HUBUNGAN KADAR TIMBAL DALAM DARAH DENGAN GANGGUAN KOGNITIF REMAJA JALANAN DI DAERAH ISTIMEWA YOGYAKARTA (DIY)

CLARA VALENCIA OKKYWULANDARI, Prof. Dr. dr. Sri Sutarni, SpS (K)

2014 | Skripsi | PENDIDIKAN DOKTER

Latar Belakang: Pencemaran timbal merupakan masalah penting yang terjadi di negara berkembang. Pencemaran ini disebabkan karena pembuangan hasil pembakaran bermotor atau dapat juga ditemukan pada air minum dimana pipa berbahan dasar timah masih digunakan. Beberapa studi telah melaporkan bahwa timbal berefek negatif terhadap kesehatan seperti saraf pusat, saraf tepi, kecerdasan, sistem kardiovaskuler, sistem hematopoetik, ginjal, pencernaan dan sistem reproduksi. Keracunan akibat timbal terjadi pada 49% anak berusia kurang dari 6 tahun di Amerika Serikat. Paparan timbal pada awal kehidupan berpengaruh terhadap kecerdasan anak di mana 278 anak afrika amerika mengalami gangguan kognitif. Tujuan: Untuk mengetahui hubungan paparan timbal dari asap kendaraan bermotor dengan gangguan kognitif pada remaja jalanan di DIY. Metode: Penelitian ini merupakan penelitian cross-section. Sampel penelitian ini remaja jalanan, jenis kelamin lakilaki dan wanita, umur 17-24 tahun. Jumlah sampel seluruhnya adalah 55. Data diambil dari remaja jalanan di Yayasan Pinggir Jalan (Girlan) Nusantara di DI Yogyakarta. Diagnosis gangguan kognitif berdasarkan MMSE dan CDT. Beberapa variabel yang juga diteliti antara lain : umur, jenis kelamin, lama paparan, BMI, tekanan darah and lama pendidikan. Data dianalisis menggunakan analisis bivariat dan univariat untuk mengetahui hubungan diantara variabel-variabel yang diamati. Hasil: Dari 55 subyek remaja jalanan, didapatkan hasil uji korelasi kadar Pb dengan skor MMSE pada menunjukkan adanya korelasi lemah (r = 0,2 - <0,4) dengan arah positif dan bermakna (p < 0,05). Hasil uji korelasi kadar Pb dengan skor CDT pada menunjukkan adanya korelasi sangat lemah (r = 0,0 - <0,2) dengan arah positif dan tidak bermakna (p > 0,05). Kesimpulan: Kadar timbal remaja jalanan DIY tidak berhubungan secara bermakna dengan skor MMSE dan CDT. Variabel lain yang berhubungan dengan gangguan kognitif adalah penyalahgunaan narkoba, lama di jalanan, tekanan darah diastole dan lama pendidikan.

Background: Lead pollution is an important issue in developing countries. It is caused by the disposal of motor combustion products or drinking water where lead-based plumbing pipes are still in use. Several studies have reported that lead has negative effect on health, such as the central nervous system, peripheral nerves, intelligence, cardiovascular, hematopoietic system, kidney, digestive and reproductive systems. Lead poisoning occurs in 49% of children under 6 years old in the United States. Exposure to lead in early life affects children's intelligence in which 278 African American children are affected with cognitive impairment. Aim: To determine the relationship between lead exposure from motor vehicle fumes on the streets and cognitive impairment in adolescents in DIY. Methods: This study was a cross-sectional study. The samples for this study were street adolescents, both male and female, aged 17-24 years. The total sample were 55 people. Data was taken from “Yayasan Pinggir Jalan (Girlan) Nusantara” in D. I Yogykarta. Diagnosis of cognitive impairment was based on MMSE and CDT. Several other variables were also examined including : age, sex, duration of exposure, BMI, Blood Pressure and duration of education. Data were analyzed using univariate and bivariate analyzes to determine the relationship between the observed variables. Results: Of the 55 subjects, correlation test showed a statistically significant weak positive correlation between blood lead concentrations and MMSE scores (r = 0,2 - <0,4, p < 0,05). Correlation tests between blood lead concentration and CDT scores shows a a very weak positive correlation (r = 0,0 - <0,2) but is not stastically significant (p > 0,05). Conclusion: Lead levels on DIY street adolescents did not significantly affect MMSE and CDT scores. Another variable that influenced cognitive impairment is drug abuse, time spent on the streets, diastolic blood pressure, and duration of education.

Kata Kunci : gangguan kognitif, timbal, remaja jalanan