term memory in nucleus. Lead in low concentration impairs Ca homeostasis intracellular and neurotransmitter release both centrally and peripherally, such as dopamine, acetylcholine, and GABA. Acetylcholine peripherally influences muscle and related to memory process and cognitive in central nervous system. The aim of this study is to discover the correlation between blood lead level Pb and cognitive decline. This is a cross-sectional study. We examined blood lead level of SPBU workers randomly and we used Mini-Mental State Examination (MMSE) to measure cognitive decline. Correlation of blood lead level with cognitive decline was statistically analyzed. There were 55 total subjects, 9 (16.3%) subjects had high Pb level (>20 μg/dL) with mean blood Pb level 5.3 (0.07-34.24) μg/dL. 37 (67.3%) subjects had cognitive decline, divided into orientation 22 (40%) subjects, registration 0, attention 31 (56.4%) subjects, recall 27 (49.1%), language 1 (1.8%) and visuospatial 0. From Spearmann correlation analyzes, we found a weak negative correlation of blood Pb level with cognitive decline (r= -0.301; p= 0.025). Domain that correlated statistically were orientation, attention, and recall (p<0.05). Conclusion. There was a weak negative correlation between blood Pb level with cognitive decline.

Kata Kunci : Pajanan Pb, gangguan kognitif, Mini-Mental State Examination (MMSE)