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"ABSTRACT

INTRODUCTION : Based on Indonesian Constitution, article 2712 mention that every Indonesian citizen has the right of having a job and wages in accordance to humanity. Bajaj as an model in this study is public transportation vehicle which is noisy and vibrating and potential to induce hearing and balance disturbances which could be dangerous to himself or to others. General Objectives of this study : To investigate the risks of noise and vibration in bajaj's drivers and to find the solutions to prevent them from hearing loss and balance disturbances.

Specific objectives : To determine : 1, hearing and balance functions induced by noise and vibration by audiometric and posturography tests 2. To find other physiologic factors such as age, blood pressure, blood glucose level, smoking habit and body mass index which could influence those functions ; 3, To determine the threshold of noise frequencies, intensity and also acceleration of vibration which contributed to noise.

Setting : Subdivision of Neurotology of ENT Department of Cipto Mangunkusumo Hospital, Jakarta, Study subjects : Bajaj drivers.

METHODS: The study was carried out from March 2000 until October 2001.Noise and vibration were measured using octave band analyzer and vibration meter. Clinical ENT examination, height and body weight for body mass index, blood pressure and blood glucose level tests were performed. The subjects were divided into four groups : the normal one, only hearing or balance problem group, group of both disturbances. The risk factors were calculated by bivariate and multivariate or logistic regression analyses.

RESULTS : Mean of bajaj's intensity level was 91 dBA, with minimum intensity 64 dBA, maximum intensity 96 dBA, mean acceleration of vibration was 4,2 misec2. Those results showed that noise and vibration of bajajs were over safety threshold, which has been established by OSHA. The rate of normal subjects was 27.72 %, whereas that of those who suffered from hearing and balance problems was 27,43%, and only 17.14% had hearing problems and 27,71 % had balance problems. The total was 72,28 % of disturbance. From the multivariate analysis, hearing and balance problems were influenced by age more than 40 years old, working periods more than 9 years, daily working hours more than 8 hours, history of heavy smoking habit and obesity. Balance problems were influenced by the same factors. But the working period was 5.9 years and hearing problems were only influenced by age more than 40 years old. It was concluded that balance function was more sensitive than hearing one. For prevention, this study also introduced risk scores for hearing and balance functions based on those physiological factors for workers who worked in noisy and vibrating areas, low risk for scores 0-5, moderate risk for scares 6-10 and high risk for scores more than 11. The sensitivity level was 70,83% and specificity was 73,20 %.

CONCLUSIONS : Mean of bajaj's intensity level was 91 dBA, with minimum intensity 64 dBA, maximum intensity 96 dBA. mean acceleration of vibration was 4,2 misec2, which are over the safety threshold. Noise and vibration could induce hearing and balance problems in 72,28% of drivers. Those problems are influenced by several factors such as age, working periods, daily working hours, smoking habit and obesity."

"Tuberkulosis merupakan masalah yang serius di masyarakat. Pada tahun 2010, World Health Organization mencatat jumlah penderita tuberkulosis di Indonesia menurun ke posisi empat dengan meningkatnya keberhasilan pengobatan obat antituberkulosis (OAT). Namun, pemberian OAT jangka panjang dapat menyebabkan efek samping ototoksik berupa gangguan pendengaran dan keseimbangan. Penelitian ini dilakukan untuk mengetahui efek ototoksik pada penderita tuberkulosis paru dengan pemberian OAT di RSUP H. Adam Malik Medan.Penelitian ini bersifat deskriptif dengan pendekatan potong lintang. Analisis univariat dilakukan dengan tabel frekuensi distribusi sedangkan analisis bivariat dilakukan dengan menggunakan uji t dan Fisher?s exact test. Didapatkan 35 penderita tuberkulosis yang memenuhi kriteria inklusi, 22 orang dengan pengobatan tuberkulosis kategori 1 dan 13 orang tuberkulosis kategori 2. Dilakukan pemeriksaan audiometri nada murni dan tes keseimbangan. Tiga orang (33,3%) penderita tuberkulosis kategori 1 dan 6 orang (66,7%) penderita tuberkulosis kategori 2 mengalami gangguan pendengaran (p < 0,05).Hasil tes keseimbangan menunjukkan perbedaan yang signifikan yaitu 7 orang (100%) tuberkulosis kategori 2 dengan positif tes Romberg dan 11 orang (100%) tuberkulosis kategori 2 positif tes tandem Romberg. Gangguan pendengaran dan keseimbangan pada penderita tuberkulosis paru dengan OAT ditemukan lebih tinggi pada kategori 2 dibandingkan dengan kategori 1 dengan perbedaan yang signifikan.

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Tuberculosis remains a serious problem in the community. In 2010, World Health Organization report that Indonesia?s ranking decrease to fourth position due to success of antituberculosis treatment. But the long term administration of antituberculosis treatment may cause ototoxic effect like hearing and balance impairment. The aim of this study was to describe ototoxic effect of subjects who were given tuberculosis treatment in H. Adam Malik General Hospital.This is a descriptive study with cross sectional approach. Univariat analysis was done by frequency distribution table, meanwhile bivariat analysis was done by t-test and Fisher?s exact test. Thirty five pulmonary tuberculosis patients met the inclusion criteria. Twenty two patients with 1st category, and 13 patients with 2nd category tuberculosis treatment. Pure tone audiometric and balance examination was evaluated. Three patients (33.3%) of 1st category tuberculosis and 6 (66.7%) patients of 2nd category tuberculosis have hearing loss with significant difference (p<0.05).Balance test showed 7 people (100%) of 2nd category tuberculosis having positive Romberg test and 11 people (100%) of 2nd category tuberculosis having positive tandem Romberg test. Hearing and balance impairment found higher in patients with 2nd category antituberculosis treatment with significantly different."

"The author begins his observation from a linguistic phenomenon in Bahasa Indonesia that indicates swapped roles and positions between machineries and workers. Many tools including vehicles and are treated as human beings. On the other hand, a lot more cases show that workers are treated as a part of technology, if not as the machine themselves. According to the author this happens simply because workers do not have their own paradigm. Workers in Indonesia, particularly in Java, think the way their employers do. Workers easily understand, and even support any sort of management decree or decision regarding their wages and economic benefit during the Asian financial crisis. The real human resources building, however, will never be achieved unless the workers can develop a perspective that is free from the penetration of the establishment and their high-tech machineries."