Bryan Mario Isakh, Tris Eryando, Besral Besral, Miko Hananto



Continuous exposure to indoor and outdoor air pollutants can be a risk of chronic obstructive pulmonary disease (COPD). This article is the result of an analysis of non-communicable disease (NCD) cohort study aimed at finding out the relationship between occupation and duration of indoor and outdoor pollution exposure to COPD events. The data source came from the NCD’s baseline cohort conducted by National Institute of Health Research and Development in 5 urban villages in Bogor Tengah sub-district, Bogor City with the total sample of 1739 people. The study design is cross sectional. The dependent variable of this study is the incidence of COPD (based on measurement results with spirometry), and the independent variables are job type, duration of indoor and outdoor exposure. Data were analyzed using chi square test. The result of the analysis showed that there was a significant correlation between the type of work to the incidence of COPD (p <0.05) (OR = 0.642; 95% CI: 0.47-0.878). Although duration of indoor and outdoor exposure did not correlate significantly, but after re-analyzed by stratification of occupation type, there was a significant correlation between the duration of outdoor pollutant exposure with COPD of respondent group with high-risk job (p = 0,052, OR = 4,558, 95% CI: 1,146-18,128). Need to anticipate the potential risk of COPD on cohort respondents.

Keywords: Exposure, air pollutants,occupation, indoor/outdoor pollution, COPD



Pajanan dari bahan pencemar udara di dalam maupun di luar ruang (indoor/outdoor) secara terus menerus dapat menjadi risiko penyakit paru obstruktif kronis (PPOK). Artikel ini merupakan hasil analisis studi kohor penyakit tidak menular (PTM) yang bertujuan untuk mengetahui hubungan antara pekerjaan dan lama pajanan pencemaran indoor dan outdoor terhadap kejadian PPOK. Sumber data berasal dari baseline kohor PTM yang dilakukan oleh Badan Litbang Kementerian Kesehatan di 5 kelurahan di kecamatan Bogor Tengah, Kota Bogor dengan jumlah sampel sebanyak 1739 orang. Disain penelitian adalah potong lintang. Variabel dependen studi ini adalah kejadian PPOK (berdasarkan hasil pengukuran dengan spirometri), dan variabel independen adalah jenis pekerjaan, lama pajanan indoor dan outdoor. Data dianalisis menggunakan uji chi square. Hasil analisis menunjukan terdapat hubungan yang signifikan antara jenis pekerjaan terhadap kejadian PPOK (p<0,05) (OR=0,642; CI 95% : 0,47-0,878). Meskipun lama pajanan indoor dan outdoor tidak berhubungan secara signifikan, namun setelah dianalisis ulang dengan stratifikasi jenis pekerjaan, terdapat hubungan yang signifikan antara lama pajanan polutan outdoor dengan PPOK kelompok responden dengan pekerjaan berisiko tinggi (p=0,052, OR=4,558, CI 95%: 1,146-18,128). Perlu tindakan antisipasi potensi risiko PPOK pada responden kohor.

Kata kunci: Pajanan, bahan pencemar udara,jenis pekerjaan, pencemaran dalam rumah/ luar rumah, PPOK


Exposure, air pollutants,occupation, indoor/outdoor pollution, COPD


ACFA (2008) Indonesia Reaching Full Lead Phase-Out and Better Fuel Quality. A Monthly Publication by Asian Clean Fuels Association, Vol. 6 Issue 4 - May/June 2008.

Apte, K. & Salvi, S. (2016) Household air pollution and its effects on health. F1000Research, 5.

Balmes, J., Becklake, M., Blanc, P. & Henneberger, P. (2003) American Thoracic Society Statement: Occupational contribution to the burden of airway disease. American journal of respiratory and critical care medicine, 167(5): 787.

Belli AJ, B. S., Aggarwal N, DaSilva C, Thapa S, Grammer L, Paulin LM, Hansel NN (2016) Indoor particulate matter exposure is associated with increased black carbon content in airway macrophages of former smokers with COPD. Environ Res. 2016 Oct;150:398-402.

Binawara, B. K., Gahlot, S., Mathur, K. C., Kakwar, A. & Rajne, R. G. (2010) Pulmonary Function Tests in Three Wheeler Diesel Taxi Drivers in Bikaner City. Pak J Physiol 2010;6(1).

Biswas, R. S. R., Paul, S., Rahaman, M. R., Sayeed, M. A., Hoque, M. G., Hossain, M. A., Hassan, M. M. U. & Faiz, M. (2016) Indoor Biomass Fuel Smoke Exposure as a Risk Factor for Chronic Obstructive Pulmonary Disease (COPD) for Women of Rural Bangladesh. Chattagram Maa-O-Shishu Hospital Medical College Journal, 15(1): 8-11.

Bose, S., Hansel, N., Tonorezos, E., Williams, D., Bilderback, A., Breysse, P., Diette, G. & McCormack, M. C. (2015) Indoor particulate matter associated with systemic inflammation in COPD. Journal of Environmental Protection, 6(05): 566.

Dement J, W. L., Ringen K, Quinn P, Chen A, Haas S (2015) A case-control study of airways obstruction among construction workers. Am J Ind Med. 2015 Oct;58(10):1083-97.

Eisner, M. D., Anthonisen, N., Coultas, D., Kuenzli, N., Perez-Padilla, R., Postma, D., Romieu, I., Silverman, E. K. & Balmes, J. R. (2010) An official American Thoracic Society public policy statement: Novel risk factors and the global burden of chronic obstructive pulmonary disease. American journal of respiratory and critical care medicine, 182(5): 693-718.

Felner, K. d. S., M (2008) COPD For Dummies Published by Wiley Publishing, Inc. 111 River St. Hoboken, NJ 07030-5774 ®.

Fontana L, L. S., Capitanelli I, Re A, Maniscalco M, Mauriello MC, Iavicoli I. (2017) Chronic Obstructive Pulmonary Disease in Farmers: A Systematic Review. J Occup Environ Med. 2017 Jun 7.

GOLD (2017) Pocket Guide to COPD Diagnosis, Management, and Prevention. A Guide for Health Care Professionals. 2017 Edition. Global Initiative for Chronic Obstructive Lung Disease, Inc. accessed Desember, 28 2017.

Hansel NN, M. M., Belli AJ, Matsui EC, Peng RD, Aloe C, Paulin L, Williams DL, Diette GB, Breysse PN (2013) In-home air pollution is linked to respiratory morbidity in former smokers with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2013 May 15;187(10):1085-90.

Hansell A, G. R., Poole S, Zock JP, Weatherall M, Vermeulen R, Kromhout H, Travers J, Beasley R (2014) Occupational risk factors for chronic respiratory disease in a New Zealand population using lifetime occupational history. J Occup Environ Med. 2014 Mar;56(3):270-80.

Kementerian Kesehatan RI (2011a) Form Pengukuran dan Pemeriksaan [Online]. Available: [Accessed 1406 2017].

Kementerian Kesehatan RI (2011b) Kuesioner Individu Kohort PT [Online]. Available:

Kementerian Kesehatan RI (2011c) Studi Kohort Penyakit Tidak Menular (PTM) [Online]. Available: [Accessed 1406 2017]. .

Kementerian Kesehatan RI (2013) Laporan Hasil Riset Kesehatan Dasar (Riskesdas) 2013. Jakarta: Badan Peneliian dan Pengembangan Kesehatan.

Lalloo, U., Ambaram, A (2009) Not All cOPD is Caused by Cigarette Smoking. CME April 2009 Vol.27 No.4; 170-173.

Mannino, D. M. & Buist, A. S. (2007) Global burden of COPD: risk factors, prevalence, and future trends. The Lancet, 370(9589): 765-773.

Martin II, W. J., Glass, R. I., Araj, H., Balbus, J., Collins, F. S., Curtis, S., Diette, G. B., Elwood, W. N., Falk, H. & Hibberd, P. L. (2013) Household air pollution in low-and middle-income countries: health risks and research priorities. PLoS medicine, 10(6): e1001455.

Nieuwenhuijsen, M. J., Kruize, H. & Schenker, M. B. (1998) Exposure to dust and its particle size distribution in California agriculture. American Industrial Hygiene Association, 59(1): 34-38.

Nieuwenhuijsen, M. J., Noderer, K. S., Schenker, M. B., Vallyathan, V. & Olenchock, S. (1999) Personal exposure to dust, endotoxin and crystalline silica in California agriculture. Annals of Occupational Hygiene, 43(1): 35-42.

Orozco-Levi, M., Garcia-Aymerich, J., Villar, J., Ramirez-Sarmiento, A., Anto, J. & Gea, J. (2006) Wood smoke exposure and risk of chronic obstructive pulmonary disease. European Respiratory Journal, 27(3): 542-546.

Pan DX, Q. Y., Wang CM, Guo Y, Bian Z, Xie KX, Chen LL, Zhang YD, Li QY (2016) Interaction between smoking and indoor air pollution on chronic obstructive pulmonary diseases. Zhonghua Liu Xing Bing Xue Za Zhi. 2016 Nov 10;37(11):1444-1449.

Paulin, L. M., Diette, G. B., Blanc, P. D., Putcha, N., Eisner, M. D., Kanner, R. E., Belli, A. J., Christenson, S., Tashkin, D. P. & Han, M. (2015) Occupational exposures are associated with worse morbidity in patients with chronic obstructive pulmonary disease. American journal of respiratory and critical care medicine, 191(5): 557-565.

PDPI (2003) Pedoman praktis diagnosis & penatalaksanaan PPOK di Indonesia. Jakarta: PDPI, 1-18.

Pope, D., Diaz, E., Smith-Sivertsen, T., Lie, R. T., Bakke, P., Balmes, J. R., Smith, K. R. & Bruce, N. G. (2015) Exposure to household air pollution from wood combustion and association with respiratory symptoms and lung function in nonsmoking women: results from the RESPIRE trial, Guatemala. Environmental health perspectives, 123(4): 285.

Rabe, K. F., Hurd, S., Anzueto, A., Barnes, P. J., Buist, S. A., Calverley, P., Fukuchi, Y., Jenkins, C., Rodriguez-Roisin, R. & Van Weel, C. (2007) Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. American journal of respiratory and critical care medicine, 176(6): 532-555.

Schikowski, T., Adam, M., Marcon, A., Cai, Y., Vierkötter, A., Carsin, A. E., Jacquemin, B., Al Kanani, Z., Beelen, R. & Birk, M. (2014a) Association of ambient air pollution with the prevalence and incidence of COPD. European Respiratory Journal, 44(3): 614-626.

Schikowski, T., Mills, I. C., Anderson, H. R., Cohen, A., Hansell, A., Kauffmann, F., Krämer, U., Marcon, A., Perez, L. & Sunyer, J. (2014b) Ambient air pollution: a cause of COPD? European Respiratory Journal, 43(1): 250-263.

Steenland K, B. V., Anttila A, Sallmén M, McElvenny D, Todd AC, Straif K. (2017) A cohort mortality study of lead-exposed workers in the USA, Finland and the UK. Occup Environ Med. 2017 May 25.

Torén K, J. B. (2015) Effect of occupational exposure to vapors, gases, dusts, and fumes on COPD mortality risk among Swedish construction workers: a longitudinal cohort study. Chest. 2014 May;145(5):992-997.

Tsuchiya K, T. M., Kamiya Y, Nakamura Y, Baba S, Suda T (2017) Non-smoking Chronic Obstructive Pulmonary Disease Attributed to Occupational Exposure to Silica Dust. Intern Med. 2017;56(13):1701-1704.

Vestbo, J., Hurd, S. S., Agustí, A. G., Jones, P. W., Vogelmeier, C., Anzueto, A., Barnes, P. J., Fabbri, L. M., Martinez, F. J. & Nishimura, M. (2013) Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. American journal of respiratory and critical care medicine, 187(4): 347-365.

Vogelmeier, C. F., Criner, G. J., Martinez, F. J., Anzueto, A., Barnes, P. J., Bourbeau, J., Celli, B. R., Chen, R., Decramer, M. & Fabbri, L. M. (2017) Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Lung Disease 2017 Report. Respirology, 22(3): 575-601.

Wallner P, K. M., Moshammer H, Zimmerman SD, Buchanich JM, Marsh GM (2017) Mortality Among Hardmetal Production Workers: A Retrospective Cohort Study in the Austrian Hardmetal Industry. J Occup Environ Med. 2017 Jun 29.

Weichenthal S, B. L., Hatzopoulou M, Van Ryswyk K, Kwong JC Jerrett M, van Donkelaar A, Martin RV, Burnett RT, Lu H, Chen H (2017) Long-term exposure to ambient ultrafine particles and respiratory disease incidence in in Toronto, Canada: a cohort study. Environ Health. 2017 Jun 19;16(1):64.

WHO (2017) Chronic respiratory diseases, COPD: Cause [Online]. Available: [Accessed 1406 2017].

Woodruff, P. G., Barr, R. G., Bleecker, E., Christenson, S. A., Couper, D., Curtis, J. L., Gouskova, N. A., Hansel, N. N., Hoffman, E. A. & Kanner, R. E. (2016) Clinical significance of symptoms in smokers with preserved pulmonary function. New England Journal of Medicine, 374(19): 1811-1821.

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