PENERAPAN KESEHATAN DAN KESELAMATAN KERJA DI PUSKESMAS DI TIGA PROVINSI DI INDONESIA

摘要

Active pulmonary Tuberculosis (TB) cases and drug resistance Myco-baterium tuberculosis strain increase the risk of health workers who contact to TB patients. Primary Health Care (PHC) workers in Indonesia have the risk to be exposed to M. tuberculosis in workplace. This study aimed to evaluate the implementation of occupational health and safety concerning prevention of M. tuberculosis transmission in PHC and the obstacles. It was a cross sectional study in 50 microscopic referral PHCs (PRM) and PHCs with capability in microscopic examination (PPM) in Banten Province, Gorontalo Province, and South Kalimantan Province. Data collection was conducted in 2012 through interview and observation to obtain data on PHC characteristic, occupational health and safety implementation, the completeness of guidelines, and facilities. Occupational health and safety implementation on pulmonary TB prevention in PHCs had not fulfilled all the WHO M. tuberculosis transmission prevention guideline yet. Training on TB prevention for the PHC workers had been conducted. Only 58 % of PHCs implemented the program and 56 % had regular health check-up and TB screening activities. Health promotion equipments and facilities for occupational health and safety were still lacking in 26 % of PHCs. Personal Protection Equipments (PPE) such as gloves and disposable maskers were available in almost all PHCs (98 % and 96 %). General facilities and laboratory facilities were still lacking in 68 % and 40 % of PHCs (n=50), respectively. Conclusions : Occupational health and safety implementation in PRM/PPM need to be improved by completing the facilities of PHC, laboratory, and health promotion. Key words : Primary health care, occupational health and safety AbstrakMunculnya kasus TB paru aktif dan kedaruratan strain TB resisten obat, meningkatkan risiko bagi pekerja yang kontak dengan penderita TB. Pekerja puskesmas di Indonesia mempunyai risiko terpajan kuman TB dari lingkungan kerja. Penelitian bertujuan mengevaluasi penerapan kesehatan dan keselamatan kerja (K3) dalam pencegahan penularan Mycobaterium tuberculosis di puskesmas dan hambatannya. Disain cross sectional, pada 50 puskesmas (PRM/PPM puskesmas rujukan mikroskopis/puskesmas pelaksana mandiri) di provinsi Banten, Gorontalo, dan Kalimantan Selatan, tahun 2012, data dikumpulkan melalui wawancara dan pengamatan. Data yang dikumpulkan meliputi karakteristik puskesmas, penerapan K3, kelengkapan pedoman, sarana dan prasarana. Penerapan K3 dalam rangka pencegahan TB paru di puskesmas belum seluruhnya sesuai dengan Pedoman Pencegahan Penularan M. tuberculosis WHO. Pelatihan pekerja puskesmas terhadap pencegahan penularan TB telah dilaksanakan oleh puskesmas. Penerapan K3 yang masih kurang adalah pelaksanaan kegiatan yang perlu dilakukan dan pemeriksaan kesehatan berkala/skrining TB masing-masing pada 58 % dan 56 % puskesmas. Alat promosi kesehatan terkait K3 masih kurang pada 26 % puskesmas. Alat pelindung diri berupa sarung tangan dan masker tersedia pada hampir semua puskesmas 98% dan 96%. Sarana prasarana masih kurang pada 68 % puskesmas dan sarana prasarana laboratorium masih kurang pada 40 % puskesmas (n=50). Penerapan K3 di PRM/PPM perlu ditingkatkan dengan melengkapi sarana dan prasarana puskesmas dan laboratorium, serta alat promosi kesehatan.Kata kunci : puskesmas, kesehatan dan keselamatan kerja