Pengaruh cuci hidung terhadap gejala, transpor mukosiliar, dan eosinofil hidung pada pekerja pabrik kayu

Abstract

Latar belakang: Bekerja di lingkungan dengan debu kayu menyebabkan inhalasi partikel melaluisaluran pernapasan termasuk hidung. Pajanan debu kayu dapat menimbulkan keluhan di hidung, gangguantranspor mukosiliar hidung (TMSH), dan reaksi inflamasi di mukosa rongga hidung. Cuci hidung NaCl0,9% dianggap dapat mengurangi gejala, memperbaiki TMSH, dan mengurangi mediator inflamasi dimukosa rongga hidung.

Tujuan: Membuktikan pengaruh cuci hidung NaCl 0,9% terhadap perbaikan skorgejala, waktu TMSH, dan jumlah eosinofil hidung.

Metode: Penelitian intervensi, uji acak terkendali disebuah pabrik kayu pada bulan Januari – Maret 2016. Sampel pekerja yang telah memenuhi kriteria inklusidan eksklusi, kemudian dihitung skor gejala hidung menggunakan SNOT20, waktu TMSH dan jumlaheosinofil hidung. Kelompok perlakuan diberi cuci hidung NaCl 0,9% sebanyak 2 kali per hari dan selalumenggunakan masker. Kelompok kontrol memakai masker saja. Perlakuan diberikan selama 2 minggu,setelah itu dihitung kembali skor gejala SNOT 20, waktu TMSH, dan jumlah eosinofil hidung.

Hasil:Didapati subyek penelitian sebanyak 36 orang pekerja pabrik kayu, 18 sampel diberi perlakuan dan 18sampel kontrol. Skor gejala hidung dan waktu TMSH setelah perlakuan, lebih baik dibanding kontrol(p<0,05). Jumlah eosinofil hidung setelah perlakuan tidak lebih rendah dibanding kontrol (p=0,324).

Kesimpulan: Cuci hidung NaCl 0,9% terbukti berpengaruh terhadap perbaikan skor gejala hidung danwaktu TMSH, tetapi tidak berpengaruh terhadap jumlah eosinofil hidung.

Kata kunci: Debu kayu, transpor mukosiliar, SNOT20, eosinofil, cuci hidung, NaCl 0,9%

ABSTRACT

Background: Working in wood dust exposure causes particle inhalation through respiratory system,including the nose. It promotes nasal symptoms, nasal mucocilliary transport (NMCT) disfunction, andinflamatory response of nasal mucosa. Nasal saline irrigation 0.9% is considered to decrease symptoms,restore nose mucocilliary transport, and decrease inflamatory mediator in nasal mucosa hence workingcaused-diseases.

Purpose: To find out the effect of nasal saline irrigation 0.9% on symptoms score,NMCT, and eosinophil count.

Method: Interventional study, randomized controlled trial at a wood factoryduring January – March 2016. Samples which fulfilled inclusion and exclusion criteria, were examinedtheir nasal symptoms score by SNOT20, NMCT time, and nasal eosinophil count. Treatment group wasgiven nasal saline irrigation 0.9% twice a day and always wore mask during work. On the other hand,control group only wore mask during work. The treatment was given for two weeks and reexamination ofSNOT20 symptoms score, NMCT time and nasal eosinophil count were conducted afterwards. Comparativeanalysis test between two groups in this study was using unpaired t-test.

Results: There were 36 samplesin this study, 18 as control group and 18 as treatment group. We found that nasal symptoms score andNMCT time after the treatment were improved, compared to the control group (p<0.05). Neverthelessnasal eosinophil count in the treatment group was not improved compared to the control group (p=0.324).

Conclusion: Nasal saline irrigation 0.9% gave positive effect to the improvement of the nasal symptomsscore and NMCT, but it had no significant influence to the nasal eosinophil count.

Keywords: Wood dust, mucocilliary transport, SNOT20, eosinophil, nasal saline irrigation