BAB VII SIMPULAN DAN SARAN
7.2 Saran
1. Kolam renang Bulungan dan Ragunan harus memberikan pelatihan mengenai pengelolaan air kolam renang kepada petugas kolam, seperti cara desinfeksi air kolam renang yang tepat dan cara pemantauan kualitas air kolam renang
100 2. Memberikan papan informasi kadar sisa klor dan pH terkini, agar dapat
dilihat oleh pengguna kolam renang sebelum berenang
3. Mencari tahu tentang perbandingan efektivitas pengolahan kolam air kolam renang di kolam renang Bulungan dan Ragunan pada periode musim hujan dan musim kemarau
4. Melihat gambaran sanitasi dan praktik higiene pengguna kolam renang di kolam renang yang ada di seluruh kota Jakarta dan sekitarnya atau di seluruh Indonesia
5. Mencari tahu sebelum berenang apakah kadar sisa klor dan pH kolam air kolam renang Bulungan dan Ragunan telah memenuhi syarat
6. Jika telah terjadi keluhan iritasi mata segera cuci mata dengan air yang banyak atau dengan larutan garam normal (NaCl 0,9%), selama 30 menit, atau sekurangnya satu liter untuk setiap mata dan dengan sesekali membuka kelopak mata atas dan bawah sampai dipastikan tidak ada lagi bahan kimia yang tertinggal. Tutup dengan perban steril. Segera bawa ke rumah sakit atau fasilitas kesehatan terdekat jika diyakini semakin tidak membaik
101 DAFTAR PUSTAKA
American National Standard Institute. 2011. Safety Standards for Pools, Spas and Bathing. Diakses pada 26 Januari 2014. Akses dari World Wide Web : http://webstore.ansi.org/safety_standards/consumer-products/bath-pool-spa.aspx
Bernard, Alfred., dkk. 2003. Lung Hyperpermeability and Asthma Prevalence In School Children : Unexpected Associations With the Attendance at Indoor Chlorinated Swimming Pools, Journal of Occupational and Environmental Medicine. Volume 60 Page 385-394.
Bernard, Alfred., Voisin, Catherine., Sardella, Antonia. 2011. Respiratory Risks Associated With Chlorinated Swimming Pools. Journal of American of Respiratory and Critical Care Medicine. Volume 183.
Black & Veatch. 2010. White’s Handbook of Chlorination and Alternative
Disinfectants 5th Edition. USA: John Wiley & Sons Inc Publication.
BPLHD DKI Jakarta. 2013. Laporan Status Lingkungan Hidup Daerah Provinsi DKI Jakarta Tahun 2013.
Capello, Michael Anthony. 2011. Assesing Bacteriological Contamination in Public Swimming Facilities Within a Colorado Metropolitan Community. Journal of Environmental Health. Volume 73.
Center Disease Control (CDC). 2008. Case of Recreational Water Illness on The Rise. Journal of Healthy Swimming and Recreational Water. Diakses pada 18 Januari 2014. Akses dari World Wide Web : http://www.cdc.gov/healthywater/swimming/rwi/
Center Disease Control (CDC). 2009. Recommendation for Preventing Pool Chemical- Associated Injuries.
Center Disease Control (CDC). 2013. Case of Recreational Water Illness on The Rise. Journal of Healthy Swimming and Recreational Water. Diakses pada 26 Januari 2014. Akses dari World Wide Web : http://www.cdc.gov/healthywater/swimming/rwi/
Center Disease Control (CDC). 2013. Your Disinfection Team : Chlorine & pH. Diakses pada 26 Januari 2014. Akses dari World Wide Web :
http://www.cdc.gov/healthywater/swimming/pools/disinfection-team-chlorine-ph.html
Chandra, Budiman. 2005. Pengantar Kesehatan Lingkungan. Jakarta: Buku Kedokteran EGC.
Chemical With Vernier. 2014. Determining the Free Chlorine Content of Swimming Pool Water. Journal of Vernier Software and Technology.
102 Children’s Environmental Health. 2001. Prioritization of Toxic Air Contaminants. Cita, D. W., dan Adriyani,R. 2009. Kualitas Air dan Keluhan Kesehatan
Pengguna Kolam Renang di Sidoarjo. Jurnal Departemen Kesehatan Lingkungan Fakultas Kesehatan Masyarakat Universitas Airlangga.
Clement, Annie. 1997. Legal Responsibility in Aquatics. Washington DC: Sport and Law Press.
Cuvillo, A dkk,. 2009. Allergic Conjungtivitis HI Antihistamines Investing Allergol Clin Immunol. Volume:19.USA.
Darajat, Endang. 2005. Kesesuaian Antara Hasil Pengukuran Tingkat Risiko Pencemaran dengan Inspeksi Sanitasi dan Hasil Pemeriksaan Bakteriologik pada Air Kolam Renang di DKI Jakarta Tahun 2005. Tesis. Fakultas Kesehatan Masyarakat Universitas Indonesia.
Dawes, Colin dan Carey L.,Boroditsky. Rapid and Severe Tooth Erosion from Swimming in an Improperly Chlorinated Pool Case Report. JCDA. Volume 74 Number 4.
Decker, WJ. 1988. Chlorine Poisoning at The Swimming Pool Revisited: Anatomy of Two Minidisasters. Diakses pada 18 Januari 2014. Akses dari World Wide Web : http://www.ncbi.nlm.nih.gov/pubmed/3245129
Department of Alberta Health. 2014. Pool Standards. Book Of Health System Accountability and Performance Pool Standards.
Department Of Health And Human Services U.S. 2010. Toxilogical Profile For Chlorine. Division of Toxicology and Environmental Medicine. Atlanta, Georgia.
Department Of Health Environmental Unit Melbourne. 2008. Pool Operator’s Handbook. Melbourne Victoria Australia.
Department of Health New South Wales. 1996. Public Swimming Pool and Spa Pool Guidelines. New South Wales.
Dinas Kesehatan DKI Jakarta Selatan. 2014. Sarana Olah Raga DKI Jakarta Selatan.
Dinas Olahraga dan Pemuda DKI Jakarta. 2012. Sarana Olah Raga DKI Jakarta. Edzwald, James K. 2011. Water Quality and Treatment Sixth Edition. USA: Mc
Graw Hills.
Effendi, Hefni. 2003. Telaah Kualitas Air bagi Pengelolaan Sumber Daya dan Lingkungan Perairan. Yogyakarta: Kanisius.
Eichelsdorfer,D., dkk,. 1975. Irritant Effect (Conjunctivitis) of Chlorine and Chloramines in Swimming Pool Water. Journal of Germany Research Foudation. Volume 45 page 17-28.
103 Emil T. Chanlett, Harold B.Gotaas. 1942. The Time Factor In The Chlorine And Chloramine Disinfection Of Contaminated Swimming Pool Water. Volume 32.
EPA. 1990. Chemical Emergency Preparedness and Prevention Advisory –
Swimming Pool Chemichals: Chlorine. United States of America. Series 8 Number 1.
Garcia, J. 2015. Pengaruh Hujan Terhadap Air Kolam Renang. Diakses pada 3
Juli 2015. Akses dari World Wide Web
http://www.maintenancepools.com/2012/11/pengaruh-hujan-terhadap-air-kolam-renang.html
Gordon, Harvey.1976. pH in Swimming Pools. Journal of British Medical. Surrey Area Health Authority, Mid-Surrey District, West Park Hospital.
Hasan, Achmad. 2006. Dampak Penggunaan Klorin. Jurnal Teknik Lingkungan P3 Teknologi Konversi dan Konservasi Energi Badan Pengkajian dan Penerapan Teknologi. Volume 7 Nomor 1 Halaman 90-96.
Hlavsa, dkk,. 2014. Recreational Water–Associated Disease Outbreaks — United States, 2009–2010. Journal of Centers for Disease Control and Prevention, Morbidity and Mortality Week Report Volume 63.
Hunter, Paul R., dan Thompson, Andrew. 2005. The Zoonotic Transmission Of Giardia and Cryptosporidium. Journal of International for Parasitology. Volume 35 Page 1181-1190.
Hurwitz, S.A,. 2009. Antibiotics Versus Placebo for Acute Bacterial Conjunctivitis. The Cochrane Collaboration. The Cochrane Library.
Ilyas, Sidarta. 2008. Penuntun Ilmu Penyakit Mata. Edisi ketiga. Jakarta : Fakultas Kedokteran Universitas Indonesia.
Indiana State Department Of Health. 2014. How To Shock The Pool. Environmental Public Health 2 North Meridian Street, 5-E. Indianapolis, IN 46204.
Island Empire Swimming. 2014. Stinging Eyes in Swimming Pools. Diakses pada 3 Juli 2015. Akses dari World Wide Web
http://www.ieswim.org/wzielsc/UserFiles/File/Stinging%20Eyes.pdf
Itah, Alfred Young dan Ekpombok, Mandu Uwen. 2004. Polution Status of Microbial Swimming Pool Nigeria. Journal of Microbiology. Volume 35 Number 2.
James, Broce dkk,. 2005. Lecture Notes Oftalmologi. Edisi 9. Jakarta: Erlangga Medical Series.
Jaya, Eko. 2004. Himpunan Peraturan di Bidang Lingkungan Hidup (2002-2004)- Suplemen 1. Jakarta
104 Kholid, Nur. 2012. Penetapan Most Probable Number Sebelum dan Sesudah Digunakan oleh Pengujung pada Kolam Renang Sartika Island Kabupaten Oku Timur. AKA Widya: Palembang.
Lemeshow, Stanley., David W. Hosmer Jr., Janelle Klar., Stephen K. Lwanga. 1990. Adequacy of Sample Size in Health Studies. England: John Wiley & Sons Ltd. xii
Leoni, dkk., 1999. Consumer Behavior. Edisi Tujuh. Prentice-Hall : New Jersey. Majmudar, P.A,. 2010. Allergic Conjunctivitis. Rush-Presbyterian-St Luke’s
Medical Center. Diakses pada 3 Juli 2015. Akses dari World Wide Web http://emedicine.medscape.com/ article/1191467-overview.
McKeown, David. 2009. Swimming Pool Operator’s Manual. Toronto: Public Health.
Nasli, Edwin. 2013. Estimasi Tingkat Risiko Kesehatan Non Karsinogenik Akibat Paparan Inhalasi Gas Klor pada Pengguna Kolam Renang di Kolam Renang Cilandak Sport Centre Cilandak Jakarta Selatan Tahun 2013.
Tesis. Fakultas Kesehatan Masyarakat Universitas Indonesia.
Nemery,B., Hoet, P.H.M.., dan Nowak, D. 2002. Indoor Swimming Pools, Water Chlorination And Respiratory Health. Journal of European and Respiratory. Volume 19.
Nightingale, Geoff B.J, dkk. 2008. Pool Operator’s Handbook. Melbourne: Environmental Health Unit Rural and Regional Health and Aged Care Services Division Victorian Government.
Nollet, Leo M L. 2007. Handbook of Water Analysis Second Edition. USA: CRC Press.
Noor, Indra. 2007. Faktor – Faktor yang Berhubungan dengan Kejadian Iritasi Mata pada Perenang di Kolam Renang Bulungan Jakarta Selatan Tahun 2007. Skripsi. Fakultas Kesehatan Masyarakat Universitas Indonesia.
Peraturan Menteri Kesehatan Republik Indonesia, No.416/Menkes/Per/IX/1990. Persyaratan Kualitas Air Bersih.
Peraturan Pemerintah Republik Indonesia. 1990. Pengendalian Pencemaran Air. Perkins, Philip H. 2000. Swimming Pools. London: Spon Press.
Permana, Teddy., dan Suryani, Dyah. 2013. Hubungan Sisa Klor dengan Keluhan Iritasi Kulit dan Mata pada Pemakai Kolam Renang Hotel Wilayah Km Yogyakarta. Jurnal Kesmas. Volume 7 Nomor 1.
105 Pratama, Adi dkk,. 2012. Tinjauan Karakteristik Air Kolam Renang Stadion Andi Mattalata dan UNHAS Kota Makassar. Bagian Kesehatan Lingkungan. FKM : UNHAS.
Rabi, Atalah, dkk. 2008. Sanitary Condition Public Swimming Pools in Amman, Jordan. International Journal of Environmental Research and Public Health. Volume 5 Number 3.
Reksosoebroto, Soebagio. 1990. Ilmu Higiene dan Sanitasi. Jakarta: APK.
Reynolds. 1982. Unit Operations and Processes In Environmental Engineering. California:Wadsworth Inc.
Riduwan. 2005. Skala Pengukuran Variabel-Variabel Penelitian. Bandung: Alfabeta.
Rylander, Ragnar.,Victorin,Katarina.,Sorensen,Stefan.1973. The Effect Of Saline On The Eye Irritation Caused By Swimming Pool Water. Journal of Environmental Hygiene. Volume 71 Page 587.
Said, Nusa Idaman. 2007. Kualitas Air dan Kesehatan Masyarakat. Jakarta. Sanroepi. Djasio, dkk. 1984. Pedoman Bidang Studi Penyediaan Air Bersih.
Jakarta
Santoso, Singgih dan Tjiptono, Fandy. 2001. Riset Pemasaran: Konsep dan Aplikasi dengan SPSS. Jakarta: PT Elex Media Komputindo.
Schets, Franciska M, dkk. 2011. Exposure Assesment for Swimmers in Bathing Waters and Swimming Pools. Journal of Water Research. Volume 45.
Sherwood, L. 2001. Fisiologi Manusia; Dari Sel ke Sistem. Edisi 2. Jakarta: EGC. Sinha, Alkansha. 2011. The Pleasures of Swimming and Importance of
Maintaining Pool Hygiene.
Siswanto, Hadi. 2002. Kamus Populer Kesehatan Lingkungan. Jakarta: Buku Kedokteran EGC.
Spivey, Angela. 2010. Swimmer Protect Theyself, Cleaning up The Environment. Journal of Environmental Health Perspectives. Volume 118 Number 11. Sugiyono (2004). Metode Penelitian Bisnis. Cetakan Kedua. Bandung: CV Alfa
Beta.
Sunu, P. 2001. Melindungi Lingkungan dengan Menerapkan ISO 14001. PT Grasindo. Jakarta
Susanna, D. 2001. Kesehatan Lingkungan. Universitas Indonesia. Jakarta.
106 Thomson, H, dkk. 2003. Assesing The Health Impact of Local Amenities: A Qualitative Study of Contrasting Experiences of Local Swimming Pool and Leisure Provision in Two Areas of Glasgow. Journal of Epidemial Community Health. Volume 57 Pages 663-667.
United Nation Water ,2014. A Post 2015 Global for Water: Syntehsis of Key Findings and Recommendations from UN-Water.
United States Environmental Protection Agency. Chemical Emergency Preparedness and Prevention Advisory (Swimming Pool Chemichals:Chlorine). Series 8 Number 1.
UPT Gelanggang Remaja Jakarta Selatan. 2014. Laporan Pengunjung Kolam Renang Bulungan dan Ragunan Karcis Hijau dan Putih.
USA Census Bureau. 2012. Statistical Abstract of the United States, Participation in Selected Sport Activities. Diakses pada 19 Januari 2014. Akses dari
World Wide Web :
http://www.census.gov/compendia/statab/2012/tables/12s1249.pdf Vaughan, D. 2010. Oftalmologi Umum. Edisi 17. Jakarta: EGC.
Villanueva, Cristina M., dan Ribera, Laia Font. 2012. Health Impact Of Disinfection By Products In Swimming Pools. Journal of Research in Environmental Epidemiology. Volume 48 Number 4.
Wardhana, Wisnu Arya. 2004. Dampak Pencemaran Lingkungan. Yogyakarta: Andi.
World Health Organization (WHO). 2006. Guidelines for Safe Recreational Environments, Volume 2 Swimming Pools and Similar Environments. Geneva: WHO Press.
Wulantika, Resa. 2011. Tinjauan Praktik Higiene Pengguna Kolam Renang dan Kualitas Air Kolam Renang X, Depok. Skripsi. Fakultas Kesehatan Masyarakat Universitas Indonesia.
Wyner, Larry J. 2007. Statistical Framework for Recreational Water Quality Criteria and Monitoring. England : John Wiley and Sons Ltd.
Zarzoso, M, Liana S, Perez Soriano. 2010. Potential Negative Effects of Chlorinated Swimming Pool Attendance on Health of Swimmers and Associated Staff. Journal of Biology of Sport. Volume 27 Number 4.
Zwiener, Christian dkk,. 2007. Drowning In Disinfection Byproducts? Assesing Swimming Pool Water. Journal of Environmental Science & Technology. Volume 41, Number 2.
107
108 Lampiran 1
No. Responden :
Tanggal wawancara dan observasi : .../.../2015 (tanggal/bulan/tahun)
Lembar Checklist Keluhan Iritasi Mata Pada Perenang Kolam Renang Tahun 2015
A. Karakteristik Responden
1. Nama :
2. Jenis Kelamin*) : Laki-laki/Perempuan
3. Umur : ... Tahun
4. Pekerjaan : ...
B. Lembar Checklist Keluhan Iritasi Mata
No Keterangan Ya Tidak
1 Mata terasa perih
2 Mata terasa panas
3 Penglihatan kabur
4 Mata memerah
5 Mata terasa gatal
a. Berapa lama Anda berenang di dalam air kolam renang? a. 10 - 15 menit
b. > 15 menit
109 Lampiran 2
Formulir Desinfeksi Sanitasi
A. Keterangan Umum
1. Lokasi :
2. Kode Sarana :
3. Tanggal Kunjungan :.../.../... Jam ... ...WIB 4. Nomor Kode Sampel Air :
B. Desinfeksi Sarana Dengan Kaporit
1. pH air saat kunjungan : 2. Kadar sisa klor saat kunjungan : 3. Sisa klor yang diharapkan : 4. pH yang diharapkan :
110 Lampiran 3
111 Lampiran 4
112 Lampiran 5
Petugas sedang memeriksa kadar sisa klor dan pH
Hasil Test Kit, kadar sisa klor 3 mg/L
Reagen pH dan reagen Chlorine Residue
Box Test Kit untuk Kolam Renang
Pencatatan setelah pemeriksaan kualitas air
Kadar sisa klor dan pH
Merk Kaporit yang digunakan Tempat penyimpanan soda ash Alat Vacuum
Petugas sedang mengaduk kaporit
Petugas sedang menuang air kaporit
Pengunjung kolam renang Bulungan yang ramai
113 Lampiran 6
Petugas sedang memeriksa kadar sisa klor dan pH
Kadar sisa klor dan pH
Kadar sisa klor dan pH Ruang Mesin Pengunjung yang ramai di kolam renang Ragunan
Kadar sisa klor dan pH Pengguna kolam renang bersiap berenang
Ruang mesin tampak dari luar dan penyimpanan kaporit
Kadar sisa klor dan pH Pengguna kolam renang kebanyakan tidak menggunakan
Petugas sedang mengawasi dan memperingatkan pengunjung
114 Lampiran 7
Case Processing Summary
Cases
Valid Missing Total
N Percent N Percent N Percent
kadar sisa klor *
Keluhan_iritasi_mata 112 100.0% 0 .0% 112 100.0%
kadar sisa klor * Keluhan_iritasi_mata Crosstabulation
Keluhan_iritasi_mata
Total Ada Keluhan
Tidak Ada Keluhan kadar sisa klor Tidak Memenuhi
Syarat
Count 53 12 65
% within kadar sisa
klor 81.5% 18.5% 100.0%
Memenuhi Syarat Count 21 26 47
% within kadar sisa
klor 44.7% 55.3% 100.0%
Total Count 74 38 112
% within kadar sisa
klor 66.1% 33.9% 100.0% Chi-Square Tests Value df Asymp. Sig. (2-sided) Exact Sig. (2-sided) Exact Sig. (1-sided) Pearson Chi-Square 16.530a 1 .000 Continuity Correctionb 14.927 1 .000 Likelihood Ratio 16.681 1 .000
Fisher's Exact Test .000 .000
Linear-by-Linear Association 16.382 1 .000
N of Valid Casesb 112
a. 0 cells (,0%) have expected count less than 5. The minimum expected count is 15,95. b. Computed only for a 2x2 table
115
Risk Estimate
Value
95% Confidence Interval
Lower Upper
Odds Ratio for kadar sisa klor (Tidak Memenuhi Syarat / Memenuhi Syarat) 5.468 2.336 12.800 For cohort Keluhan_iritasi_mata = Ada Keluhan 1.825 1.301 2.560 For cohort Keluhan_iritasi_mata = Tidak Ada Keluhan .334 .188 .591 N of Valid Cases 112
Case Processing Summary
Cases
Valid Missing Total
N Percent N Percent N Percent
lama berenang * keluhan 112 100.0% 0 .0% 112 100.0%
lama berenang * keluhan Crosstabulation
keluhan
Total Ada Keluhan
Tidak Ada Keluhan
lama berenang Batas Count 40 27 67
% within lama berenang 59.7% 40.3% 100.0%
Melebihi Batas Count 21 24 45
% within lama berenang 46.7% 53.3% 100.0%
Total Count 61 51 112
% within lama berenang 54.5% 45.5% 100.0%
Chi-Square Tests Value df Asymp. Sig. (2-sided) Exact Sig. (2-sided) Exact Sig. (1-sided) Pearson Chi-Square 1.844a 1 .174 Continuity Correctionb 1.356 1 .244 Likelihood Ratio 1.845 1 .174
Fisher's Exact Test .183 .122
Linear-by-Linear Association 1.828 1 .176
N of Valid Casesb 112
a. 0 cells (,0%) have expected count less than 5. The minimum expected count is 20,49. b. Computed only for a 2x2 table
116
Risk Estimate
Value
95% Confidence Interval
Lower Upper
Odds Ratio for lama berenang (Batas / Melebihi Batas)
1.693 .790 3.629
For cohort keluhan = Ada
Keluhan 1.279 .884 1.851
For cohort keluhan = Tidak
Ada Keluhan .756 .507 1.127
N of Valid Cases 112
Case Processing Summary
Cases
Valid Missing Total
N Percent N Percent N Percent
Kadar pH * Keluhan 112 100.0% 0 .0% 112 100.0%
Kadar pH * Keluhan Crosstabulation
Keluhan
Total Ada Keluhan
Tidak Ada Keluhan
Kadar pH Tidak Memenuhi Syarat Count 53 12 65
% within Kadar pH 81.5% 18.5% 100.0%
Memenuhi Syarat Count 21 26 47
% within Kadar pH 44.7% 55.3% 100.0% Total Count 74 38 112 % within Kadar pH 66.1% 33.9% 100.0% Chi-Square Tests Value df Asymp. Sig. (2-sided) Exact Sig. (2-sided) Exact Sig. (1-sided) Pearson Chi-Square 16.530a 1 .000 Continuity Correctionb 14.927 1 .000 Likelihood Ratio 16.681 1 .000
Fisher's Exact Test .000 .000
Linear-by-Linear Association 16.382 1 .000
N of Valid Casesb 112
a. 0 cells (,0%) have expected count less than 5. The minimum expected count is 15,95. b. Computed only for a 2x2 table
117
Risk Estimate
Value
95% Confidence Interval
Lower Upper
Odds Ratio for Kadar pH (Tidak Memenuhi Syarat / Memenuhi Syarat)
5.468 2.336 12.800
For cohort Keluhan = Ada
Keluhan 1.825 1.301 2.560
For cohort Keluhan = Tidak
Ada Keluhan .334 .188 .591