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1. Prof. Budi Haryanto, MSPH, MSc, PhD, FCR
Department of Environmental Health
Research Center for Climate Change
Universitas Indonesia
Polusi Udara Jakarta:
Status, Dampak Kesehatan,
dan Pengendaliannya
Lokakarya Peringatan Hari Kesehatan Lingkungan Dunia
Jakarta, 26 September 2022

2. Air Quality Index & Health Impacts

3. AQI
Greater
Jakarta
8
pm,
September
25,
2022

4. AQI
Greater
Jakarta
9
pm,
September
25,
2022

5. AQI
Greater
Jakarta
5
am,
September
26,
2022

6. AQI
Greater
Jakarta
6
am,
September
26,
2022

7. AQI
Greater
Jakarta
7
am,
September
26,
2022

8. AQI
Greater
Jakarta
8
am,
September
26,
2022

9. AQI
Greater
Jakarta
9
am,
September
26,
2022

10. WHO has named air pollution
as the world’s largest
environmental health risk.
Source: WHO 2019, The ten threats to global health

11. Proporsi Relatif Dampak Lingkungan
Yg Disebabkan oleh Pencemaran
Udara
Note: Average for 6 developing cities
Source: Lvovsky et al.

13. Air pollution & deaths in Java vs SEARO

14. POLUTAN UDARA

15. PENCEMARAN UDARA & PENYAKIT

16. PENCEMARAN UDARA & KEMATIAN

17. 17
Polutan & Penyakit
Kanker: PM2.5
atau lebih kecil, PAHs, metals (AS
Cd Cr)
Penyakit jantung: CO, O3
, PM, Pb
Penyakit2 saluran nafas: SO2
, NO2
, PM10
dan
PM2.5
, O3
Gangguan pertumbuhan fisik: Pb, Hg, Cd
Gangguan system syaraf: Pb, PCBs, Methyl Hg,
Mn

18. • Kematian dini
• Kanker paru
• Peningkatan kasus PPOK
• Memperparah penyakit paru kronis
• Serangan jantung
• Kunjungan ke rumah sakit dan IGD pasien penyakit paru
& jantung
• Gangguan pernafasan dan pengobatan pada penderita
penyakit paru kronis dan asma
• Berkurangnya fungsi paru
• Kelahiran prematur
• BBLR
Dampak Kesehatan Partikulat

19. KELOMPOK RENTAN
✔ Anak-anak
✔ Lansia
✔ Penderita penyakit paru & jantung
✔ Perokok
✔ Olahraga berat
✔ Pekerja di sumber polusi

20. Hasil-hasil riset Internasional
■ Studi time-series di dunia: Sekitar 5% sampai
10% peningkatan kematian karena
penyakit-penyakit tersebut berhubungan dengan
peningkatan PM10
sebesar 100 µg/m3
per-hari
(rata-rata). Di Asia 6% - 30% (PAPA Nov ’08).
■ Penelitian cohort prospective 8111 populasi kulit
putih dewasa: peningkatan risiko kematian
sebesar 26% pada perbedaan konsentrasi PM2.5
di udara sebesar 18,6 µg/m3
(Dockery et al,
1993).
■ Penelitian yang melibatkan 552.138 populasi
dewasa di 151 kota metropolitan USA:
peningkatan risiko kematian sebesar 17% pada
perbedaan konsentrasi PM2.5
di udara sebesar
24.5 µg/m3
(Pope et al, 1995).

21. TEMUAN RISET
Di Amerika Serikat, telah diketahui bahwa bronchitis
kronik menyerang 1 dari 5 orang pria usia 40-60
tahun, hal ini berhubungan dengan merokok dan
tinggal di daerah perkotaan yang udaranya
tercemar.
Penyakit jantung ditemukan 2x >morbiditasnya di
daerah dengan polusi udara tinggi.
Carbon-monoksida (CO) menghambat transfer
oksigen di darah dan dapat menyebabkan bahaya
pada jantung, apalagi bila telah ada tanda-tanda
penyakit jantung sebelumnya.
(Afinitas CO terhadap haemoglobin adalah 210 kali lebih besar daripada O2
sehingga bila kadar CO Hb ≥ 50%, akan dapat terjadi nekrosis otot jantung.

22. TEMUAN RISET…
Mortalitas akibat Kanker Paru pada non-smokers
di daerah urban 10x lebih besar daripada daerah
rural. Kanker lambung, ditemukan 2x lebih
banyak pada daerah dengan polusi tinggi (Stocks
& Campbell).
PPOK/COPD (Penyakit Paru Obtruktif Kronis)
merupakan penyebab kematian terbanyak ke 3 di
dunia, dimana lebih dari 80% kematian terjadi di
negara miskin dan berkembang. Faktor risikonya
adalah: merokok, indoor pollution, polusi di salam
industry (debu, gas, bahan kimia) (WHO, 2021).

23. PM2.5
MOBIL PRIBADI - A.C. 2005
Depok – Gatot Subroto (mg/m3
)

24. CO Mobil Pribadi ber-AC
Ciputat – Salemba (ppm)

26. Riset Kohort ISPA Anak Sekolah Jakarta 2004
Group Number of
incidence
Incidence
Rate (%)
Survival
Time (days)
Hazard Ratio P - value
Sore throat
High polluted
Low polluted
122
115
9.2
7.4
3 – 4
7 – 8
1.3
1.0
0.21
Cough
High polluted
Low polluted
101
129
4.9
11.0
8 – 9
3 – 4
0.5
1.0
0.00
Phlegm
High polluted
Low polluted
98
139
9.1
8.1
3 – 4
4 – 5
0.9
1.0
0.70
Nasal
High polluted
Low polluted
56
123
8.7
12.2
2 – 3
5 – 6
1.3
1.0
0.13
Cough+Phlegm
High polluted
Low polluted
54
68
3.8
3.1
1 – 2
1 – 2
1.2
1.0
0.45
Cough+Nasal
High polluted
Low polluted
55
55
5.4
5.3
1 – 3
1 – 2
1.1
1.0
0.79

27. ASMA & GANGGUAN FUNGSI PARU
TANGERANG & MAKASSAR 2011
DISEASES
TANGERANG
N=4250
%
MAKASSAR
N=2900
%
Asthma
Abnormal lung function
1.3
21
1.3
24

28. 38.5% gangguan fungsi paru
pada Ibu Rumah tangga
Tidak ada perbedaan kejadian
ISPA anak sekolah di wilayah
tinggi polusi dan rendah polusi

29. Exposure to PM2.5
and Lung Function Impairments on the Public
Transportation Drivers in Jakarta 2019
56% adult male impaired lung function
Tia Prabawati Suhengsia
, Budi Haryantoa*
Submitted to Akademi Saisns Malaysia Journal (Q2)

30. Penyakit Terkait Polusi Udara
Jakarta 2010 (UI-KLHK-UNEP)
1,210,581 people suffered by asthmatic bronchiale (12.6%)
153,724 people with bronchopneumonia ( 1.6%)
2,449,986 with ARI (25.5%)
336,273 people with pneumonia ( 3.5%)
153,724 people with COPD ( 1.6%)
1,246,130 people with coronary artery diseases (13.0%)
57.8% of the Jakarta population had already suffered by various air
pollution-related diseases in 2010

31. US $ 53,846,154 – 2,962,112,861
Dampak Ekonomi Penyakit Terkait
Polusi Udara KLHK-UNEP 2010

33. Diseases-related to Air Pollution &
BPJS’s Claimed in Jakarta

35. Statistic regression between air quality parameters
and disease outcomes in the city of Bandung,
Palembang, and Jakarta 2014-2020

36. Risk of Diseases-related Air Pollution
in Jakarta 2016-2021
An increase per 10 μg/m3
PM2.5
was associated with a
5.7% increase of Pneumonia cases
An increase per 10 μg/m3
SO2
was associated with a 6.7%
increase of Pneumonia cases
An increase per 10 μg/m3
PM10
was associated with a
1.4% increase of Acute Respiratory Infection cases

37. PTM 60% kematian
Cardiovascular diseases,
Diabetes Mellitus,
Cancer,
COPD (chronic obstructive pulmonary
disease)
In Indonesia 2018: CVDs Rp.10,5 T, Cancer
Rp.3,4 T, Stroke Rp. 2,6 T, Chronic renal disorder
Rp.2,4 T, Thalassemia Rp.490 M, Hemophilia Rp.
358 M, Cirrhosis hepar Rp.334 M, & Leukemia
Rp. 333 M.
Total Rp. 20 T.
"Kemenkes: Biaya Penyakit Tidak Menular Capai Rp20 Triliun Pada 2018", https://tirto.id/dK5x

38. AIR POLLUTION & COVID-19
The death risk of Covid-19 is 4.5 times more in high PM2.5
polluted areas than in low polluted areas (Wu et al. Harvard
study, NEMJ April 2020). Based on 2002-2019 PM2.5
data in
3080 counties in America (98% of the population). 15% of those
exposed to long-term PM2.5
were more likely to die from
Covid-19.
Studies in high-polluted areas of Northern Italy, Covid mortality
is 12%, while the whole of Italy is 4.5% (Conticini et al, Env
Pollution, 2020)
83% of Covid-19 deaths occurred in areas of high NO2
pollutant
levels in Italy, France, Spain and Germany (Ogen et al, Science of
the Total Environment, 2020).
All Covid-19 patients in the Philippines have congenital
diseases, the majority of which are related to air pollution
(Bugaoisan, 2020).

39. AIR POLLUTION & COVID-19…
In Mexico City, each average increase of 1 μg/m3
in PM2.5
was associated with
a 7.4% increase in Covid-19 deaths (Lopez-Feldman et al, 2021)
In 36 OECD countries, high PM2.5
concentrations (>WHO standard) in
2015-2017 were associated with COVID-19 morbidity and mortality on the
40th and 60th days since the first cases were discovered in each country
(Barnett-Itzhaki, Levi, 2021) .
In the UK, PM2.5
concentrations are associated with a 12% increase in positive
cases of COVID-19 (Travaglio et al, 2021). An increase per 1 μg/m3
PM2.5
long-term exposure was associated with a 4.4% increase in Covid-19 deaths
(Konstantinoudis et al, 2021).
In DKI Jakarta, each average increase of 50 μg/m3 in PM2.5 was associated
with a 11% increase in Covid-19 deaths (Haryanto et al, 2022 unpublished)
In countries with high levels of air pollution, these risk factors must be
considered in preparation for controlling Covid-19. Because air pollution
increases the high mortality rate (Maria Neira, Director of Public Health &
Env, WHO, 2020).

45. Strategies to control air pollution
Reduce vehicles on the road
Improve fuel quality and or implement clean
energy
Adequate engine technology
Manage land transportation
Increase the number of AQMS

46. Emission reduction scenarios
RCCCUI-TCAP-IIASA 2014-2017

47. 2025: 31.2 %
2050: 56.5 %
EURO 4 Total NOx
emission reduction:
In 2017: In 2020:
2025: 46.8 %
2050: 56.3 %
2025: 36.4 %
2050: 56.5 %
In 2023:

49. 2025: 26.0 %
2050: 58.3 %
EURO 4 Total PM10
emission reduction:
In 2017: In 2020:
2025: 32.2 %
2050: 68.7 %
2025: 25.8 %
2050: 58.3 %
In 2023:

50. Human Protection to Air Pollution
1. Read the daily forecast to see what air pollution
forecasts look like.
2. Close your doors and windows when the AQI is
over 151.
3. Recirculate the air in your car while you drive.
4. Wear a mask that filters out most bad air particles
5. Take a shower after spending a lot of time
outside.
6. Travel to work a bit earlier so you aren’t exposed
to as much exhaust.
7. Switch to a healthy diet so you aren’t as
vulnerable.

51. CONCLUSION
Air pollution is a major cause of diseases (58%)
among Jakarta population in 2010
Air pollutants are highly existed and estimated
sharply increased in the future
Air pollutants will be putting more population in
severe risk of serious health effects
Air pollution related diseases is preventable and
manageable 🡪 willingness, commitment, focus, and
serious actions of all stakeholders

52. Source: NASA
THANK YOU