CEGAH CORONA
Memilih Disinfektan yang Aman:
Yuk Kaum Muda Pasti Bisa!
Fatma Lestari
Gaul Online Bareng DK3N
Selasa, 31 Maret 2020
Perkenalan
1993: S1 Kimia FMIPA UI
1997: S2 Kimia FMIPA UI
2006 : PhD in Safety Science, UNSW, Sydney, Australia
1995 - sekarang: Dosen Dep K3 FKM UI
2014 : Guru Besar FKM UI
2014 – sekarang: Disaster Research & Response Centre UI
2019: UN Disaster Risk Reduction Working Group on Natech
2008 - 2019: Tim Independen Keselamatan Migas
2020: Dewan K3 Nasional
2020: Tim Ahli PMI - Disinfektan
Agenda
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Statistik Coronavirus & Prediksi
Populasi berisiko
Virus Korona
Silent Carrier
Berapa lama virus korona berada di permukaan?
Seberapa sering kaum muda menyentuh wajah?
Siapa garda terdepan pencegahan penyebaran virus
korona?
Cuci tangankah anda setelah dari toilet?
Bagaimana disinfektan membunuh virus corona?
Mengenal jenis-jenis disinfektan
Memilih disinfektan
Apakah aman mencampur pelbagai produk disinfektan?
Apakah aman menyemprot disinfektan ke tubuh manusia?
Statistik
Mortality Rate
World: 3.4%
Indonesia: 8.6%
Italy: 9%
Iran: 7.8%
Spanyol: 6%
https://www.covidvisualizer.com
https://www.worldometers.info/coronavirus/coronavirus-death-rate/
Realita vs Prediksi
https://www.worldometers.info/coronavirus/
https://news.detik.com/berita/d-4957064/tim-fkm-ui-tanpa-intervensi-negara-25-juta-orang-ri-bisa-kena-corona/2
Populasi berisiko
https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/
Virus Corona
https://www.scientificanimations.com/3d-medical-animation-still-shot-showing-coronavirus-structure/
Silent Carrier
https://www.weforum.org/agenda/2020/03/people-with-mild-or-no-symptoms-could-be-spreading-covid-19/
23 Mar 2020
Around 60% of people with coronavirus show mild or
no symptoms.People without symptoms can infect
others
By our most conservative estimate, at least 59% of
the infected individuals were out & about, without
being tested and potentially infecting others
Berapa lama Virus Corona berada di permukaan?
Human coronaviruses
can remain infectious
on inanimate surfaces
for up to 9 days
Seberapa sering Kaum Muda menyentuh wajah?
On average, each of the 26 observed students
touched their face 23 times per hour.
Siapakah Garda Terdepan Pencegahan Penyebaran Virus Corona?
ANDA
Cuci tangankah anda sesudah dari toilet?
The survey, conducted by Wirthlin Worldwide in August 2003,
observed 7,541 people in public washrooms in New York,
Chicago, San Francisco, Dallas, Miami, and Toronto.
https://www.sciencedaily.com/releases/2003/09/030916074111.htm
Bagaimana disinfektan membunuh virus Corona?
Disinfeksi: proses membunuh kuman/mikroba (bakteri, jamur, virus) yang terdapat di permukaan benda mati
(non-biologis) seperti: pakaian, lantai, dinding, logam
MEKANISME AKSI
• Merusak dinding sel
• Denaturasi &
pengendapan protein
• Denaturasi &
Saponifikasi Lemak
• pH (ion hidroksil)
• Alkilasi asam nukleat
• Berikatan dengan
fosfolipid membrane sel
Video: https://www.youtube.com/watch?v=s2EVlqql_f8
•
Kimiawi: sabun, desinfektan kimia, pH
tinggi/rendah
•
Non Kimiawi: panas, UV, sinar
matahari, pasteurisasi
https://www.who.int/publications-detail/water-sanitation-hygiene-and-waste-management-for-covid-19
Mengenal jenis-jenis desinfektan kimia
• Alkohol
• Etanol
• Isopropil Alkohol
• Klorin & Senyawaan Klorin
• Natrium hipoklorit
(cairan)
• Kalsium hipoklorit
(padatan)
• Aldehid
• Formaldehid
• Glutaraldehid
• Asam Perasetat
• Asam perasetat
• Asam perasetat & hidrogen
peroksida
• Fenol
• ortho-phenylphenol
• ortho-benzyl-parachlorophenol
• Biguanida:
• Klorheksidin
• Senyawa Ammonium Quartener
• Benzalkonium klorida
• Hidrogen peroksida
• Iodofor
• Larutan iodin
• Orto-phtalaldehid (OPA)
https://www.cdc.gov/infectioncontrol/guidelines/disinfection/disinfection-methods/chemical.html
Disinfektan: bahan yang dapat digunakan
untuk membunuh kuman/mikroba yang
terdapat di permukaan benda mati (nonbiologis) seperti: pakaian, lantai, dinding,
logam
Bimo A. Tejo. IIHA Webinar. 2020
Efektivitas Disinfektan
Kuat
Contoh: Kaporit
dilarutkan  Hipoklorit
0.5%
Lemah
Jenis Bahan Kimia
Contoh: Kaporit
dilarutkan  Hipoklorit
0.05%
Konsentrasi
Waktu kontak (wet time)
waktu yang dibutuhkan oleh disinfektan untuk tetap berada dalam bentuk cair/basah pada
permukaan & memberikan efek “membunuh” kuman
15 detik……………..10 menit
https://www.beckershospitalreview.com/quality/the-importance-of-contact-time-andvisible-wetness-to-ensure-effective-disinfection.html
Memilih disinfektan secara tepat
• Pilih disinfektan yang tepat untuk membunuh
kuman
Daftar Sementara Bahan Aktif dan Produk Rumah Tangga untuk
Siaran Pers
Bisa diakses melalui www.lipi.go.id
Disinfeksi Virus Corona Penyebab COVI D-19
• Lakukan kaji risiko - SDS
Disinfektan menjadi salah satu kunci dalam pencegahan penyebaran virus corona penyebab COVI D-19.
Namun informasi yang kurang tepat mengenai antisipasi COVI D-19 seringkali menimbulkan kepanikan
yang tidak perlu juga kesalahan dalam penggunaannya. Lembaga I lmu Pengetahuan I ndonesia (LI PI )
merilis daftar sementara bahan aktif dan produk rumah tangga untuk disinfeksi virus corona penyebab
COVI D-19. LI PI menghimbau masyarakat agar membeli sesuai kebutuhan dan memprioritaskan
ketersedian bahan serta produk tersebut untuk kepentingan penanganan medis COVI D-19 yang lebih
mendesak.
• Cek regulasi, standar, rekomendasi
• Konsentrasi tepat – baca instruksi kemasan
Bandung, 23 M aret 2020. COVID-19 merupakan penyakit menular yang disebabkan oleh severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2) yang merupakan virus corona jenis baru. Virus corona
merupakan virus yang memiliki selubung atau sampul (enveloped virus) dengan pelindung lapisan lemak.
Di i fek a da a e ak a i a e ak e eb ehi gga e b a virus corona cukup lemah dibandingkan
dengan norovirus yang merupakan virus tanpa selubung dan virus lainnya yang memiliki cangkang protein yang
lebih kuat,
gka Kepala Loka Penelitian Teknologi Bersih LIPI, Ajeng Arum Sari di Bandung, Jawa Barat
pada Senin (23/3).
• Waktu kontak
• Teknik menggunakan tepat – baca instruksi
Peneliti Loka Penelitian Teknologi Bersih LIPI, Chandra Risdian mengungkapkan banyak produk rumah tangga
umum mengandung konsentrasi bahan aktif yang sesuai untuk disinfeksi. Dirinya menjelaskan, bahan aktif dan
konsentrasi efektifnya yang tercantum dalam Tabel 1 telah terbukti efektif melawan virus corona berdasarkan
studi literatur yang dilakukannya.
Se ai e gg aa age e be ih, e a a a ai a g efek if e hada virus corona adalah dengan metode
PersBerdasarkan informasi yang diterima dari The Robert Koch
e be ia a da e ak a a a , e a gSiaran
Chandra.
Bisa diakses melalui www.lipi.go.id
Institute (RKI), Jerman, Chandra menjelaskan bahwa jika produk disinfektan yang aktif terhadap virus corona
Daftar
Sementara
Bahan
Aktifsetidaknya
dan Produk
Rumah
Tangga
untukterhadap virus berselimut
tidak tersedia,
produk
disinfektan
lain yang
memiliki
aktivitas
virucidal
Virus Corona Penyebab COVI D-19
(enveloped virus) jugaDisinfeksi
dapat digunakan.
Tabel 1
Disinfektan menjadi salah satu kunci dalam pencegahan penyebaran virus corona penyebab COVI D-19.
NamunNo.
informasiBahan
yang kurang
aktif tepat mengenai antisipasi COVI D-19 seringkali menimbulkan kepanikan
yang tidak perlu juga kesalahan dalam penggunaannya. Lembaga I lmu Pengetahuan I ndonesia (LI PI )
a
Accelerated
hydrogen
peroxide
(0.5%)
merilis1daftar sementara
bahan
aktif dan
produk
rumah tangga untuk disinfeksi virus corona penyebab
COVI
PI menghimbau
masyarakat
agarammonium
membeli sesuai
dan memprioritaskan
chloride
/ quaternary
/ alkylkebutuhan
dimethyl benzyl
ammonium chloride)
2 D-19. LIBenzalkonium
ketersedian bahan
sertab produk tersebut untuk kepentingan penanganan medis COVI D-19 yang lebih
(0.05%)
mendesak.
3
Chloroxylenol (0.12%)c
Bandung,
merupakan
4 23 M aret
Ethyl2020.
alcoholCOVID-19
atau ethanol
(62-71%)d,epenyakit menular yang disebabkan oleh severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2)
yang merupakan virus corona jenis baru. Virus corona
b
5 virus Iodine
in iodophor
(50 ppm)
merupakan
yang memiliki
selubung
atau sampul (enveloped virus) dengan pelindung lapisan lemak.
b
Di i fek6 a da a Isopropanol
e ak a atau
i a 2-propanol
e ak e eb
gga e b a virus corona cukup lemah dibandingkan
(50%)ehi
dengan norovirus yang merupakancvirus tanpa selubung dan virus lainnya yang memiliki cangkang protein yang
7
Pine oil (0.23%)
lebih kuat,
gka Kepala Loka Penelitian Teknologi Bersih LIPI, Ajeng Arum Sari di Bandung, Jawa Barat
8 (23/3).Povidone-iodine (1% iodine)d
pada Senin
d, f
9
Sodium
hypochlorite
(0.05
Peneliti Loka
Penelitian
Teknologi
Bersih
LIPI,0.5%)
Chandra Risdian mengungkapkan banyak produk rumah tangga
umum mengandung
konsentrasi
bahan
aktifb yang sesuai untuk disinfeksi. Dirinya menjelaskan, bahan aktif dan
10
Sodium
chlorite
(0.23%)
konsentrasi efektifnya yang tercantum dalam Tabel 1 telah
terbukti efektif melawan virus corona berdasarkan
11
Sodium dichloroisocyanurate (0.1-0.5%)g
studi literatur yang dilakukannya.
Bimo A. Tejo. IIHA Webinar. 2020
Memilih disinfektan secara tepat
Table 2. List of Household Disinfectants/Cleaning Products Effective Against
Coronaviruses
A. Corrosive to metals, wipe away residues with wet cloth after 10 minutes.
B. Flammable at high concentration. Keep away from heat/sparks/open flames/hot surfaces.
C. Not all recommended dilutions stated on the label meet the concentration requirement
indicated in Table 1. Adjustment in dilution ratio may be required.
https://www.nea.gov.sg/our-services/public-cleanliness/environmental-cleaning-guidelines/guidelines/interim-list-of-household-products-and-active-ingredients-for-disinfection-of-covid-19
Memilih Disinfektan pembunuh Virus Corona
Sodium hypochlorite
0.01-0.5%
Glutardialdehyde
2%
Etanol
62-71%
Ortho-phtalaldehyde
0.55%
Benzalkonium
chloride
0.04%
Surface disinfection with 0.1% sodium hypochlorite or 62-71%
ethanol significantly reduces coronavirus infectivity on
surfaces within 1 min exposure time
Memilih disinfektan secara tepat
Larutan
Pemutih
Zat Aktif:
Hipoklorit
Pembersih
Lantai
Zat Aktif:
Benzalkonium
Klorida
Larutan Klorin
Zat Aktif:
Hipoklorit
Desinfektan
Peroksida
Zat Aktif:
Hidrogen
Peroksida
Karbol/Lysol
Zat Aktif:Fenol
COVID-19 virus berbentuk
envelope dengan membran
luar yang rentan
Apakah aman mencampur pelbagai produk disinfektan?
Dikutip dari World of Buzz dari The Poiseon National Malaysia Sabtu (6/7/2019)
TIDAK!
sebuah insiden terjadi. Seorang ibu rumah tangga tewas keracunan parah
setelah mencampur
pemutih & detergen.
https://intisari.grid.id/read/031777202/jangan-pernah-campur-detergen-dan-pemutih-saat-mencuci-karena-hal-mengerikan-ini-bisa-terjadi?page=all
Mengapa?
X
Lysol & Bleach
Gas Klorin & Kloramin
Gas beracun, dapat
menyebabkan iritasi mata &
saluran pernafasan,
kematian
Hidrogen peroksida &
Cuka
Amoniak & Pemutih
Cuka & Pemutih
Peracetic Acid
Hidrazin
Gas beracun, menyebabkan
kerusakan saluran
pernafasan
Gas Klorin & Kloramin
Gas beracun, dapat
menyebabkan iritasi mata &
saluran pernafasan,
kematian
Ledakan
https://www.doh.wa.gov/YouandYourFamily/HealthyHome/Contaminants/BleachMixingDangers
Concept and design: Dumas, Zock, Speizer, Le Moual, Camargo.
Acquisition, analysis, or interpretation of data: All authors.
Apakah aman menyemprot disinfektan ke tubuh manusia?
Drafting of the manuscript: Dumas.
Critical revision of the manuscript for important intellectual content: Varraso, Boggs, Quinot, Zock, Henneberger, Speizer, Le Moual, Camargo.
Statistical analysis: Dumas, Zock.
Obtained funding: Le Moual, Camargo.
Administrative, technical, or material support: Varraso, Boggs, Quinot, Speizer, Le Moual, Camargo.
Supervision: Boggs, Speizer, Camargo.
JAMA Network Open
Conflict of Interest Disclosures: Drs Dumas, Varraso, Le Moual, and Camargo and Ms Boggs reported receiving grants from the National Institute for Occupational Safety and Health
JAMA Netw Open. 2019 Oct; 2(10): e1913563.
PMCID: PMC6813668
(NIOSH) ofonline
the Centers
for18.
Disease
Control and Prevention (CDC) during the
conduct of this study. Dr Zock reported receiving personal fees from Partners HealthCarePMID:
System,31626315
Inc, and
Published
2019 Oct
doi: 10.1001/jamanetworkopen.2019.13563:
10.1001/jamanetworkopen.2019.13563
being a paid consultant on an NIOSH R01 grant. No other disclosures were reported.
Association of Occupational Exposure to Disinfectants With Incidence of Chronic Obstructive Pulmonary
Funding/Support:
This study
wasFemale
supported inNurses
part by grants R01 OH-010359 from the CDC (Dr Camargo, principal investigator [PI]) and UM1 CA-176726 from the National Institutes of
Disease
Among
US
Health. The research leading to the results presented herein has received funding from the People Program (Marie Curie Actions) of the European Union’s Seventh Framework Program
Orianne Dumas, PhD, 1,2 Raphaëlle Varraso, PhD,1,2 Krislyn M. Boggs, MPH,3,4 Catherine Quinot, PhD,1,2 Jan-Paul Zock, PhD,5,6,7 Paul K. Henneberger, ScD,8 Frank E. Speizer, MD,3
1,2
3,4
(FP7/2007-2013)
(Dr Dumas,
PI) under
REA grantJr,agreement
through the PRESTIGE program coordinated by Campus France.
Nicole
Le Moual, PhD,
and Carlos
A. Camargo,
MD, DrPHPCOFUND-GA-2013-609102
1
INSERM U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807, Villejuif, France
Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or
2
University de Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180, Montigny le Bretonneux, France
approval
the manuscript;
andMedicine,
decision Department
to submit theofmanuscript
for publication.
ChanningofDivision
of Network
Medicine, Brigham
and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
3
4
Department of Emergency Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
Disclaimer:
The findings
and Health
conclusions
in this Barcelona,
report are those
Barcelona Institute
for Global
(ISGlobal),
Spainof the authors and do not necessarily represent the views of the NIOSH.
5
6
Universitat Pompeu Fabra (UPF), Barcelona, Spain
Additional
Contributions:
ThePública
Nurses’(CIBERESP),
Health StudyMadrid,
II is coordinated
CIBER Epidemiología
y Salud
Spain at the Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, Massachusetts. We thank
7
8
Respiratory
Health
National
Occupational
Health, Morgantown, West Virginia
the
participants
andDivision,
staff of the
Nurses’Institute
Healthfor
Study
II for their Safety
valuableandcontributions.
Corresponding author.
Article
Information
Received
2019 Jun 4; Accepted 2019 Sep 2.
Accepted for Publication: September 2, 2019.
Copyright 2019 Dumas O et al. JAMA Network Open.
Published: October 18, 2019. doi:10.1001/jamanetworkopen.2019.13563
This isAccess:
an open This
access
article
underdistributed
the terms ofunder
the CC-BY
License.
Open
is an
opendistributed
access article
the terms
of the CC-BY License. © 2019 Dumas O et al. JAMA Network Open.
Corresponding Author: Orianne Dumas, PhD, INSERM U1168, VIMA—Aging and Chronic Diseases, Epidemiological and Public Health Approaches, 16 Ave Paul Vaillant Couturier,
Key Points
94807 Villejuif CEDEX, France (orianne.dumas@inserm.fr).
Author Contributions: Dr Dumas had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Question
Concept and design: Dumas, Zock, Speizer, Le Moual, Camargo.
Is exposure to disinfectants and cleaning products associated with incidence of chronic obstructive pulmonary disease among health care workers?
Acquisition, analysis, or interpretation of data: All authors.
Drafting of the manuscript: Dumas.
Findings
Critical revision of the manuscript for important intellectual content: Varraso, Boggs, Quinot, Zock, Henneberger, Speizer, Le Moual, Camargo.
Statistical analysis: Dumas, Zock.
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters
In a cohort study of 73 262 US female nurses participating in the Nurses’ Health Study II who were followed up from 2009 to 2015, occupational exposure to cleaning
products and disinfectants was significantly associated with a 25% to 38% increased risk of developing chronic obstructive pulmonary disease independent of asthma
Administrative,
and smoking.technical, or material support: Varraso, Boggs, Quinot, Speizer, Le Moual, Camargo.
Obtained funding: Le Moual, Camargo.
Supervision: Boggs, Speizer, Camargo.
Meaning
Conflict of Interest Disclosures: Drs Dumas, Varraso, Le Moual, and Camargo and Ms Boggs reported receiving grants from the National Institute for Occupational Safety and Health
(NIOSH) of the Centers for Disease Control and Prevention (CDC) during the conduct of this study. Dr Zock reported receiving personal fees from Partners HealthCare System, Inc, and
This study’s findings suggest that regular use of chemical disinfectants among nurses may be a risk factor for developing chronic obstructive pulmonary disease.
being a paid consultant on an NIOSH R01 grant. No other disclosures were reported.
Funding/Support: This study was supported in part by grants R01 OH-010359 from the CDC (Dr Camargo, principal investigator [PI]) and UM1 CA-176726 from the National Institutes of
TIDAK
Studi kohort 73.262
perawat di US rutin disemprot
disinfektan meningkatkan risiko 25-38%
Chronic Obstructive Pulmonary Disease
Abstract
Health. The research leading to the results presented herein has received funding from the People Program (Marie Curie Actions) of the European Union’s Seventh Framework Program
(FP7/2007-2013) (Dr Dumas, PI) under REA grant agreement PCOFUND-GA-2013-609102 through the PRESTIGE program coordinated by Campus France.
Importance
Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or
approval of the manuscript; and decision to submit the manuscript for publication.
Exposure to disinfectants in health care workers has been associated with respiratory health outcomes, including asthma. Despite the biological plausibility of an
association between disinfectants (irritant chemicals) and risk of chronic obstructive pulmonary disease (COPD), available data are sparse.
Additional Contributions: The Nurses’ Health Study II is coordinated at the Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, Massachusetts. We thank
Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the NIOSH.
the participants and staff of the Nurses’ Health Study II for their valuable contributions.
Objective
Received 2019 Jun 4; Accepted 2019 Sep 2.
To investigate the association between exposure to disinfectants and COPD incidence in a large cohort of US female nurses.
Copyright 2019 Dumas O et al. JAMA Network Open.
This is an open access article distributed under the terms of the CC-BY License.
https://nasional.kompas.com/read/2020/03/16/13130231/cegahpenyebaran-virus-corona-pengunjung-istana-disemprot-disinfektan
Design, Setting, and Participants
Key Points
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6813668/?report=printable
The Nurses’ Health Study
II is a US prospective cohort study of 116 429 female registered nurses from 14 US states who were enrolled in 1989 and followed up through
Question
Terima kasih
fatma@ui.ac.id