Analisa Dampak Gas Amoniak dan Klorin pada Faal Paru Pekerja Pabrik Sarung Tangan Karet "X" Medan

Abstract

Rubber gloves manufacturing process produces ammonia and chlorine gas. Ammonia gas arises as the result of adding high concentration of liquid ammonia (0.6 %) as an anticoagulant to latex and chlorine gas arises as the result of rubber gloves wash process using high concentration of chlorine (500-700 ppm). Inhaling Ammonia and chlorine gas with enough concentration and duration of exposure, will damage pulmonary function. There are fifteen workers in the Ammonia department, twenty eight workers in the Chlorine department for three work shifts that are working without respiratory protective devices, and four workers in the Management Representative department as control. The purpose of this cross sectional study is to analyze ammonia and chlorine gas effect on workers pulmonary function by giving a questionnaire to evaluate the respiratory symptoms, testing workers pulmonary function by using Spirometer, and measuring the level of ammonia gas in the Ammonia department, chlorine gas in the Chlorine department, and ammonia and chlorine gas in the MR room. The results showed that in the Ammonia department, the respondents reported having dry throat (80%), dry respiratory tract (73.3%), eye irritation (66.6%), nose irritation and cough (53.3%), and unconsciousness (6.67%). In the Chlorine department, the respondents reported having choked (92.85%), wet nose (96.24%), cough and chest pain (89.28%), dry throat, eye irritation, and breathing difficulty (85.71%), and unconsciousness (7.14%). All workers in the MR department did not report any respiratory symptoms. The chlorine gas and ammonia gas levels were below the threshold limit value, the ammonia levels in the Ammonia department were 1.7, 1.9, and 3.5 ppm, the chlorine levels in the Chlorine department were 0.0869 and 0.0697 ppm. These values can’t express the normal level, because by the time the research was done, the chlorine process was run 25%, and the whole process was run only 24.19%. The ammonia and chlorine gas levels in the MR room are 0.05 and <0.00001 ppm. One worker from the Ammonia department had mild restrictive pulmonary and three workers from the Chlorine department had mild obstructive (1 worker) and mild restrictive (2 workers). All workers in the MR department had normal pulmonary function. No relationship was found between workplace and pulmonary dysfunction. Few recommendations are given in order to keep the workers pulmonary function healthy, such as having regular medical check up for each worker and regular ammonia and chlorine gas measurement.

Gas amoniak dihasilkan dari proses penambahan cairan amoniak berkadar tinggi yaitu 0.6% sebagai antikoagulan pada latex, dan gas klorin dihasilkan dari proses pencucian sarung tangan karet dengan kadar 500-700 ppm. Pemaparan gas amoniak dan gas klorin dengan lama paparan dan konsentrasi yang cukup, akan menyebabkan gangguan paru. Pabrik sarung tangan karet ”X” memiliki 15 pekerja di bagian Amoniak, 28 pekerja di bagian Klorin yang terbagi dalam 3 shift yaitu pagi, siang, dan malam yang bekerja tanpa menggunakan alat pelindung pernafasan, dan 4 pekerja di bagian Manajemen Representatif (MR) sebagai kontrol. Penelitian dilakukan dengan menggunakan metode cross sectional untuk menganalisa dampak amoniak dan klorin pada faal paru pekerja di bagian Amoniak dan Klorin dengan memberikan kuesioner untuk menilai keluhan-keluhan pernafasan, pemeriksaan faal paru menggunakan spirometer, dan pemeriksaan udara untuk mengetahui kadar gas amoniak di bagian Amoniak, klorin di bagian Klorin, dan gas amoniak dan klorin di ruang MR. Hasil kuesioner menunjukkan bahwa di bagian Amoniak, terdapat keluhan berupa tenggorokan kering (80%), jalan pernafasan kering (73.3%), mata perih (66.67%), iritasi hidung dan batuk (53.3%), dan pingsan (6.67%). Di bagian Klorin, terdapat keluhan berupa hidung berair (96.42%), merasa tersedak (92.85%), batuk dan sakit pada dada (89.28%), kering tenggorokan, mata iritasi dan dada sesak (85.71%), dan pingsan (7.14%). Di ruang MR, seluruh pekerja tidak mengalami keluhan. Hasil pemeriksaan udara menunjukkan bahwa kadar pada lingkungan kerja masih berada dibawah ambang batas, yaitu gas amoniak di bagian Amoniak sebesar 1.7, 1.9, dan 3.5 ppm, gas klorin di bagian Klorin sebesar 0.0869 dan 0.0697 ppm, dan di ruang MR, gas amoniak sebesar 0.05 ppm, dan gas klorin <0.00001. Kadar gas di bagian Amoniak dan Klorin tidak dapat menunjukkan kadar normal di pabrik, karena pada saat penelitian dilakukan, proses klorin berjalan sebesar 25% dan proses secara keseluruhan sebesar 24.1%. Hasil spirometri menunjukkan bahwa di bagian Amoniak terdapat 1 pekerja memiliki gangguan ringan jenis restriktif, di bagian Klorin terdapat 3 pekerja yang memiliki gangguan ringan yaitu 1 pekerja dengan jenis obstruktif dan 2 pekerja dengan jenis restriktif, dan di bagian MR, seluruh pekerja memiliki faal paru yang normal. Setelah dilakukan uji korelasi pearson, ditemukan tidak ada hubungan antara tempat kerja dengan gangguan paru. Untuk menjaga kesehatan faal paru pekerja, disarankan untuk mengadakan pemeriksaan kesehatan secara berkala pada pekerja dan pemeriksaan kadar gas amoniak dan klorin secara teratur.