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Journal : MEDIA MEDIKA INDONESIANA

Pajanan Pestisida Sebagai Faktor Risiko Hipotiroidisme pada Wanita Usia Subur di Daerah Pertanian Suhartono, Suhartono; Djokomoeljanto, RRJ. Sri; Hadisaputro, Suharyo; Subagio, Hertanto Wahyu; Kartini, Apoina; Suratman, Suratman
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 2 YEAR 2012
Publisher : MEDIA MEDIKA INDONESIANA

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Abstract

Pesticide exposure as a risk factor for hypothyroidism in women at childbearing age in agricultural areasBackground: Hypothyroidism in women at childbearing age (WCA) will cause reproduction disorder, i.e. infertility, spontaneous abortion, impaired growth and development of foetus, placental abruption, and preterm delivery. Pesticide exposure is suspected to cause hypothyroidism. The research objective is to prove that pesticide exposure is a risk factor for hypothyroidism among WCA in agricultural areas.Methods: Case-control studies were used as study designs. Study subjects were 44 WCA as cases and 45 WCA as controls. Pesticide exposure was measured by asking WCA’s involvement in agricultural activities using structured questionnaire and by checking their levels of cholinesterase. Hypothyroidism was determined based on the results of TSH, FT4, and T3 level. Confounding variables were also measured. These variables were age, body mass index (BMI), participation in hormonal contraception, liver function, urinaryiodine excretion, urinary thiocyanate level and blood lead level. Chi-square test, OR (95% CI), and multivariate logistic regression were implemented to test the hypothesis.Results: Pesticides exposure is a risk factor for hypothyroidism (crude-OR=3.04; 95% CI=1.20-7.81; nilai p=0.033 and adjusted OR=3.31, 95% CI=1.25 to 8.78, p=0.016). The higher the degree of exposure, the greater the risk of having hypothyroidism.Conclusion: Pesticides exposure is a risk factor for hypothyroidism among WCA in agricultural areas.Keywords: Pesticide exposure, risk factor, hypothyroidism, women at childbearing age, agricultural areaABSTRAKLatar belakang: Hipotiroidisme pada kelompok wanita usia subur (WUS) dapat menyebabkan gangguan reproduksi, seperti infertilitas, abortus spontan, gangguan tumbuh-kembang janin, dan kelahiran prematur. Pajanan pestisida dapat mengganggu fungsi tiroid. Tujuan penelitian adalah membuktikan bahwa pajanan pestisida merupakan faktor risiko hipotiroidisme pada WUS di daerah pertanian.Metode: Desain penelitian yang digunakan adalah kasus-kontrol. Subyek penelitian adalah 44 WUS sebagai kasus dan 45 sebagai kontrol. Pajanan pestisida diukur menggunakan kuesioner dan pemeriksaan kadar kolinesterase. Kejadian hipotiroidisme diukur menggunakan parameter kadar TSH, FT4 dan T3. Variabel perancu yang diukur meliputi umur, indeks massa tubuh (IMT), penggunaan KB hormonal, fungsi hati, ekskresi yodium urin, kadar tiosianat urin, dan kadar Pb darah. Uji hipotesis yang digunakanadalah uji Chi-square, uji OR (95%CI), dan regresi logistik multivariat.Hasil: Pajanan pestisida merupakan faktor risiko hipotiroidisme pada WUS di daerah pertanian (crude-OR=3,04; 95%CI=1,20- 7,81; nilai p=0,033 dan adjusted OR=3,31; 95%CI=1,25-8,78; p=0,016). Semakin tinggi derajat pajanan pestisida, semakin besar risiko terjadinya hipotiroidisme.Simpulan: Pajanan pestisida merupakan faktor risiko kejadian hipotiroidisme pada WUS di daerah pertanian.
Hipotiroidisme pada Wanita Usia Subur (WUS) di Daerah Pertanian: Penelitian di Kecamatan Kersana Kabupaten Brebes Suhartono, Suhartono; Djokomoeljanto, Sri; Hadisaputro, Suharyo; Subagio, Hertanto Wahyu; Kartini, Apoina
MEDIA MEDIKA INDONESIANA 2010:MMI VOLUME 44 ISSUE 1 YEAR 2010
Publisher : MEDIA MEDIKA INDONESIANA

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Abstract

Background: Hypothyroidism can cause infertility, spontaneous abortion, fetal growth-development disorders, placental abruption and prematurity. Exposure to pesticides, both of organochlorines and organophosphate, can cause hypothyroidism. The aim of the study was to examine the prevalence of hypothyroidism in WCA in agricultural areas.Methods: A cross-sectional study was conducted in two hundred and eight women of WCA who were randomly selected from four villages and TSH levels were examined. The TSH cut-off point for the diagnosis of hypothyroidism was 4.5 μIU/mL. In a sub-sample, fT4 levels, UEI and thiocyanate in urine, were also examined. Result: The mean level of TSH was 3.66 (±5.330) μIU/mL, the lowest value was 0.05, and the highest was 60 µIU/mL; the median was 2.38 μIU/mL; the mean FT 4 (n=89) was 16.207±3.0438 pmol/L; UEI median value (n=41) was 288.0 mcg/L; while the mean of urinary thiocyanate levels (n=41) was 1.468±1.25 mcg/mL. There were 47 WCA (22,6%) with hypothyroidism, 46 of which (97.9%) are sub-clinical hypothyroidism.Conclusion: The prevalence of hypothyroidism in WCA was 22.6% and almost all women had sub-clinical hypothyroidism. Pesticide exposure is suspected as a risk factor for hypothyroidism in this population.ABSTRAKLatar belakang: Hipotiroidisme merupakan keadaan, di mana kelenjar tiroid tidak dapat memproduksi hormon cukup untuk memenuhi kebutuhan tubuh. Pada WUS, hipotiroidisme dapat menyebabkan infertilitas, abortus spontan, gangguan tumbuh-kembang janin, placental abruption dan bayi lahir sebelum waktunya. Pajanan pestisida, baik dari golongan organoklorin maupun organofosfat, dapat menyebabkan hipotiroidisme. Penelitian ini bertujuan mengkaji berapa besar prevalensi hipotiroidisme pada WUS yang bertempat tinggal di daerah pertanian.Metode: Penelitian ini menggunakan desain cross-sectional. 208 WUS dipilih secara acak dari empat desa dan dilakukan pemeriksaan kadar TSH. Diagnosis hipotiroidisme ditegakkan berdasarkan kadar TSH 4,5 µIU/mL. Pada sebagian WUS (sub-sampel) dilakukan pemeriksaan kadar fT4, UEI dan kandungan tiosianat dalam urin. Hasil: Rerata kadar TSH adalah 3,66 (±5,330) µIU/mL, nilai terendah 0,05, nilai tertinggi 60 µIU/mL sedangkan median TSH 2,38 µIU/mL; rerata fT 4 (n=89) adalah 16,207±3,0438 pmol/L; nilai median UEI (n=41) adalah 288,0 µg/L; rerata kadar tiosianat urin (n=41) adalah 1,25±1,468 µg/mL. Didapatkan 47 WUS (22,6%) dengan hipotiroidisme, 46 di antaranya (97,9%) adalah hipotiroidisme sub-klinik.Simpulan: Prevalensi hipotiroidisme pada WUS sebesar 22,6%, hampir semuanya hipotiroidisme sub-klinik. Pajanan pestisida patut dicurigai sebagai faktor risiko pada WUS di daerah pertanian yang diteliti ini.
Co-Authors A J Endharta A. Haris A. Rusgiyono Abdul Hamid Abdul Haris Abdul Karim Achmad Mauludiyanto Aditia, Dita Selvia Ag Soemantri Agus Setyawan Agus Subagio Agus Suharsono Agus Suwandono Agustinus Soemantri Aiman Farag Mohammed Ali, Aiman Farag Mohammed Ainil Karomah Aisiah Aisiah, Aisiah Aji Winara Akhmad Fathurrohman Albertus Ata Maran Ali Rosidi Alice Ximenis Naben Alif Rahman Dhani Alim, Kusuma Yati Amalia Sakina, Nova Ana Setyowati Andria Prima Ditago Anggraeni, Ika Esti Anggun Marlina Puspitasari, Anggun Marlina Anies Anies Anna Nur Nahari, Anna Nur Apoina Kartini Apryanti, Yohana Putri Ardiani, Hanifah Ari Dwi Kurniawati, Ari Dwi Ari Suwondo Arif Harjanto Arifian Rahman Arimoto, Takafumi Aris Puji Widodo Armini, Ni Kadek Arnelli Arnelli Arono Arono Artikasari, Artikasari Arulita Ika Fibriana Arum Siwiendrayanti Arum, Silfia Sekar Ary Widiyanto Ashanur Jenni, Ashanur Aslim Rasyad Asril Aminullah Astari, Karina Ayu Cintya Paraswati, Ayu Cintya B. Raharjo Bagoes Widjanarko Basuki Basuki Bayu Surarso Beni Lestari, Beni Beta Noranita Boediman, Drajat Brodjol Sutijo BRW. Indriasari, BRW. Budhi Setianto budi manfaat, budi Budi Santosa Budianto, Anwar Budiyono Budiyono Cahya Rosyida, Desta Ayu Castro, Toto Chamdani, Muhammad Christian Lilik Henry, Christian Lilik Corry Wahyuni Hidayat, Corry Wahyuni Cut Nanda Defira, Cut Nanda Cut Yulvizar D. Ispriyanti D. S. Widodo Dana, I Made Gde Meranggi Darmayanti, Tri Darsono Darsono Darwis, Darsef Dasrul Dasrul Dedi Hariyanto, Dedi Dedi Natawijaya Dedy Dwi Prastyo Defi Mustika Sari Destri Susilaningrum Dewi Andriyani Dharminto Dharminto Dhoriva Urwatul Wutsqa Diah Rahayu Wulandari Diah Ratnasari Dian Rahmawati Dias Aji Bantarwati Didik Setiyo Widodo Dinda Rachma Anggiani, Dinda Rachma Diyah Fatmasari Djalal Er Riyanto Djokomoeljanto, Sri Dwi Astuti, Siti Choirul Dwi Endah Kusrini Dwi Kusrianto Putro, Dwi Kusrianto Dwi Marinajati Dwi Pudjonarko Dwi Wastoro Dadiyanto, Dwi Wastoro Dwiatmono Agus Dwiatmono Agus Widodo Dyah, Dyah E. Setiawati Edy Suryadi Eijsvogels, Thijs Eka Sudarsana Eko Adi Sarwoko Eko Eko Sediyono Eko Sediono Eko Sediyono Endang Ambarwati, Endang Endang Pujiastuti, Rr Sri Eni Mahawati Epa Suryanto Erlin Fitria Dewi, Erlin Fitria Erna Setiawati, Erna Esty Kurniasih, Esty Esty Yunita Sari, Esty Etik Susanti, Etik Eva Laylatus F. Ariyanto Fachrul Kurniawan Falah, Nurul Fanoeel Thamrin Fany Aditya Rahman Farida Ariany Farikhin Farikhin Faturohman, Akhmad Fauzan Masykur Fauziah, Syifa Fernando, Okta Fidiyatun Fidiyatun Gamantyo Hendrantoro Gasela, Fitria Gautama, Mada Gumono Gumono, Gumono Gunawan Gunawan H. Sutanto Hajar, Muhammad Abduh Ibnu Hanafi Kamarz Hanan Lanang Dangiran, Hanan Lanang Handini, Yuslinda Dwi Hardhono Susanto Hari Ismanto Haryono Haryono Helmi Arif Wibawa Helmie Arif Wibawa Hendra Budi Sungkawa, Hendra Budi Henry Setyawan, Henry Heri Kuswanto Heri Nugroho Herni Utami Hertanto Wahyu Subagio Heru Tjahjana Hiasa, Fina Hidayat, Syarief Thaufik I Made Widagda, I Made I. Marhaendrajaya Ida Ariyanti, Ida Ika Nur Jannah, Ika Nur Ikawati, Kartika Ike Ani Windiastuti Ilafi Andalita Ilmiyah, Nita Imam Djamaluddin Mashoedi Imam Husni Al Amin Imam Suyanto Imelsa Ika Wulandari, Imelsa Ika Imran, Bahtiar Iqbalsyah, T.M. Irma Dewiyanti Iskandar, Arif Ismaini Ismaini Isnawati, Salafiyah Izza Hananingtyas J. 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