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KETAHANAN LINGKUNGAN: KESEHATAN LINGKUNGAN

KETAHANAN LINGKUNGAN: KESEHATAN LINGKUNGAN. Disarikan oleh : soemarno , psl ppsub 2013. PENGENALAN DAN KONTROL BAHAYA DI HUNIAN. Determine if personnel have potential occupational exposure to environmental hazards. Obtain training.

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KETAHANAN LINGKUNGAN: KESEHATAN LINGKUNGAN

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  1. KETAHANAN LINGKUNGAN:KESEHATAN LINGKUNGAN Disarikanoleh: soemarno, pslppsub2013

  2. PENGENALAN DAN KONTROL BAHAYA DI HUNIAN • Determine if personnel have potential occupational exposure to environmental hazards. • Obtain training. • Voluntarily notify supervisor or OMC of any pre-disposition to environmental hazards that can create medical emergencies. • Use personal protective equipment, administrative controls, and engineering controls when exposed to environmental hazards. Sumber: Environmental Health Hazard . Atallah Z. Rabi …. Diunduh dari: www.sawa2006.com/.../22%20-......  15/12/2012

  3. MENGURANGI / KONTROL BAHAYA LINGKUNGAN • Prevent the creation of a hazard in the first place • Reduce the amount of hazard brought into being • Prevent the release of existing hazard • Modify the rate or spatial distribution of release of hazard from its source • Separate, in time or in place, the hazard and that which is to be protected. • Separate the hazard and that which is to be protected by interaction of a material barrier. • Modify the basic qualities of the hazard. • Make that which is to be protected more resistant to damage from the hazard • Counter damage already done by the environmental hazard • Stabilize, repair, and provide rehabilitative corrective measures Sumber: Environmental Health Hazard . Atallah Z. Rabi …. Diunduh dari: www.sawa2006.com/.../22%20-......  15/12/2012

  4. Kita menghadapibanyakmacambahaya • Lima tipe-utamabahaya • Biologis: pathogens • Kimiawi • Fisika • Kultural • Pilihan Gaya hidup Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  5. JENIS-JENIS BAHAYA BIOLOGIS Do We Face? In terms of death rates, the most serious infectious diseases are flu, AIDS, diarrheal diseases, malaria, and tuberculosis; most of these deaths occur in developing countries. Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  6. Bbrp penyakit dapat menular dari satu orang ke orang lainnya Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012 • Nontransmissible disease • Infectious disease • Transmissible disease (contagious or communicable disease) http://www.rims.edu.in/HealthCareCDACKolgksaha/Zoom-%20Infectious%20Diseases%20-%20Ringworm-Jock%20Itch-Worms-Amebas-Malaria.html

  7. Bbrp penyakit dapat menular dari satu orang ke orang lainnya • Sejak 1950, kematian akibat penyakit infeksi telah menurun, karena : • Perawatan kesehatan lebih baik • Antibiotika • Vaksin • Disability-adjusted life years (DALYs) Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  8. Penyakit infeksi masih menjadi ancaman utama Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012 • Penyakitinfeksimenyebarmelalui: • Udara • Air • Makanan • Cairantubuh • EpidemikdanPandemik • Resistensibacteridanserangga Global warming has various effects on human health. The main indirect effects are on infectious diseases. Although the effects on infectious diseases will be detected worldwide, the degree and types of the effect are different, depending on the location of the respective countries and socioeconomical situations. Diunduhdari: http://linkinghub.elsevier.com/retrieve/pii/S2210909910000056?via=sd

  9. JALUR PENYAKIT INFEKSI PADA MANUSIA Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  10. RESISTENSI GENETIK THD ANTIBIOTIK Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012 • Bacteria: rapid reproduction, easily spread • Penggunaanantibiotikaygberlebihan • Penggunaanpesticida yang berlebih Antibiotic Resistance is the adaptation of bacterial strains to certain of the ANTIBIOTIC MEDICATIONS doctors prescribe to treat infections the BACTERIA cause, rendering the antibiotic ineffective. Sumber: http://www.beltina.org/health-dictionary/antibiotic-resistance.html _...diunduh 15/12/2012

  11. RESISTENSI GENETIK THD ANTIBIOTIK Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012 • Methicillin-resistant Staphylococcus aureus (MRSA) • Resistant to most antibiotics • Symptoms of MRSA • How will it be controlled? Mechanisms of Antibiotic Resistance. Sumber: http://www.scq.ubc.ca/attack-of-the-superbugs-antibiotic-resistance/ _...diunduh 15/12/2012

  12. ANCAMAN GLOBAL AKIBAT TUBERCULOSIS • Why is tuberculosis on the rise? • Not enough screening and control programs • Genetic resistance to a majority of effective antibiotics • Person-to-person contact has increased • AIDS individuals are very susceptible to TB Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  13. BEBERAPA PENYAKIT VIRUS SANGAT MEMATIKAN • Influenza or flu virus • #1 Killer • Transmission • HIV • #2 Killer • Antiviral drugs Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  14. BEBERAPA PENYAKIT VIRUS SANGAT MEMATIKAN • Global strategy to slow down the spread of HIV • Reduce the number of new infections • Concentrate on those most likely to spread HIV • Free testing • Education for prevention • Provide free or low-cost drugs • Research Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  15. BEBERAPA PENYAKIT VIRUS SANGAT MEMATIKAN • Hepatitis B virus (HBV) • #3 Killer • Mode of transmission • Viruses that move form animals to humans • West Nile virus • Severe acute respiratory syndrome (SARS) • Reduce chances of infection: Wash your hands Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  16. PENYEBARAN PENYAKIT INFEKSI DARI BINATANG KE MANUSIA • Ecological medicine • Human practices that encourage the spread of diseases from animals to humans • Emerging infections • HIV • SARS • West Nile virus • Lyme virus Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  17. Malaria— oleh NYAMUK PEMBAWA PARASIT • Malaria • Caused by Plasmodium sp. carried by Anopheles mosquitoes • Penyebaran • Gejala-gejala • Siklus Malarial

  18. Malaria— oleh NYAMUK PEMBAWA PARASIT • Malaria on the rise since 1970 • Drug resistant Plasmodium • Insecticide resistant mosquitoes • Effect of global warming • AIDS patients particularly vulnerable • Prevention of spread and current research Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  19. Mengurangi penyakit infeksi • Good news • Vaccinations on the rise • Oral rehydration therapy • Bad news • More money needed for medical research in developing countries Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  20. Solusi: Penyakit Infeksi, Cara-cara untuk mencegah atau mereduksi kejadiannya SOLUTIONS Infectious Diseases Increase research on tropical diseases and vaccines Reduce poverty Decrease malnutrition Improve drinking water quality Memperbaikikualitas air minum Reduce unnecessary use of antibiotics Educate people to take all of an antibiotic prescription Mengurangipenggunaanantibiotikdalambudidayaunggas Require careful hand washing by all medical personnel Immunisasi anak-anak thd penyakit virus Provide oral rehydration for diarrhea victims Conduct global campaign to reduce HIV/AIDS Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  21. MENGHADAPI BAHAN KIMIA BERBAHAYA Managing the risks of toxic substances is an ongoing, integrated process Sumber: http://www.oag-bvg.gc.ca/internet/English/parl_cesd_200911_02_e_33197.html_...diunduh 15/12/2012

  22. BEBERAPA BAHAN KIMIA DAPAT MENYEBABKAN KANKER, MUTASI, DAN GANGGUAN JANIN Bahan kimia toksik: Carcinogens Mutagens Teratogens Sumber:_http://risk.arizona.edu/healthandsafety/chemicalsafetyinfo/index.shtml...diunduh ….. 15/12/2012

  23. PCB ADA DI BERBAGAI TEMPAT • Kelompoksenyawakimia yang mengandungkhlor: • Sangatstabil • Nonflammable • Break down slowly in the environment • Travel long distances in the air • Larutdalamlemak • Biomagnifikasi • Food chains and webs • Banned, but found everywhere Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  24. Potential Pathways on Which Toxic Chemicals Move Through the Environment Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  25. Bbrpa bahan kimia mempengaruhi sistem immune, Nervous, dan Endocrine • Some natural and synthetic chemicals in the environment can weaken and harm • SistemKekebalan • SistemSyaraf • Sistem Hormonal Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  26. Bbrpa bahan kimia mempengaruhi sistem immune, Nervous, dan Endocrine • Hormonally active agents (HAAs) • Gender benders • Penggangguakelenjar Thyroid • BahankimiaToksik • Phthlates • Efekpadasistem hormonal system • Kanker Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  27. EFEK TOKSIK AKIBAT MERKURI Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012 • Hg: teratogen and potent neurotoxin • Once airborne, persistent and not degradable • 1/3 from natural sources • 2/3 from human activities • Enters the food chain: biomagnification Biomagnification, also known as bioamplification or biological magnification, is the increase in concentration of a substance that occurs in a food chain as a consequence of: Persistence (can't be broken down by environmental processes) Food chain energetics Low (or nonexistent) rate of internal degradation/excretion of the substance (often due to water-insolubility) http://flyfishingconsultant.blogspot.com/2010/07/i-do-not-eat-fish-why-is-that.html

  28. EFEK TOKSIK AKIBAT MERKURI • 2007: Hg hotspots identified • How are humans exposed? • Inhalation: vaporized Hg or particulates of inorganic salts • Eating fish with high levels of methylmercury • Effects of Hg on humans • Who is most at risk? Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  29. Siklusmerkuridalamlingkunganakuatik Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  30. PENYELESAIAN PENCEMARAN MERKURI SOLUTIONS Pencemaran Merkuri Pencegahan Prevention Control Kontrol Sharply reduce mercury emissions from coal-burning plants and incinerators Phase out waste incineration Remove mercury from coal before it is burned Switch from coal to natural gas and renewable energy resources such as wind, solar cells, and hydrogen Tax each unit of mercury emitted by coal-burning plants and incinerators Convert coal to liquid or gaseous fuel Require labels on all products containing mercury Phase out use of mercury in batteries, TVs, compact fluorescent lightbulbs, and all other products unless they are recycled Collect and recycle mercury-containing electric switches, relays, and dry-cell batteries Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012 Fig. 17-B, p. 451

  31. Bisphenol A • Menyerupai Estrogen • Found in many common products • Laboratory findings • Effects on human health • Should it be banned? Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012 Diunduhdari: http://www.bisphenol-a.org/pdf/BPAsafe.pdf

  32. Bagaimana Evaluasi dan Menangani Bahaya Kimia ? Scientists use live laboratory animals, non-animal tests, case reports of poisonings, and epidemiological studies to estimate the toxicity of chemicals, but these methods have limitations. Many health scientists call for much greater emphasis on pollution prevention to reduce our exposure to potentially harmful candidates. Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  33. EFEK BERBAHAYA DARI BAHAN KIMIA Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012 • Toxicology • Toksisitastergantungpada: • Dose • Age • Genetic makeup • Multiple chemical sensitivity (MCS) • Kelarutandanpersistensibahankimia • Biomagnifikasi Diunduhdari: http://www.sciencedirect.com/science/article/pii/S0014579308001166

  34. KECELAKAAN KIMIA “Chemical accident" means an accident involving a fortuitous, or sudden or unintended occurrence while handling any hazardous chemicals resulting in continuous, intermittent or repeated exposure to death, or injury to, any person or damage to any property but does not include an accident by reason only of war or radio-activity Sumber: http://www.hrdp-idrm.in/e5783/e17327/e27015/e27708/_...diunduh 15/12/2012

  35. Estimasi Paparan Manusia thd bahan kimia dan mengukur efeknya Pengukuran & Pemodelan Ilmiah Ramalankandungantoksikdalammanusia Metabolisme Akumulasi Ekskresi Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  36. Studi Kasus: Melindungi anak-anak dari bahan kimia toksik • Analysis of umbilical cord blood: significance • Infants and children more susceptible to the toxic effects of chemicals than adults • Eat, drink water, and breathe more per unit of body weight than adults • Put their fingers in their mouths • Less well-developed immune systems and body detoxification processes Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  37. Estimasi toksisitas: Hewan uji di Lab dan Uji non-hewan • Dose-response curve: median lethal dose (LD50) • Nonthreshold dose-response model • Threshold dose-response model • Can the data be extrapolated to humans? Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  38. Estimasi toksisitas: Hewan uji di Lab dan Uji non-hewan • More humane methods using animals • Replace animals with other models • Computer simulations • Tissue culture and individual animal cells • Chicken egg membranes • What are the effects of mixtures of potentially toxic chemicals? Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  39. Kurva Hipotetis Dose-Response untuk menentukan LD50 Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  40. Tingkat Toksisitas dan Rataan LD untuk manusia Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  41. KURVA RESPON DOSIS Nonlinear dose-response Linear dose- response Effect Effect Threshold level Dose Dose No threshold Threshold Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012 Fig. 17-15, p. 456

  42. ESTIMASI EFEK BERBAHAYA BAHAN KIMIA • Case reports and epidemiological studies • Limitations of epidemiological studies • Too few people tested • Length of time • Can you link the result with the chemical? • Can not be used for new hazards Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  43. APA BAHAYA DOSIS RENDAH DARI BAHAN TOKSIK? Acute-based Predicted No-effect Concentrations (PNECacute), as well as two existing EQSs for the pesticides chlorpyrifos and chlorfenvinphos compared to a correlation of observed effects on community structure of aquatic macroinvertebrate communities, expressed as SPEAR index (SPEAR[%]) and a measure of toxic stress, calculated as Toxic Units (TU) for the most toxic compound (based on data from von derOhe et al., 2009). The two red dots represent sites at which chlorfenvinphos was responsible for the TUmax. Sumber: http://www.sciencedirect.com/science/article/pii/S0048969711001136_...diunduh 15/12/2012

  44. BAHAN KIMIA BERBAHAYA DI RUMAH Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012

  45. Teddy bear Shampoo Baby bottle Clothing Perfluorochemicals to add shine Some stuffed animals made overseas contain flame retardants and/or pesticides Can contain bisphenol-A Can contain perfluorochemicals Nail polish Mattress Perfluorochemicals and phthalates Flame retardants in stuffing Perfume Phthalates Carpet Padding and carpet fibers contain flame retardants, perfluorochemicals, and pesticides Hairspray Phthalates Food Some food contains bisphenol-A TV Wiring and plastic casing contain flame retardants Milk Fat contains dioxins and flame retardants Sofa Foam padding contains flame retardants and perfluorochemicals Frying pan Nonstick coating contains perfluorochemicals Computer Toys Fruit Water bottle Tennis shoes Tile floor Imported fruit may contain pesticides banned in the U.S. Can contain bisphenol-A Flame retardant coatings of plastic casing and wiring Vinyl toys contain phthalates Can contain phthalates Contains perfluorochemicals, phthalates, and pesticides Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012 Fig. 17-16, p. 458

  46. EFEK BERBAHAYA DARI BAHAN KIMIA Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012 • Severe limitations estimating toxicity levels and risks • Acceptable levels vary between 1/100 and 1/1000 of the estimated harmful levels Diagram illustrating dose response curve for Chemical A Diunduhdari: … http://www.stewardshipcommunity.com/?id=339

  47. PENCEGAHAN Polusi & Prinsip Ke-hati-hatian • Those introducing a new chemical or new technology would have to follow new strategies • A new product is considered harmful until it can be proved to be safe • Existing chemicals and technologies that appear to cause significant harm must be removed Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012 Dose-Effect and Dose-Response Since the basic question in toxicology is how dose is related to toxicity, most toxicology studies are designed to investigate how living creatures react as doses vary incrementally, from low to high levels. Diunduhdari: http://toxlearn.nlm.nih.gov/htmlversion/module1.html

  48. Individuals Matter: Ray Turner and His Refrigerator • 1974: Ozone layer being depleted by chlorofluorocarbons (CFCs) • 1992: International agreement to phase out CFCs and other ozone-destroying chemicals • Ray Turner: citrus-based solvents to clean circuit boards Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012 The cycle of the ozone depletion and how its shown to be depleted. Diunduhdari: http://optioneenvirochemblog1.wordpress.com/2012/03/28/e4-ozone-depletion/

  49. Risiko dan Menghindari Bahayanya Sumber: Environmental Hazard and Human Health. ………….www.bergen.edu/.../Environmental.../chapter_...diunduh 15/12/2012 We can reduce the major risks we face if we become informed, think critically about risks, and make careful choices. The relationship between risk assessment and selection of controls Sumber: http://security.practitioner.com/introduction/infosec_5_5.htm ... diunduh 17/12/2012

  50. Risiko kesehatan datang-dari Kemiskinan, Gender dan Gaya-hidup • AnalisisRisiko • RisikoKesehatan “terbesar”: • Kemiskinan • Gender • Pilihan Gaya Hidup Analyzing Health Problems for Risk Factors Sumber: http://www.uic.edu/sph/prepare/courses/ph420/resources/pt2analysis.htm_...diunduh 17/12/2012

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