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PAK - GETARAN

PAK - GETARAN. ERWIN DN. DEFINISI PENYEBAB PATHOGENESIS DIAGNOSIS TERAPI PROGNOSIS PENCEGAHAN. PAK AKIBAT GETARAN. Penyakit akibat getaran adalah penyakit atau gangguan kesehatan akibat getaran PAK akibat getaran : PAK akibat getaran seluruh tubuh

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PAK - GETARAN

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  1. PAK - GETARAN ERWIN DN

  2. DEFINISI • PENYEBAB • PATHOGENESIS • DIAGNOSIS • TERAPI • PROGNOSIS • PENCEGAHAN

  3. PAK AKIBAT GETARAN • Penyakit akibat getaran adalah penyakit atau gangguan kesehatan akibat getaran • PAK akibat getaran : • PAK akibat getaran seluruh tubuh • PAK akibat getaran setempat (segmented vibration/ tool hand vibration)

  4. Whole Body Vibration • Getaran mekanaik yang disampaikan lewat tempat duduk (ex: alat berat) / lantai • Getaraan dari alat berat  tempat duduk tulang belakang supir

  5. WORKERS AT RISK • Supir Traktor, truk, mobile crushers • Fork-lifts • Masnis, supir bus, taksi, motor boat, helikopter, pesawat • Mesin / Alat berat (hammering and punching machinery) • Orang yang bekerja di landasan yang bergetar

  6. Vibrations

  7. Vibration • Exposure to vibration can occur while using power tools or while driving equipment. • Vibration from power tools can place stress on the tissues of the fingers, hand and arms. • Whole body vibration from driving puts stress on the spinal tissues.

  8. Whole Body Vibration Exposure 4 s/d7 % pekerja di Eropa& USA terpapar WBV yang berbahayabagikesehatannya

  9. Terdapat berbagai faktor yang perlu diperhatikan dalam menilai efek getaran pada manusia , yaitu: • Karakteristik fisik dari frekuensi dan intensitas getaran • Tipe dari sumber getaran • Lamanya pemajanan • Arah getaran • Posisi tubuh • Kerentanan individu • Faktor lingkungan misalnya suhu udara, kebisingan, beban kerja dll.

  10. Efek fisik getaran Pada otot skelet (4-12 Hz)

  11. Osteoarthritis

  12. Osteoarthritis

  13. Osteoarthritis

  14. Osteoarthritis

  15. Efek getaran dan frekuensi

  16. Frekuensi-efek

  17. EFEK PADA KESEHATAN WBV

  18. GANGGUAN KESEHATAN MENURUT FREKUENSI

  19. Respon fisiologis thd WBV yg masih dapat ditolerir o/ manusia adalah : • Denyutjantungmeningkat (10 – 15x/mnt) padakondisieksperimen yang normal, tanpamemperhatikanfrekuensi pajanan kontinyu pulih • TD meningkatpdfrek. ± 5 Hz menurunpdfrek. ± 10 - 20 Hz

  20. Tidal Volume : meningkatpadasemuafrekuensi (maks. Pd frek. 5 – 7 Hz) • RR meningkat linier dg intensitas • Pd 5-7Hz : VC menurun O2 Uptake meningkat.

  21. Efek WBV pd ginjal , darah & endokrin : - Belumatautidakterdapatbukti yg jelas • Efek WBV pd keseimbangan : - tgt kerentananindividu.

  22. Efek Getaran Pada Performance • Ggn. Fgs. &ketajamanpenglihatan - sebanding dgamplitudogetaran - maksimum pd frek.10 -25 Hz. • Penurunan performance pada tracking task (pekerjaanmengikutijejakmisalnyajejaksatelit, pesawatudaradll) - sebanding denganamplitudogetaran - maksimumpdfrek. rendah(≤ 5 Hz)

  23. HNP (Hernia Nucleus Pulposus) • Tergelincirnya nukleus pulposus (anulus fibrosus)/slipped disc • Pathogenesis: WBV  kerusakan tulang rawan  slipped disc  tekanan pada radiks dorsalis LBP

  24. HERNIA NUCLEUS PULPOSUS (SLIP DISC)

  25. Beberapa Faktor Risiko LBP • sikaptubuhygjelek& kurang OR - sikapberdiri yang membungkukkedepan, - dada kempes - pungung lordosis -tidaktegap , - perut buncit  tekananBB jatuhkedepansbgkompensasipunggung hrsditarikkebelakang--hiperlordosislumbal jk lama  kelelahanotot& rangsangan pdligamen nyeri.

  26. Bad posture

  27. Obesitas & kehamilan trimester akhir  perpindahantekananBB kedepan • >>> duduk otot hamstring kaku & pendek d.Panjangtungkai yang tidaksama e. Sepatu tumit yang tinggi / pemendekan tendon achilles titik Berat bergeserkedepan

  28. kelemahanototdindingperut , gluteus maksimis & ileopsoassertapemendekanotot-ototekstensorpunggug(otot yg penting u/ mempertahankan sudut lumbosacralis pd posisi optimal (30º ))  kelemahan = ”unstable back”. g. Merokok (blm jelas) - tekanan intra diskus meningkat (batuk kronis) - peregangan otot - nikotin h. Kesegaran jasmani IKJ Baik  < berisiko LBP i. Lama masa kerja semakin lama (dg beban berat) risiko semakin meningkat

  29. Y X Y Y X X Z ax, ay, az = acceleration in the directions of the x, y, z, axes x axis = back - to – chest y axis = right – to – left z axis = foot (or buttocks) - to - head ACGIH TLVs and BEIs HandbookWhole-Body Vibration Threshold Limit Values (TLV’s)

  30. Pencegahan • Hindari paparan WBV > NAB  pilih peralatan/mesin yang anti getaran, pemeliharaan mesin, gunakan peredam, sepatu anti getaran • Atur waktu kerja istirahat : 1 jam kerja-10 menit istirahat • Istirahat : stretching, massaging, relaxing • Terapi sesuai gejala • Hindari faktor risiko • Jaga badan tetap hangat

  31. GETARAN SELURUH TUBUH Paparan menahun (f=)Paparan akut (F=) Gangguan aliran darah amplifikasi /resonansi Di daerah ginjal dan saluran kencing Kerusakan permanen pada sendi/tulang Arthritis Peradangan/inflamasi Slipped disc (L4-L5 atau L5 S1) GangguanFungsiGinjal dan sal.Kencing, dg indicator: Hematuria HNP BUN Serum Creatini LBP Urea

  32. PAK –GETARAN SETEMPAT

  33. What is HAV (Hand-Arm Vibration)? • What is HAV (Hand-Arm Vibration)? • transmitted from work processes into workers hands and arms. • It can be caused by operating hand-held power tools such as : road breakers, • hand-guided equipment (ex:s lawn mowers) • holding materials being processed by machines such as • pedestal grinders.

  34. What injuries can HAV cause? Regular exposure to HAV can cause a range of permanent injuries to your hands and arms that are known as hand-arm vibration syndrome (HAVS). The injuries can include damage to the following:

  35. What injuries can HAV cause? • oBlood Circulatory System (vibration white finger) - >> tjd jika suhu tubuh/tangan dingin atau basah • - tanda awal: ujung jari putih (kadang2) , baal , seperti terusuk • jarum • - akhir serangan: jari putih  berubah merah & sangat nyeri • Sensory Nerve Damage - kerusakan syaraf di jari rasa raba & rasa suhu berkurang  baal • permanen, kesemutan di jari • Damage to Muscle, Bones & Joints - kekuatan tangan hilang • - nyeri di lengan & pergelangan tangan

  36. Hand Arm HealthEffects (bisanyasetelah 3-5th) Vascular and circulation problems. Neurológical. Muscular disorders Others

  37. Symptoms – Advanced Stages • White or Blanched Finger Tips • Aggravated by cold • Mistaken for frostbite • Few minutes initially • With Continued Exposure • Blanching spreads • Attacks Increase in • Frequency • Intensity • Duration

  38. Symptoms – Latter stages • Occur in all seasons • On and off job • Triggered by • Cold • Vibrating objects • Nicotine • Severe Cases • Gangrene • Amputation

  39. Stockholm HAVS Classification System (Vascular Assessment)

  40. Stockholm HAVS Classification System (Sensorineural Assessment)

  41. Health Effects Vascular Disorders Muscle Normal Artery Damage Artery Normal flow Flow Restriction

  42. Typical HAV Sources • Fastening Tools • Cutting Tools • Finishing Tools • Gardening Tools • Compaction Tools • Drilling/Boring Tools • And More

  43. Vibration Exposure Hand Arm

  44. Hand Arm Vibration Exposure

  45. Hand Arm Vibration Exposure

  46. Hand Arm vibration exposure

  47. What other factors can contribute to vibration injury? • o • * How high the vibration levels • * How long you use the tools and equipment • * How awkward it is for you to use the equipment • * How tightly you have to grip the equipment • * How cold and wet you get when using the equipment • Individual susceptibility - smokers are at a greater risk

  48. Upaya Pencegahan • Jaga agar paparan tak melampaui NAB • Atur waktu kera-istirahat (1 jam-10 mnt) • Istirahat : massaging, swinging, shaking • Pakai gloves (VIP) • Jaga agar badan tetap hangat • Hindari faktor risiko

  49. Hand-arm vibration acceleration level (m/sec2) Tool Type 1,183 Riveter, Caulker 424 Chipping Hammer 416 Motorcycle 339 Jack-Leg Drill 251 Grinder 195 Pavement Breaker 125 Pedestal Grinder 75 Chain Saw 59 Brush Saw 20 Hand Grinder Acceleration levels from Hand Arm Vibrations

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