Paper PPAK

8/18/2019 Paper PPAK

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OCCUPATIONAL ASTHMA PADA PEKERJA PEMINTALAN BENANG

TONKA WISABAYU KELANA (1006786000)

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BAB I

PENDAHULUAN

LATAR BELAKANG

Pe!"#$% "&'" 'e'e"*+,$ . 1/ "*$ &e2+*+, 3+'2", 4+2"&$5 D""%

$$+ 42e, e*""$ "e "*$ 2$#+" &ee*%$ "& . "& e*%$#e2 . "*%$#e2 "

"22e*e5 A&'" "#$"% e#e*3"" &e#"*" $$ 'e*+"#" #"&+& e*""&" !"

"2$ &e*$ "" e"*" $+&%*$ 'e2e$,$ &$2$4&$& "&e&%4&$& " #"#e* "*+

"#$"% #e*3"5 U"*" $$ " 42",*"" 3+" ""% 'e'$+ "&'" "" &e"$"

$$9$+5 T$"# 'e,e*"#" 3$#" 2$#+" e#e*3"" ""% &e""$ e'$+ "&'"

&e"*" signifikan "" e#e*3" &e"*" $$9$+"25 Le$,"*$ /0 :"% #$'$" $#e"2$

&e""$ asthmogenic " ";%"* e#e*3"" $'"" e#e*3" ""% %e*""* +#+

"!"#5

P*e9"2e&$ "*$ occupational astma %$"# $#e%",+$ " #e'+#$" %$"#

%e*e%e#&$5 Te*""% "!"# 9"*$"e2 !" ""% 'e'e"*+,$ 3+'2", *e9"2e

%e*'"&+# (1) #e&e,e,"%" *e'4*$ "*$ e#e*3" (4%4, < e#e*3" 'e'$2$#$ "&'"

%+*+" "%"+ 'e*+"#" &e4*" e*4#4#) () #4&e%*"&$ "*$ &+&%"&$ ! $3+'"$

"" e#e*3"" (=) *e9"2e&$ "*$ 9e%$2"&$ "%"+ "2"% e*2$+" $*$ $ %e'"%

#e*3" (>) %e*""%!" coexistent asthmogenic factors or agents (/) +*"&$ "%"+

2"'"!" %e*"3"5

S""% 'e!e+%#" occupational asthma, ee*"" #4&e e*2+ $ %"'",#"

%e*'"&+# < (1) ""#", "&'" " ""#", "*" e#e*3" 'e'$2$#$ #e2"$" $$? ()

""#", ,++"!" "%"*" "&'" " 2$#+" #e*3"? (=) ""$'"" 'e'+"%

$"4&" occupational asthma?, (>) ""$'"" %e*"$ "*$ occupational astma?, (/)

""#", $'2$#"&$ 2e"2 @ $&"$2$%"& "*$ occupational asthma ?

TUJUAN

- Me$e%$;$#"&$ ","!" 4%e&$"2 "" e#e*3" e'$%"2" e"

- Me$e%$;$#"&$ e!"#$% "&'" "#$"% #e*3" "" e#e*3"

- Mee%",+$ e"%"2"#&""" '"&"2", #e&e,"%" 4#+"&$ "" e#e*3"

MASALAH

A" &"3"#", ;"#%4* e!"#$% !" $,""$ e#e*3" e'$%"2" e"

AKULTAS KEDOKTERAN UNIERSITAS INDONESIA

PROGRAM STUDI MAGISTER KEDOKTERAN KERJA 010 - 011

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BAB II

ILUSTRASI KASUS

IDENTITAS PASIEN

N"'" < T5 S

U'+* < =1 %",+

Je$& Ke2"'$ < L"#$ - 2"#$

S%"%+& Pe*$#"," < Me$#",

Ke++#" "2"' #e2+"*" < A"# #e+" "*$ e*&"+"*"

A"'" < I&2"'

Pe$$#" < S"*3"" Te#$#

Pe#e*3"" < Oe*"%4* e'$%"2" e" $ K4*e"

ANAMNESA PENYAKIT ("+%4""'e&" "" 10 Se%e'e* 010)

Keluhan utama

Se&"# ""& ,$2" %$'+2 &e3"# +2" 2"2+

Riwayat perjalanan penyakit sekarang

P"&e 'ee2+, &e*$ &e&"# ""& !" '++2 3$#" %e*#e" e+ " $$5

Ke2+," $*"&"#" &e3"# +2" 2"2+5 S""% ""& &e&"# 3+" #e2+"* +!$ &""%

'e,e'+" ""&5 See2+'!" "&$e %$"# e*", 'e*"&"#" &"#$% &ee*%$ $$5

Ke2+," $$ $*"&"#" &e'"#$ 'e"+ &e,$" "&$e "%" e*4"%

Riwayat penyakit dahulu

T$"# "" *$"!"% 'ee*$%" TB "*+ " %$"# "" *$"!"% "&'" &e3"# #e$2

Riwayat penyakit dalam keluarga

R$"!"% "&'" "2"' #e2+"*" $ &"#"2

R$"!"% TB "*+ "2"' #e2+"*" $&"#"2

Riwayat kebiasaan

Me*4#4# $&"#"2




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ANAMNESA OKUPASI

JENIS PEKERJAAN

Jenis pekerjaan bahan/material yangdigunakan

tempat kerja (perusahaan) Masa kerja(dalam bulan / tahun)

Operator pemintalan

benang

Cotton / kapas Pemintalan benang di

korea

4 bulan

URAIAN TUGAS

P+#+2 08500 "+ " e*"#"% "*$ 'e& #"*!""

P+#+2 08500 . 1 500 e#e*3" &e""$ 4e*"%4* e'$%"2" e" "&$e e#e*3"

&e""$ 4e*"%4* 'e&$ '"&+# e" e*2e#"" '"e* %$$& $"&"5 S+"&"" $

%e'"% #e*3" %e*2$,"% e+ #"" !" e%e*""5 "&$e e#e*3" &$;% 8 3"' &e,"*$

&e2"'" &e$ . &"%+ 5

P+#+2 1-00 . 1=500 $&%$*","% '"#" &$"

P+#+2 1=500 . 17500 'e2"3+%#" e#e*3"" &e""$ 4e*"%4* e'$%"2" e"

e" %+"& &"'" &ee*%$ &ee2+' 3"' '"#" &$"



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------------------------------------------------------------------------------------------------------------------------------------------d. 8nguinal Normal

3- Mata mata kanan mata4kiri

a. &ersesi 9arna Normal Normalb. 3eloak 5ata Normal Normal,. 3on'ungtiva Normal Normal

d.3esegarisan gerak bolamata

Normal Normal

e. Sklera Normal Normalf. Lensa mata tidak keru" tidak keru"g. Bulu 5ata Normal Normal

". &engli"atan ! dimensi Normal Normal

i. isus mata : tana koreksi : -engan koreksi:

5-elinga elinga kanan elinga kiri

a. -aun Telinga Normal Normalb. Liang Telinga Normal Normal

Serumen tidak ada tidak ada,. 5embrana Timani 8ntak 8ntakd. Test berbisik Normal Normale. Test 7aru tala ;inne Normal Normalf. 9eber g. S>>.

6- Hidung

a. 5eatus Nasi Normalb. Setum Nasi Normal,. 3onka Nasal Normald. Nyeri 3etok Sinus maksilar Normale. &en,iuman : >>>>>>

7- igi dan usi

* $ 0 % + ! 2 1 1 2 ! + % 0 $ *

* $ 0 % + ! 2 1 1 2 ! + % 0 $ *

8- enggorokana. &"aryn? Normal

5 Tonsil :@kuran

$anan : To T1 T2 T! 9 Normal 9 /ieremis

$iri : To T1 T2 T! 9 Normal 9/ieremi

,. &alatum Normald. Lain lain

,:- ;eher $eterangan

"5 7erakan le"er Normal Terbatasb. 3elen'ar T"yroid Normal Tidak Normal,. &ulsasi arotis Normal Bruitd. Tekanan ena Jugularis Normal Tidak Normale. Tra,"ea Normal -eviasif. Lainlain : >..

,,- 'ada $eterangana. Bentuk Simetris 4simetris

5 5ammae Normal Tidak Normal Tumor : @kuranLetak3onsistensi

,. Lain = lain

,- Paru4 Paru dan Jantung$eterangan

a. &alasi Normal Tidak Normal

$anan $iri



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------------------------------------------------------------------------------------------------------------------------------------------b. &erkusi Sonor ;edu /iersonor Sonor ;edu /iersonor

&ktus $ordis : Normal Tidak Normal sebutkan ......... ....Batas Jantung : Normal Tidak Normal sebutkan >>>

,. 4uskultasi : bunyi napas esikular Bron,"ovesikular esikular Bron,"ovesikular Bunyi Naas

tamba"an tak ada ;onk"i 9"eeAing tak ada ;onk"i 9"eeAing

BunyiJantung

Normal Tidak Normal Sebutkan ....

,1- Abdomen$eterangan

a. 8nseksi Normal Tidak Normalb. &erkusi Timani ;edu

5 4uskultasi: Bising @sus Normal Tidak Normal

d. /ati Normal Teraba>>.'b? >>

'ba,e. Lima Normal Teraba s"oeffne >..

f. 7in'al

$anan Normal

TidakNormal

$iri : Normal

Tidak Normal

g. Ballotement

$anan Normal TidakNormal

$iri : NormalTidak Normal

,5 yeri "osto > >. ..... ..... >> >. ..... ..... vaskularisasi baik tidak baik baik tidak baik kelainan 3uku 'ari tidak ada ada tidak ada ada &emeriksaan 3"usus : >>>>

$anan $iri,3b-ulang / *endi %kstremitas ba=ah

7erakan Normal tidak normal Normal t idak normal

3ekuatan otot >> >. ..... ..... >> >. ..... .....

Tulang Normal tidak normal Normal tidak normal

Sensibilitas baik tidak baik baik tidak baik

Dedema tidak ada ada tidak ada ada

arises tidak ada ada tidak ada ada

vaskularisasi baik tidak baik baik tidak baik

kelainan 3uku 'ari tidak ada ada tidak ada ada

&emeriksaan k"usus : &asien menolak dilakukan rotgen dan sirometri

1%,. Dtot motorik

1. TrofiNormal

Tidak Normal Normal Tidak Normal



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------------------------------------------------------------------------------------------------------------------------------------------ 2. Tonus

NormalTidak Normal Normal Tidak Normal

!. 3ekuatan (Es motorik)

% % % % % % % % 7erakan abnormal : tidak ada ti, ata?ia

lainya ..

,5- !e>leks kanan kiria. ;efleks Eisiologis atella lainnya .........

Normal Tidak Normal Normal Tidak Normal

b ;efleks Patologis? Babinsky lainnya @@@

negatif &ositif negatif &ositif

,6- $ulit %>loresensi dan;okasi nya

a. 3ulit Normal Tidak Normalb. Selaut Lendir Normal Tidak Normal,. 3uku Normal Tidak Normal

5 Lain = lain >>>

!%*UM% $%;A&A YA '&'APA?

-idaatkan bunyi


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P%!MA*A;AHA PA*&% !%AA P%AA;A$*AAA

No Jenis ermasala"an5edis F non medis

(okuasi dll)

;en,ana Tindakan

1 asma ec. Debu

kapas

- Se*$"2 e"# e$*"%4*! ;24 (PE)- Se$;$ *4,$"2 ,"22ee- P+2'4"*! +%$4 Te&%$

- Se*$"2 N4&e$;$ B*4,4*494"%$4Te&%$

- L"*!4&4!

- Te'4*"*! W4*# Re&%*$%$4&

- $''+424$ "&&e&&'e%



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BAB III

TINJAUAN PUSTAKA

C4%%4 "%"+ #""& $+"#" ,"'$* /0 e+""!" $ +$" $ $"

%e#&%$25 C,$" US R+&$" I$" " Je" 'e*+"#" Ne"*" . Ne"*" e+"

+%"'" "#" "," $$5

Te*,$*+!" e+ #""& %e2", 'e+3+#" e!e" occupational lung

disease, byssinosis "" &e"$" #e$2 "*" e#e*3" %e#&%$25 B$"&"!" 'e"'$2

"#%+ 1/ . 0 %e*""* "" ,$, 2e9e2 4; +&% ( &e#$%"* 05/ . 150 '@'=) "$ "*"

e#e*3" +%+# 'e3"$ *e"#%$;5 OSHA " ACGIH 'ee%"#" &%""* 05 '@ '=

e+ #""& !" *e&$*"2e !" $ +#+* e" 9e*%$"2 e2+%*$"%4* &e""$ 2$'$%

%e*""* e+ #""& "" $+&%*$ e"5

D$"4&" occupatioanal asthma %e*"%+ e&"*!" &+"%+ &+&%"& "%"+ :"%5

B"!"# 4*" e" !" 'e'$2$#$ "&'" #"*e" e#e*3"" 'e'$2$#$ *$"!"% "%4$5

Me+*$"$ $"4&" e!"#$% $$ ,"*+& $%e"##" "2"++ "&$e %$"# 'e'$2$#$

*$"!"% "&'"5 Se*$ e#e*3" 'e2"4*#" +!$ 'e$ "" %e*"&" $$#"% ""&

ee# "%+# . "%+# "*", "" "$ "%"+ '"2"' ,"*$ " &e'+, "2"' &e'"2"'

"%"+ "2"' &e'$+ &e%e2", 3"+, "*$ %e'"% #e*3"5

Pee"2" 2$#+" " e#e*3"" !" &e&$;$# !" ""% 'e!e"#"

"&'" ""% &e"*" &$$;$#" 'e+*"$ "'"# #2$$# "$ "&$e5 E9"2+"&$ %e'"%

#e*3" "%"+ $+&%*$ ""% 'e+#"#" "e e!e" &"#$%!"5 Mee2$'$"&$

,":"* 'e"'", 9e%$2"&$ " e*+"," . e*+"," $ 2$#+" #e*3"

'e*+"#" *$'"*! *e9e%$4 "*$ occupational asthma "$ &e'+" e#e*3"5

Pe!"#$% $$ ""% 'e!e"#" "&$e ,"*+& 'e"*$ e#e*3"" 2"$ !" 44# "%+"

",#" '$%" #4'e&"&$ "%"& #e%$"# '"'+" 'e*e#"5

PATO&ISIOLOGI




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A&'" $ $"4&e &e"*" #2$$& e*"&"*#" &$%4' " %e&% ;+&$ "*+ %e%"$

9"*$e%"& "*$ "%4;$&$424$ 'e+3+ "#,$* !" &"'" $%""$ e" 9"*$"&$ 4&%*+#&$

e*""&" " ,$e**e&4&$; "*$ *4,$"25 I;2"'"&$ 3"2" ""& 'e*+"#"

"%4;$&$424$ %e*3"$!" "&'"5 P42" *e&4 $4;2"'"&$ %e*,"" '42e#+2 e&"* "%"++

#e$2 e*e" . e"5 M42e#+2 e&"* 'e'e"*+,$ IE !" 'e,"&$2#" *e"#&$

$''e$"%e e2"!e "%"+ +"2 *e&45 M42e#+2 !" #e$2 e*%$"# &e""$ ,"%e

'e'e*2+#" #43+"&$ e" *4%e$ 2"$ &ee2+' 'e$'+2#" *e&4 $'+5

D"2"' ee*"" #"&+& "'"*" accupational asthma '$*$ e"

nonoccupational asthma. H$, " L4 '42e#+2 ""% 'e'$+ $;$2%*"&$ "*$ &e2

$;2"'"&$ &ee*%$ e4&$4;$2 2$';4&$% " &e42 '"&%5

DIAGNOSIS

P"" "!"# #e""" ""'e&" !" "$# ""% 'e!$'2+2#" "&'" "#$"%

e#e*3""5 Ke%$#" '+2"$ +*$" #e "*", e!e"!" ,"2 +%"'" !" $e*,"%$#"

+%+# ""% 'e'"%+ $"4&e !" &e&$;$# <

- $9e&%"%$"&$ "%"+ 'e"!"#" "3"" @ %e'"% #e*3" !"

- e$2"$" "$*"! *e&4& $%e'"% #e*3" "%"+ +"" e!e" $ %e'"% #e*3"

D$"4&" "&'" "#$"% #e*3" 'e2$+%$<

- C?osure 4ssessment

- P,!&$424$ A&&e&&'e% 'e2$+%$


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Te'4*"*! W4*# Re&%*$%$4&

Se$;$ B*4,4*494"%$4 Te&%$

- 8mmunologi, 4ssessment

PROGNOSA

S"!"!" ee2$%$" 'e$$#"&$#" "," &e"$" e&"* "&$e e"

"&'" "#$"% #e*3" 'e!e"#" ee*"" e*"3"% #e*+&"#" !" %$"# ""%

$e*"$#$5 Le$, "*$ 60 "*$ &+"%+ &+3e# ""2 +%+# &e'+, ",#" &e%e2",

$$",#" "*$ ""*"5 Te%" %e*""* &e%e2", '++2 4&e% "*$ &+"%+ &!'%4'

""% 'e$'+2#" &"#$% "&'" !" e*"% !" e*&$&%e ",#" &e%e2", ""*"

&+", $,$2"#"5 Pee2$%$" 'e'+#%$#" e*2+!" $"4&" $$ $", "*$

%e'"% !" %e*""* " e4"%" !" %e"%5 S"'"$ &e#"*" %$"# $#e%",+$

&e"*" "&%$ e*e"" !" &$$;$#" "2"' *44&" "%"*" !" 2"%e " 4

2"%e



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BAB I'

KESIMPULAN DAN SARAN

KESIMPULAN

1. e+ #""& ""% 'e$'+2#" occupational asthma

2. e*2+!" $"4&" " e'e*$#&"" ;+&$ "*+ ""* ""% 'ee%+#"

&e"*" %e"% "+"!"

3. e*2+ $ %e*"$ e" "$# #"*e" "% 'e$'+2#" ","!" !" 2"%e

'"++ 42"%e "$ ee*$%"!"

SARAN

15 '$+' 4"% %e*"%+*

5 ee*"" 2"'" 3"" %e*""* e+ #""& ",+2+5

=5 2"#+#" e'e*$#&"" +%+# "*+ ""* ""% $'4$%4* e*#e'""!"5



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D";%"* P+&%"#"

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5 A5 D"9$ W"e* R5 G*e4*!5 E!24e$" 4; 4+"%$4"2 ,e"2%, " &";e%! C," 10<

Re&$*"%4*! S!&%e'

=5 A5 Lee I9e&%e*5 J4, D5 Nee;+&5 E!24e$" 4; 4+"%$4"2 ,e"2%, " &";e%! C," 8<

Te%$2e G44& I+&%*!

>5 D"9$ C5C,*$&%$"$5 D"9$ H5We'"5 O+"%$4"2 ,e"2%, *e4$:$ " *e9e%$4

4*# *e2"%e $&e"&e " $3+*!F B"**! S5Le9!5 D"9$ H5 We'" F 4+*%, E$%$4FL$$4%% $2$"' W$2#$& USA 000

/5 R4 B"2#$&&44 MD DIH MS RCP (C)( Lee S5 Ne'" MD MA) O+"%$4"2"&%,'"5 1@1@15 D$&$%"&$ "*$ 5'e&"e54'@'ee'e "" %""2 84#%4e* 010-10-1

0. J. &aul Leig" &"- &atri,k S. ;omano 5- 5&/ 5ar, B. S,"enker 5- 5&/and 3at"leen 3reiss 5-. osts of D,,uational D&- and 4st"ma. 21122. -isitasi dari ===-meds"ape-"om/indeC/list ada tanggal * oktober 21

75 M4*%4 L$'" P,D He"2%, e;;e%& 4; "$*4*e "*%$+2"%e M"%e*5 6 Dee'e* 0075T,e Ne E2" J4+*"2 Me$$e5 D$&$%"&$ "" 8 4#%4e* 010



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