Ruang Lingkup Agromedis

dr. Ancah CNM, Ph.D

Department of Public Health
 Contents
• Apa itu agromedis?
• Apa ruang lingkupnya?
• Agriculture and Hazards
• Prevention for hazards
 What is agromedicine?

Agromedik menurut buku Agricultural Medicine : A

Practical Guide adalah suatu program yang
bertujuan memberikan manfaat bagi petani dan
keluarganya dan menyediakan informasi tentang
nutrisi, standar keamanan pangan, keselamatan
kerja, dan program preventif kesehatan.
 What is agromedicine scope?
Existing problems of this population
– Environmental stress and strain
– Extreme climatic conditions
– Very poor Housing and sanitation
– Problem of malnutrition
– Exposure to physical and biological agents
– Poor socio economic conditions predisposes to infectious
diseases
– Recent introduction of modern agricultural techniques like
• Mechanization of agriculture operations
• Use of various chemicals such as pesticides, fertilizers
and animal feeds (Hormones and Antibiotics) has led to
emergence of newer occupational health problems
Hazard and Risk
• A hazard is anything in the
workplace that has
the possible to
harm people. Hazards can
include objects in the
workplace, such
as machinery or dangerou
s chemicals.
• a “risk” is the likelihood of
potential harm from that
hazard being realized.
 Agriculture and Hazards

• Agricultural sector
Exposure to the weather
is one of the most
Close contact with animals
hazardous to
and plants
health
Extensive use of chemical
• Agricultural work Use of hazardous
possesses several agricultural tools and
characteristics that machinery.
are risky for health
• This brief outlines
the health hazards
of agriculture
 Hazard Clasification
• Mechanical hazard
• Physical hazard
• Biological hazard
• Chemical hazard
• Psyco-social hazard
• Work organization hazard
• Ergonomic hazard
• Environmental hazard
 Mechanical Hazards

Poorly designed and/or guarded agricultural

machinery is a major cause of fatalities and
accidents. Injuries from cutting tools are
another major risk.
• Noisy machinery, and Physical Hazards
noisy working
environments such as
intensive livestock
houses
• Excessive vibration from
tractors, chainsaws and
so on
• Deaths and injuries
from falls
• Deaths and injuries
from working with
livestock
 Physical Hazards

• Solar radiation
resulting in skin
cancers
• Extreme
temperatures when
working outside and
inside glass houses
Physical Hazards
Asphyxiation in grain
silos, wells and so on
 Biological Hazards
• Agricultural
workers are at risk
from a wide range
of work related
diseases and
disorders.
• These range from
diseases caught
from birds and
animals to asthma
and other lung
diseases from
biologically
contaminated
dusts.
 CHEMICAL HAZARDS

• Pesticides, Fertilizer and

solvents can result in health
hazards ranging from
poisoning to long term effects
on female and male
reproduction, cancers and so
on.
 Psycho-social hazards
• These include problems that can cause ill
health such as low pay, sexual and other
harassment, job insecurity, poor promotion
mechanisms, delay in payment of salaries.
 Work Organisation Hazards
These include hazards that are caused by poor
work organization such as
• badly organized shift work and working hours,
• excessive overtime,
• lone working,
• lack of control over work.
 Ergonomic hazards

These include hazards associated with the failure to

make the job fit the worker and can cause
permanent injuries and disablement. For example:
• Badly designed machinery
• Prolonged static working positions
• Repetitive work
• Unsuitable tools used by workers
• Poor seating
 Environmental hazards
Agricultural work can also create environmental hazards
beyond the immediate workplace. For example,
• workers and their families,
• local communities, and
• the environment can become contaminated by
pesticides in spray drift,
• polluted water and soil,
• as well as through consuming local crops,
• meat and fish containing pesticide residues.
This additional exposure greatly increases the risks of ill
health especially when this is linked to poor diet and
malnutrition.
Prevention is better than cure
• The best way of
protection is to take
action before
occurrence of a fatality,
injury, or an illness.
 Steps for prevention and control

When confronted with a hazard it is important to

approach prevention and control techniques in the
following strict order.
1. Ask whether the hazard can be eliminated. For
example, remove the need to use a toxic pesticide by
using organic farming methods
2. If the hazard cannot be prevented or eliminated,
consider substitution with a less risky process or
substance in the case of chemicals
If a hazard cannot be 4. But only as a last resort to
prevented through elimination supplement other control
or substitution consider measures listedabove. For
control options, in the example:
following order: – Coveralls
1. Technical/engineering – Masks
control – Respirators
– Enclosure – Goggles
– Isolation – boots
– ventilation 5. Other Methods
2. Safe systems of work – general cleanliness of the
– changing work schedules workplace
– extending rest periods – personal hygiene and care
– training and information – medical health surveillance
3. Issuing Personal Protective
Equipment (PPE)
 Hazard Identification Techniques
• Body mapping
• Hazard mapping
– Involving members when carrying out Hazard, Risk
&Effect checks
• Health surveys
– Information exchange in meetings and informal
discussions
 Body mapping:
• Provides an easy and effective way to encourage
workers to speak out and report symptoms of ill
health that they suffer
• Promotes collective action and builds trade union
organization
• Identifies common patterns of health problems
amongst workers in a particular workplace or
doing the same job
• Highlights areas for further investigation and
action
Body mapping
 Hazard Mapping
Aims: help us to:
• Identify priority hazards
• Discuss the potential risks from these hazards
• Develop plans to deal with the risks
Hazard Mapping
 Examples of hazards
• Physical hazards – noise, radiation, vibration,
temperature
• Chemical hazards – pesticides, dusts, diesel
exhaust fumes
• Biological hazards- infectious diseases, bacteria,
body fluids
• Work design hazards – ergonomic hazards,
working alone
• Stress hazards – workload, harassment,
discrimination, shiftwork
 TASK: In your small group:
• Draw a typical work activity/ workplace you are
all familiar with
• Place as much detail in the drawing as possible –
people, tools, materials chemicals
• When the map is complete, mark hazards using
pens (coloured if they are available) on the
drawings
• Make sure that there is someone in your small
group that briefly notes down
• What is said around the body map
Planning the next steps:
Efek Pestisida

• Efek Reproduksi
• Karsinogen
• Teratogen
• Hepatotoksik
• Nefrotoksik
 Masalah Pestisida : Insektisida
1. Insektisida organofosfat
Parathion, diklorvos, parathion-methil, azinvos-methil (Guthion),
klorfenvinfos, diazinon, dimetoat, disulfoyhon (Di-siston), malathion,
mevinfos, dan triklorfon (Dipterex).
Menghambat asetil kolin esterase (AChE), mengakibatkan
akumulasi asetilkiolin (Ach).

GEJALA tremor, inkoordinasi, kejang-kejang, diare,

urinasi tanpa sadar, bronkokonstriksi, miosis, kontraksi otot
yang diikuti dengan kelemahan, hilangnya refleks dan
paralisis.
 Masalah Pestisida : Insektisida
2. Insektisida karbamat
karbaril (Sevin), aldikarb (Temik), karbofuran, metomil, dan propoksur
(Baygon)
Ester asam N-methyl carbamat juga bekerja menghambat
AChE.

Tanda-tanda toksisitas karbamat muncul lebih cepat; juga,

rentang dosis yang menyebabkan efek toksik minor dan efek
lethal cukup besar. Dengan alasan ini, berdasarkan toksisitas
akut, karbamat lebih aman daripada insektisida organofosfat.
 Masalah Pestisida : Insektisida
3. Insektisida organoklorin
• DDT maupun metoksiklor adalah derivat etana berklor tetapi
metoksiklor jauh kurang toksik dan tidak begitu bertahan di
lingkungan dibandingkan DDT.
• Insektisida siklodien-Endrin sangat toksik, eldrin dan dieldrin
agak kurang toksik, dan klordan, heptaklor, serta mirex makin
kurang toksik.
• Lindan masih sering digunakan dan zat ini sangat toksik tetapi
tidak begitu banyak ditimbun, akibatnya penggunaan Lindan
jauh lebih luas daripada heksaklorosikloheksan.
 Masalah Pestisida : Insektisida
4. Insektisida tanaman dan insektisida lain
• Nikotin dari tembakau sangat toksik secara akut dan bekerja pada
susunan saraf.
• Piretrum diperoleh dari bunga tumbuhan Chrysanthemum
cinerariaefolium toksisitas yang rendah pada mamalia tetapi dapat
menimbulkan alergi pada orang yang peka, menyebabkan
dermatitis kontak.
• Rotenon diekstraksi dari tumbuhan Derris elliptica. Toksisitas
terhadap mamalia juga rendah tetapi lebih toksik bagi serangga dan
ikan.
• Banyak mikroorganisme diketahui bersifat pathogen bagi serangga.
Bacillus thuringensis dan Bacullovirus pada serangga tertentu.
Mikroorganisme ini diketahui tidak pathogen bagi manusia.
 Masalah Pestisida : Herbisida
• Ada beberapa jenis herbisida yang toksisitasnya pada manusia
belum diketahui secara pasti.
• Senyawa klorofenoksi bekerja pada tumbuhan sebagai
hormon pertumbuhan. Toksisitasnya pada manusia relatif
rendah.
• Herbisida bipiridil misalnya parakuat dan bikuat telah
digunakan secara luas.
• Toksisitas zat ini dengan mekanisme pembentukan radikal
bebas.
• Toksisitas parakuat ditandai oleh efek paru-parunya, bukan
saja setelah pajanan lewat inhalasi tetapi juga melalui jalur
oral.
 Masalah Pestisida : Fungisida
• Senyawa merkuri, misalnya etil dan etilmerkuri merupakan
fungisid yang sangat efektif dan telah dipergunakan secara
luas untuk mengawetkan butir padi-padian. Tetapi beberapa
kecelakaan tragis yang menyebabkan banyak kematian dan
kerusakan neurologi menetap terjadi akibat penggunaannya
sehingga bahan kimia tersebut tidak digunakan.
• Fungisida lain adalah senyawa N-heterosiklik tertentu
misalnya benomil dan tiabendazol. Toksisitas bahan kimia ini
sangat rendah sehingga dipergunakan secara luas dalam
pertanian. Heksaklorobenzen digunakan sebagai zat pengolah
benih, tetapi zat ini pernah menyebabkan keracunan massal.
 Masalah Pestisida : Rodentisida
• Warfarin adalah suatu antikoagulan yang bekerja sebagai
antimetabolit vitamin K, dengan demikian menghambat
pembentukan protrombin. Bahan kimia ini telah digunakan
secara luas karena toksisitasnya hanya terlihat setelah
termakan berulang kali dan hal ini tidak akan terjadi pada
anak-anak dan hewan piaraan.
• Tiourea sangat toksik pada tikus tetapi tidak begitu toksik bagi
manusia. Toksisitasnya terutama berupa edema paru-paru
dan efusi pleura.
• Rodentisida lain yang mencakup produk tumbuhan misalnya
alkaloid striknin, perangsang SP kuat, squill merah yang
menghandung glikosida skillaren A dan B. Glikosida ini
mempunyai efek kardiotonik dan emesis sentral mirip dengan
digitalis.
 Masalah Pestisida : Fumigan
• Sesuai dengan namanya, kelompok pestisida ini
mencakup beberapa gas, cairan yang mudah
menguap, dan zat padat yang melepaskan berbagai
gas lewat reaksi kimia. Dalam bentuk gas, zat-zat ini
menembus daerah penyimpanan dan tanah untuk
mengendalikan serangga-serangga, hewan pengerat,
dan nematoda tanah.
• Karena sifat karsinogenesitasnya, etilendipromid
tidak digunakan lagi. Yang sering dipakai adalah
akrilonitril dan kloropikrin.