KARYA TULIS AKHIR

HUBUNGAN PAPARAN GETARAN SELURUH TUBUH

DENGAN LOW BACK PAIN PADA SOPIR

BUS PUSPA INDAH DI TERMINAL

LANDUNGSARI MALANG

Oleh :

Okta Dwi Kusuma Ayu

201310330311089

UNIVERSITAS MUHAMMADIYAH MALANG

FAKULTAS KEDOKTERAN

2016

HUBUNGAN PAPARAN GETARAN SELURUH TUBUH

DENGAN LOW BACK PAIN PADA SOPIR

BUS PUSPA INDAH DI TERMINAL

LANDUNGSARI MALANG

Diajukan kepada

Universitas Muhammadiyah Malang

untuk Memenuhi Salah Satu Persyaratan

dalam Menyelesaikan Program Sarjana

Pendidikan Dokter

Oleh :

Okta Dwi Kusuma Ayu

201310330311089

UNIVERSITAS MUHAMMADIYAH MALANG

FAKULTAS KEDOKTERAN

2016

PERNYATAAN ORISINALITAS

Karya tulis akhir ini adalah karya saya sendiri, dan semua sumber baik yang dikutip

maupun dirujuk telah saya nyatakan dengan benar.

Nama : Okta Dwi Kusuma Ayu

NIM : 201310330311089

Malang, 18 Desember 2016

Penulis

DAFTAR ISI

Halaman

LEMBAR PENGESAHAN..................................................................................i

HALAMAN PERNYATAAN ORISINALITAS.................................................ii

LEMBAR PENGUJI............................................................................................iii

KATA PENGANTAR..........................................................................................iv

UCAPAN TERIMA KASIH................................................................................vi

ABSTRAK...........................................................................................................vii

ABSTRACT...........................................................................................................viii

DAFTAR ISI .......................................................................................................ix

DAFTAR TABEL ...............................................................................................xiv

DAFTAR GAMBAR ..........................................................................................xv

DAFTAR SINGKATAN ....................................................................................xvi

DAFTAR LAMPIRAN.......................................................................................xvii

BAB 1 PENDAHULUAN.........................................................................................1

1.1 Latar Belakang...............................................................................................1

1.2 Rumusan Masalah..........................................................................................3

1.3 Tujuan penelitian............................................................................................3

1.3.1 Tujuan Umum.....................................................................................3

1.3.2 Tujuan Khusus....................................................................................3

1.4 Manfaat penelitian..........................................................................................4

1.4.1 Manfaat Peneliti.................................................................................4

1.4.2 Manfaat Institusi.................................................................................4

1.4.3 Manfaat Masyarakat ..........................................................................4

BAB 2 TINJAUAN PUSTAKA.................................................................................5

2.1 Getaran..........................................................................................................5

2.1.1 Pengertian Getaran.............................................................................5

2.1.2 Bentuk Getaran...................................................................................5

2.1.3 Klasifikasi Getaran.............................................................................8

2.1.4 Efek Getaran.......................................................................................10

2.1.5 Faktor Yang Mempengaruhi Efek Getaran.........................................14

2.1.6 Nilai Ambang Batas Getaran..............................................................15

2.1.7 Alat Ukur Getaran..............................................................................20

2.1.8 Faktor yang Mempengaruhi Besaran Akselerasi Getaran..................21

2.1.9 Faktor yang Mempengaruhi Getaran Bus..........................................22

2.1.10 Pencegahan atau Pengendalian Getaran.............................................23

2.1.11 Peredam Getaran................................................................................24

2.2 Nyeri Punggung Bawah (Low Back Pain)....................................................25

2.2.1 Anatomi Punggung..............................................................................25

2.2.2 Definisi Nyeri......................................................................................28

2.2.3 Fisiologi Nyeri.....................................................................................30

2.2.4 Jalur Nyeri di Sistem Saraf Pusat........................................................32

2.2.5 Definisi Nyeri Punggung Bawah (LBP)..............................................33

2.2.6 Etiologi Nyeri Punggung Bawah.........................................................34

2.2.7 Faktor Risiko Nyeri Punggung............................................................37

2.2.8 Klasifikasi Nyeri Punggung Bawah....................................................39

2.2.9 Gejala Nyeri Punggung.......................................................................40

2.2.10 Nyeri Punggung dan Mengemudi.......................................................41

2.2.11 Faktor Pekerjaan yang mempengaruhi low back pain........................42

2.2.12 Patofisiologi Low Back Pain..............................................................43

2.2.13 Pemeriksaan fisik...............................................................................45

2.2.14 Tes-Tes................................................................................................46

2.2.15 Pemeriksaan Diagnostik.....................................................................47

2.2.16 Skala Nyeri pada Low Back Pain.......................................................48

BAB 3 KERANGKA KONSEP DAN HIPOTESIS

3.1 Kerangka Konseptual....................................................................................49

3.2 Hipotesis Penelitian......................................................................................50

BAB 4 METODE PENELITIAN...............................................................................52

4.1 Jenis Penelitian..............................................................................................52

4.2 Lokasi Dan Waktu Penelitian .......................................................................53

4.3 Populasi dan Sampel.....................................................................................53

4.3.1 Populasi................................................................................................53

4.3.2 Sampel..................................................................................................53

4.3.3 Besar Sampel .......................................................................................53

4.3.4 Teknik Pengambilan Sampel................................................................53

4.3.5 Karakteristik Sampel Penelitian...........................................................53

4.3.6 Variabel Penelitian...............................................................................54

4.3.6.1 Variabel bebas..........................................................................54

4.3.6.2 Variabel tergantung..................................................................54

4.3.7 Definisi Operasional.....................................................................54

4.4 Instrumen Penelitian......................................................................................55

4.5 Prosedur Penelitian........................................................................................57

4.5.1 Alur Penelitian......................................................................................57

4.5.2 Pengumpulan Data...............................................................................58

4.8 Analisis Data............................................................................................59

4.9 Jadwal Penelitian.....................................................................................59

BAB 5 HASIL PENELITIAN....................................................................................60

5.1 Hasil Penelitian.............................................................................................60

5.1.1 Besar Intensitas Getaran........................................................................60

5.1.2 Low Back Pain pada Sopir Bus Puspa Indah........................................61

5.1.3 Tabulasi Silang Antara Getaran Seluruh Tubu dan Low Back Pain......62

5.2 Analisis Data.................................................................................................64

BAB 6 PEMBAHASAN............................................................................................66

BAB 7 PENUTUP......................................................................................................73

7.1 Kesimpulan..........................................................................................................73

7.2 Saran.....................................................................................................................74

DAFTAR PUSTAKA.................................................................................................75

LAMPIRAN...............................................................................................................81

....

DAFTAR TABEL

Tabel 2.1 Reaksi kenyamanan ISO 2631-1..............................................................17

Tabel 2.2 Exposure action value exposure limit value.............................................19

Tabel 4.1 Definisi Operasional.................................................................................50

Tabel 4.2 Jadwal Penelitian......................................................................................55

Tabel 5.1 Getaran seluruh tubuh..............................................................................60

Tabel 5.2 Dereajat Low Back Pain pada Sopir Bus Puspa Indah.............................61

Tabel 5.3 Prevalensi Low Back Pain pada Sopir Bus Puspa Inda...........................62

Tabel 5.4 Tabulasi Silang Antara Getaran Seluruh Tubuh dan Low Back Pain.......63

Tabel 5.4 Hasil Uji Rank Spearman.........................................................................64

DAFTAR GAMBAR

Gambar 2.1 Gejala yang timbul sebagai akibat vibrasi 1-20 Hz...........................7

Gambar 2.2 Resonasi organ tubuh akibat getaran................................................11

Gambar 2.3 Sikap tubuh terhadap getaran mekanis............................................13

Gambar 2.4 Zona kesehatan, ISO 2631-1,1997...................................................16

Gambar 2.5 Penentuan risiko kesehatan berdasarkan ISO 2631-1.....................16

Gambar 2.6 Nilai numerik untuk akselerasi vibrasi untuk arah sumbu Z.......….18

Gambar 2.7 Kurva kriteria pengukuran tingkat getaran.......................................19

Gambar 2.8 Alat ukur getaran seluruh tubuh.......................................................20

Gambar 2.9 Arah getaran sumbu x, y ,z pada posisi duduk.................................21

Gambar 2.10 Tulang belakang...............................................................................26

Gambar 2.11 Tulang punggung, Columna vertebralis...........................................27

Gambar 3.1 Kerangka Konsep.............................................................................49

Gambar 4.1 Alur Penelitian..................................................................................57

DAFTAR SINGKATAN

HB : Hemoglobin

CT Scan : Computerized Tomography Scanner

DALY : Disability-Adjusted Life Year

GBD : Global Burden of Disease

HAV : Hand-Arm vibration

HZ : Hertz

IHME : Institute For Health Metrics And Evaluation

IMT : Indeks Masa Tubuh

LBP : Low Back Pain

LED : Laju Endap Darah

LMN : Lower Motor Neuron

MEN : Menteri

NAB : Nilai Ambang Batas

MRI : Magnetic Resonance Imaging

PER : Peraturan

RMS : Root Mean Square

UMN : Upper Motor Neuron.

USG : ultrasonografi.

WBV : Whole Body Vibration

WMSDs : Work-Related Musculoskeletal Disorder

DAFTAR LAMPIRAN

Lampiran 1 Informed Consent, Lembar Persetujuan, Kuesioner..........................81

Lampiran 2 Data Penelitian.....................................................................................87

Lampiran 3 Uji Stastistik.........................................................................................89

Lampiran 4 Ethical Clearence.................................................................................90

Lampiran 5 Surat Rekomendasi Penelitian.............................................................91

Lampiran 6 Surat Ijin Penelitian.............................................................................92

Lampiran 7 Lembar Kosultasi.................................................................................94

Lampiran 8 Dokumentasi Penelitian.......................................................................93

DAFTAR PUSTAKA

Anizar, 2009, Teknik Keselamatan dan Kesehatan Kerja di Industri, Graha Ilmu,

Yogyakarta.

Alhamda S, Riani Y, 2015, Buku Ajar Ilmu Kesehatan Masyarakat, Padang:

Politeknik Kesehatan padang.

Andini,F, 2015, Risk Factors Of Low Back Pain In Worker

<http://juke.kedokteran.unila.ac.id/index.php/majority/article/viewFile/495/4

96 >

Andrianyah et al, 2016, Analisis Faktor Risiko Keluhan Nyeri Punggung Bawah

(NPB) Pada Mahasiswa Tingkat III FK UPN Veteran Jakarta. Fakultas

Kedokteran UPN’’ Veteran” Jakarta, Jurnal Profesi Medika, Vol 9, no.3.

Baradaran et all, 2016, Cross-Cultural Adaptation, Validation, and Reliability Testing

of the Modified Oswestry Disability Questionnaire in Persian

Population with Low Back Pain, Asian Spine Journal, [Online], Vol. 10, no. 2, pp.

215–219, viewed 3 mei 2016

<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4843055/>

Bahrudin M, 2011, Pemeriksaan Klinis Di Bidang Penyakit syaraf, UMM PRESS,

Malang, pp. 193-199.

Bahrudin, M, 2013, Neurologis Klinis, UMM PRESS, Malang, pp. 215-218.

Basuki, Kristiawan. 2009, Faktor risiko kejadian low back pain pada operator

tambang sebuah perusahaan tambang nickel di Sulawesi Selatan. Jurnal

Promosi Kesehatan Indonesia.Vol. 4, no. 2, pp. 115-121, viewed 7 Mei 2016

<http://ejournal.undip.ac.id/index.php/jpki/article/download/2346/2068>

Bull et all, 2005, Simple Guide Nyeri Punggung, Erlangga, Jakarta Pusat, pp. 30-36.

Bimoriotejo, 2009, Low Back Pain (LBP), viewed 9 April 2016,

http://www.backpainforum.com

Blood et all, 2010, Whole body vibration exposures in metropolitan bus drivers: A

comparison of three seats, Journal of Sound and

Vibration, Vol.11, no.1, pp.109–120, viewed 12 Mei 2016,

http://faculty.washington.edu/petej/Blood,BusSeatComparison,JSV2010.pdf

Bovenzi, 2015, Relationships of low back outcomes to internal spinal load:a

prospective cohort study of professional drivers, Int Arch Occup Environ

Health no 88, pp.487–499, https://www.ncbi.nlm.nih.gov/pubmed/25218458

Bovenzi, 2009, Metrics of whole-body vibration and exposureresponse relationship

for low back pain in professional drivers:a prospective cohort study. Int Arch

Occup Environ Health 82 pp. 893–917

<https://www.ncbi.nlm.nih.gov/pubmed/18953559>

Davey, P. 2006, At a Glance Medicine. Erlangga, Jakarta. pp.114-116.

Davies, K. 2007, Buku Pintar Nyeri Tulang dan Otot, Erlangga, Jakarta, pp. 46-56.

Eger T, Godwin A, 2014, Whole-body Vibration Exposure: What you need to know to

prevent vibration induced injuries

<https://www.workplacesafetynorth.ca/sites/default/files/resources/Wholebo

dy%20Vibrations%20Exposure%20-%20Dr.%20Tammy%20Eger%20-

%20CROSH.pdf >

Harrianto R. 2009, Buku Ajar kesehatan Kerja, EGC, Jakarta.

Helmi, Z. 2012, Buku Ajar Gangguan Muskuloskeletal, Salemba Medika, Jakarta,

pp.311-318.

HSE, Health and Safety Executive, 2005. Whole-body vibration: The Control of

Vibration at Work Regulations 2005. Guidance on Regulations. First

published.< www.hs e .gov.uk/pubns/indg242.pdf >

Hoy, D et al, 2014, the Global Burden of Low Back Pain: estimates from the global

burden of disease 2010 study, Ann Rheum Dis 73, pp. 968-974

< http://ard.bmj.com/content/73/6/968.long>

ILO, 2013 Keselamatan Dan Kesehatan Kerja Sarana Untuk Produktivitas, Katalog

dalam Publikasi,Jilid 5, Score, Jakarta, pp.11-12.

ISO 2631-1 1997, Mechanical vibration and shock: evaluation of human exposure to

whole-body vibration - part 1: general requirements, International

Organization for Standardization, Geneva.

Gabriel J, 2013, Fisika Kedokteran, EGC, Jakarta, pp. 96-98.

Kantana T, 2010, Faktor-faktor yang mempengaruhi keluhan low back pain pada

kegiatan mengemudi tim ekspedisi PT. Enseval Putera Megatrading Jakarta

Tahun 2010. Jakarta: Universitas Islam Negeri Syarif Hidayatullah

Kim, et al, 2016.Whole Body Vibration Exposures and Health Status among

Professional Truck Drivers: A Cross-sectional Analysis. Vol. 60, No. 8, pp.

936–948 <http://annhyg.oxfordjournals.org>

Kaplan HI, Sadock BJ, Grebb JA, 2010, Sinopsis Psikiatri Ilmu Pengetahuan Perilaku

Psikiatri Klinis. Binarupa Aksara, Tangerang

Karnanda, Chairani, Harjono.2016.Analisis Faktor Keluhan Nyeri Punggung Bawah

(NPB) Pada Mahasiswa Tingkat III FK UPN Veteran Jakarta. Jurnal Profesi

Medika .Vol.9 / No.3

Lalit, et al, 2015, The Prevalance Of Muskuloskeletal Disorders Among Bus Drivers

in Tricity, Vol. 2, no.5, pp. 850-854.

Murdaka E dan Bambang, 2013, Fisika Dasar untuk Mahasiswa Ilmu-Ilmu Eksakta,

Teknik & Kedokteran, edisi 2, C.V ANDI OFFSET, Yogyakarta

Motmans, 2012, Reducing whole body vibration in forklift drivers. Work; 41: 2476–

81 < https://www.ncbi.nlm.nih.gov/pubmed/22317090>

Morello R. De Capua C. 2010, A Wearable Measurement System for the Risk

Assessment Due to Physical Agents: Whole Body Mechanical Vibration

Injuries, In: Lecture Notes in Electrical Engineering, Vol. 75 pp.195-206.

<http://link.springer.com/chapter/10.1007%2F978-3-642-15687-8_10#page-

1>

Nahar et al, 2012, Prevalence of low back pain and associated risk factors among

professional car drivers in Dhaka city, Bangladesh, South East Asia Journal

of Public Health, Vol 2, no 1, pp.60-63, viewed 1 Maret 2016, dari

<http://www.banglajol.info/index.php/SEAJPH/article/view/15267>

Okunribido et al, 2008. The role of whole body vibration,posture and manual

materials handling as risk factors for low back pain in occupational drivers.

Ergonomics 51 (3), 308-329

<http://www.tandfonline.com/doi/full/10.1080/00140130701637262>

Park et al, 2013, Health Risk Evaluation of Whole-body Vibration by ISO 2631-5

and ISO 2631-1 for Operators of Agricultural Tractors and Recreational

Vehicles. Ind Health Journal,Vol 51, no. 3, pp. 364-366, viewed 21 Januari

2016 < http://www.ncbi.nlm.nih.gov/pubmed/23558167 >

Peraturan Mentri Tenaga Kerja dan Transmigrasi, 2011, Nilai Ambang Batas Faktor

Fisika dan Faktor Kimia Di Tempat Kerja, Nomor Per.13/Men/X/2011,

viewed 5 Maret 201 < http://www. betterwork.org/in-labourguide/wp-

content/uploads/PERMENA.pdf >

Putz, R , Pabst R,.2006, Atlas Anatomi Manusia Sobotta, EGC, Jakarta.

Pratiwi M. et al, Beberapa Faktor yang Berpengaruh Terhadap Nyeri Punggung

Bawah pada Penjual Jamu Gendong. Jurnal Promosi Kesehatan Indonesia

Vol. 4, No. 1, pp.61-66, viewed 5 Maret 2016,

http://www.ejournal.undip.ac.id/index.php/jpki/article/viewFile/2429/2147

Prince, Sylvia A. 2006. Patofisiologi Volume 2, Edisi 6. EGC, Jakarta, pp 1097-1098

Ricard, S Snell ,MD.2006. Anatomi Klinik untuk Mahasiswa Kedokteran, Edisi 6,

EGC, Jakarta.

Silbernagl S, Lang F, 2006, Teks & Atlas Bewarna Patofisiologi, EGC, Jakarta

Sayed, 2012. Evaluation of Whole-Body-Vibration Exposure to Cairo Subway

(Metro) Passengers. International Journal of Computer Applications ,

Volume 55, 7-15.

<http://www.ijcaonline.org/archives/volume55/number8/8773-2704>

Soedirman, Suma’mur, 2014, Kesehatan Kerja Dalam Perspektif Hiperkes &

Keselamatan Kerja, Erlangga, Jakarta, pp.122-127.

Sucipto,Cecep D, 2014. Keselamatan dan Kesehatan Kerja, Gosyen Publishing,

Yogyakarta.

Suma’mur, 2009, Higiene Perusahaan dan Kesehatan Kerja ( HIPERKES), Cv

Sagung Seto, Jakarta.

Suryanto, Dhany. 2006, Pengaruh Pajanan Getaran Seluruh Tubuh Terhadap Kejadian

Nyeri Punggung Bawah Pada Pengemudi Bajaj Dan Ojek Di Sekitar

Kelurahan Kayu Putih [Tesis], Universitas Indonesia

Thamsuwan et al., 2013, Whole body vibration exposures in bus drivers: a

comparison between a high-floor coach and a low-floor city bus,

International Journal of Industrial Ergonomics 43 (2013) 9e17

Poter, J.M. and GYI, D.E., 2002, The prevalence of musculoskeletal troubles among

car drivers. Occupational Medicine, 52, 4–12.

Nusa, Y. 2013. Hubungan Antara Umur, Lama Kerja Dan Getaran Dengan Keluhan

Sistem Muskuloskeletal Pada Sopir Bus Trayek Manado – Langowan Di

Terminal Karombasan. Jurnal Minat K3. Fakultas Kesehatan Masyarakat,

Universitas Sam Ratulangi. Manado