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The model of prevention decompression sickness occurrence on traditional divers around the island of Makassar
Atjo Wahyua,
Corresponding author
atjowahyu.2006@gmail.com

Corresponding author.
, Furqaan Naiema, A. Ummu Salmahb, Yahya Thamrina, Tahir Abdullahb
a Department of Occupational Health and Safety Public Health Faculty, Hasanuddin University, Indonesia
b Department of Biostatistics and Family Planning-Health Public Health Faculty, Hasanuddin University, Indonesia
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Indonesia is an archipelago with two-thirds of the sea area larger than the land&#46; This can be seen by the shoreline in almost every island in Indonesia &#40;&#177;81&#44;000<span class="elsevierStyleHsp" style=""></span>km&#41;&#44; which makes Indonesia ranks second only to Canada as a country that has the longest coastline in the world&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">1&#44;2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">This condition is exacerbated by a lack of attention and government support in terms of anticipating and preventing the risk of diving in the non-formal sector workers are still relatively underserved working population is a population that has not received adequate medical care&#46; Likewise&#44; the problem is closely related to the health status of traditional divers are divers behavior when doing his job&#44; the average in terms of divers who follow no formal education or training&#44; while the training that has been there still unreached in accordance of ability&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Developed countries&#44; like the United States&#44; cases of accidents caused by diving is still very high and estimated at 3 to 4 cases per 10&#44;000 divers&#44; on average each year are 1000 cases&#46; While in the Asia-Pacific region ranging between 500&#8211;600 cases excluding Japan&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Diseases caused by a dive that had recorded as many as 560 cases in the Naval Hospital &#40;AL&#41; Muntohardjo from 2007 to 2009&#44; 20 people were paralyzed and 15 died after Paralyzed&#46; Presumably&#44; because the divers do not pay attention to the depth and diving duration&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">5&#44;6</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Small islands around the city of Makassar&#44; it was found that the prevalence of traditional divers accidents in 2011&#8211;2014&#44; the victim paralyzed 85 people&#44; the death toll of 50 people a total number of victims of 135 people&#46; As for the island Lae-Lae obtained 40&#37; experiencing DCS&#44; and 60&#37; traditional divers dive to a depth of over 19 meters past the allowable threshold value which is 10 meters&#46;<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">7&#8211;9</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The unavailability of a watch or a pointing device which is a standard tool depth dive diver worsen conditions in Makassar&#46; Plus the lack of adequate training dives healthy and safe&#44; among other things how to plan dives and do stop to prevent the occurrence of decompression in traditional divers&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">10</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="par0035" class="elsevierStylePara elsevierViewall">This research is observational analytic research with a cross-sectional study design that with a sample size of 120 people taken at random from some island in Makassar&#44; from a population of 259 divers with research instrument was a questionnaire&#44; which competent doctor&#39;s diagnosis&#44; timer&#47;stopwatch&#44; meter&#44; scales and microtoice&#46; The statistical test used to analyze and determine the model of prevention of occurrence DCS to control the confounding factor is the regression test logistics&#44; while the statistical tests were used to assess the effect of length of service&#44; age&#44; nutritional status and behavior of the decompression by means of variable intervening depth&#44; frequency and duration are used path analysis &#40;path analysis&#41; using Amos application&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Result</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Descriptive data</span><p id="par0040" class="elsevierStylePara elsevierViewall">The study lasted nearly two months&#44; namely from the date of 2 August to 24 September on divers in Makassar&#44; based on <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> showed that Age with a high risk of decompression &#62;35 years&#46; However&#44; the results in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> showed that most respondents aged &#8804;35 years and most experienced decompression with a complaint that is 63 &#40;81&#46;8&#37;&#41; &#8804;35 years and 31 &#40;72&#46;1&#37;&#41; in those aged &#62;35 years&#46; As well as shows that most respondents are divers with a long working life and high incidence of decompression complaints that 63 &#40;75&#37;&#41;&#44; and as many as 31 respondents &#40;86&#46;15&#37;&#41; of the new working life categories&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> showed that most respondents diving with unsafe category or more than 30 meters and 52 &#40;72&#46;2&#37;&#41; underwent decompression with the high complaint&#46; Some have maintained great diving frequency still normal but still decompressing with a high complaint by 60 &#40;80&#37;&#41; of a total of 75&#46; For the duration of the majority of respondents diving &#60;30<span class="elsevierStyleHsp" style=""></span>min and 85 &#40;81&#46;7&#37;&#41; of them experienced decompression with the high complaint&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Multivariate analysis</span><p id="par0050" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> is a hypothesis testing see <span class="elsevierStyleItalic">p</span>-value less than 0&#46;05 then the relationship between significant variables&#46; The test results are presented in the following table&#58;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">Simultaneously&#44; <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> and <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> showed that on influence coefficient path analysis and hypothesis of the indirect influence between variables showed that all independent variables have an indirect relation to the incidence of decompression influence value &#40;total effect&#41; is the largest effect of working period on the incidence of decompression through frequency dive is equal to 0&#46;256 and influence behavior toward decompression through diving depth has influence smallest value of 0000&#46; In addition&#44; there is a negative influence between age and incidence of decompression through the diving frequency of &#8722;0138&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Discussion</span><p id="par0060" class="elsevierStylePara elsevierViewall">The results showed that most of the divers on the island of Makassar in 2018 had a normal nutritional status of as many as 87 &#40;72&#46;5&#37;&#41; the rest is not normal to severe underweight category 4 &#40;3&#46;3&#37;&#41; of the respondents&#44; skinny with 17 &#40;14&#46;2&#37;&#41; lightly grease 3 &#40;2&#46;5&#37;&#41; and fat weight 9 &#40;7&#46;5&#37;&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">The results are consistent with research Sabrina &#40;2007&#41; and Amir &#40;2015&#41; which states that there is an association between nutritional status and decompression&#44; this is due to less variation nutritional status of the respondent where the majority of nutritional status to normal as many as 89 &#40;74&#46;1&#37;&#41; respondents&#46;<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">9&#8211;11</span></a> While the existing theory and research results in Mendez-Dominguez &#40;2018&#41; differ from the results of this study&#44; where the divers in Mexico there is influence between nutritional status and the incidence ofdecompression&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">12</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">This is in line with research Sukmajaya &#40;2010&#41; on factors related to decompression in professional divers and traditional divers in Gili Matra North Lombok NTB that where respondents are comprised of 80 professional divers and 69 traditional divers shows that the frequency of dives associated with the incidence of decompression at professional divers&#46;<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">13&#8211;15</span></a> Logistic regression variable working period in the table shows that the factors most associated with decompression with <span class="elsevierStyleItalic">p</span>-value 0&#46;001&#44; with a value of Wald against decompression&#44; is 10&#44;235&#44; which means that the service life of 10&#44;235 times associated with the incidence of decompression&#46; Value OR &#40;exp1&#41; of 6748 is the strength of the relationship between working life and the incidence of decompression&#46; While the path analysis results obtained <span class="elsevierStyleItalic">p</span>-value 0&#46;104 which shows that there is no direct influence between the working period with decompression&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Although the working period cannot directly influence the decompression&#44; indirectly through intervening variable depth and frequency has an influence on decompression&#46; Because divers with long working lives feel more experienced and dive deeper and more frequent the risk of decompression will be even greater&#46; As the results Suzuki et al&#46; that the depth of influence decompression&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Changes in bodily functions&#44; cardiovascular and hormonal systems as part of the process of becoming parents will lead to a lack of ability to work&#46; In the world of diving itself&#44; the ideal age limit is 16&#8211;35 years old&#44; with a note that if forced to dive with over 35 years of age then the diver should be in a state of physical and mental health through electrocardiographic examination for the presence of heart disease&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">The test results obtained direct path analysis for the p-value 0&#46;106 which shows that there is no direct effect between age and incidence of decompression&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Conclusion</span><p id="par0090" class="elsevierStylePara elsevierViewall">Nutritional status has no direct influence by decompression&#44; but it has an indirect influence on decompression through intervening variable depth and frequency&#46; Working lives do not have direct influence with decompression&#44; but it has an indirect influence on decompression through intervening variable depth and frequency&#46; Age does not have direct influence with decompression&#44; but it has an indirect influence on decompression through intervening variable depth and frequency&#46; The behavior has an influence either directly or indirectly to decompress but through the intervening variable depth&#44; frequency and duration&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Conflict of interest</span><p id="par0095" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">This study aims to find models of the occurrence of occupational diseases prevention dives with control variables simultaneously confounding factors include &#40;working period&#44; diving frequency&#44; duration&#44; age&#44; nutritional status&#44; warming up before diving&#44; smoking habits and alcohol consumption&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Method</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This research is a cross-sectional study design that with 120 people as sample taken by random sampling from some island in Makassar&#46; The study conducted by questionnaire&#44; which competent doctor&#39;s diagnosis&#44; timer&#47;stopwatch&#44; meter&#44; scales and microtoice&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">There is no direct influence between variables nutritional status&#44; working lives&#44; age and decompression sickness&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Behaviors have influence&#44; either directly or indirectly to decompress but through the intervening variable depth&#44; frequency and duration&#46;</p></span>"
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Original language: English
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