Friday, December 1, 2023 | 03:22 WIB

6M+1S health protocol to combat air pollution


Jakarta, IO – The high level of air pollution correlates with an increase in disease, especially respiratory illness. Surveillance data from the Health Ministry from January to July 2023 in the Greater Jakarta (Jakarta, Bogor, Depok, Tangerang and Bekasi) showed that there was an increase in cases of upper respiratory tract infection (ISPA) and pneumonia compared to the previous year, averaging about 100,000 cases per month. According to Dr. dr. Maxi Rein Rondonuwu, DHSM, MARS, Director General of Disease Prevention and Control (P2P) of the Health Ministry, ISPA cases in August have increased to nearly 200,000 cases. 

“In Greater Jakarta, there has been an increase in air pollutants. In line with that, from our surveillance data, there has been an increase in ISPA and pneumonia cases reported by health centers and hospitals. To tackle the problem of air pollution, we cannot work alone. Collaboration between ministries and agencies is needed. As of August 14, the Health Ministry has formed a Committee for Respiratory Disease Management and Air Pollution Impacts (PPRDPU), whose members made up of experts in the field of respiratory diseases and air quality management,” said Dr. Maxi, Monday (28/8/2023). 

The committee works based on a strategic plan including efforts to detect and reduce health risks. Detection in the form of installing air sensors in the PM2.5 area will be prioritized for hospitals, health centers, schools and markets in 18 cities and 11 provinces, namely Jakarta, Bekasi, Depok, Bandung, Bogor, Cikarang, Karawang, Tangerang, South Tangerang, Serang, Surabaya, Medan, Pekanbaru, Batam, Makassar, Pontianak, Semarang and Yogyakarta. This is in addition to the development of an integrated SatuSehat early warning system as well as education and counseling on the 6M+1S health program, especially for vulnerable populations, namely children, pregnant women, people with comorbidities and the elderly. 

Trash Burning 

Prof. Dr. dr. Agus Dwi Susanto, Sp.P(K), chair of the PPRDPU committee who is also the president director of Persahabatan Hospital, Jakarta, explained that air pollution is contamination of physical, chemical or biological substances in the atmosphere in amounts that can endanger health. Sources of pollutants, in the form of gases and particles, come from motor vehicles, industrial activities (coal burning), households (trash burning), and cigarette smoke. 

The pollutant indicator is PM2.5 airborne particles (particulate matter) which are less than 2.5 micrometers, commonly called fine particulate matter. According to WHO air quality guidelines, the annual average concentrations of PM2.5 should not exceed 5 micrometers/m3, while 24- hour average exposures should not exceed 15 micrometers/m3 more than 3-4 days per year. 

Prof. Dr. dr. Agus Dwi Susanto, Sp.P(K)
Prof. Dr. dr. Agus Dwi Susanto, Sp.P(K) (Source: PERSAHABATAN HOSPITAL)

Prof. Agus pointed out that besides PM2.5 and PM10, the other most common pollutants are nitric dioxide (NO2), sulfur dioxide (SO2) and ozone (at ground level). In Indonesia, respiratory disease due to air pollution is the fifth highest risk factor for death after high blood pressure, blood sugar, lung disease and obesity. 

In 2022, according to healthcare and social security agency BPJS Kesehatan, the most common respiratory diseases are pneumonia, tuberculosis, ISPA, asthma, chronic obstructive pulmonary disease (COPD) and lung cancer which cost the state up to nearly Rp10 trillion, and close to Rp12 trillion for heart disease. According to National Development Planning Board (Bappenas) research in 2022, increased pollutants have contributed to an increase in ISPA and pneumonia cases in Jakarta over the past 10 years. 

To prevent the adverse effects of air pollution, he advised people to implement the 6M+1S health protocol: checking air quality through an application or website; reducing outdoor activities and closing ventilation at homes/offices/schools/public places when air pollution is high; using indoor air purifiers (plants or air purifiers); avoiding sources of pollution and cigarette smoke; using masks when pollution is high; implementing clean and healthy living behavior; and immediately consults a health worker if respiratory complaints arise. 

Plants as Air Purifier 

Due to the negative effects of pollution, Prof. Agus said that prevention is better than cure. Avoid outdoor activities unless necessary, including sports as much as possible. In vulnerable groups, secondary infections due to air pollution will usually exacerbate existing illnesses. If you really have to leave the house, wear a mask that can filter PM2.5 particles, especially for those who have to work outdoor while being exposed to pollutants for an extended period of time. 

“For example, traffic police or road sweepers are advised to wear an elastomeric respirator mask with a PM2.5 filtration capability of more than 95 percent or a respirator with or without valve type N95 (83 percent), KN95 (80-95 percent) or KF (94 to 95 percent). Ordinary people can use face mask with PM2.5 filtration up to 99 percent; cloth mask plus PM2.5 filtration disposable filter (95 percent); enhanced performance barrier face coverings/BFCs (50-80 percent). Otherwise, use a medical/surgical mask (41-81 percent).” 

Read: ISPA Cases In Greater Jakarta Rise To 200K Due To Worsening Air Pollution

Inside the house, aloe vera or sansivieria can be used to replace air purifier. “According to NASA, the effectiveness of these plants is quite good because they can filter up to 60-70 percent of pollutants. However, care must be taken when maintaining it. Don’t let the plants become a new source of pollutants in the house, for example moss, which contains bacteria,” he said. 

Regarding the idea of spraying water to minimize air pollution, Dr. Maxi still doubts its effectiveness. “It is still debatable, on a small scale it may work, but on a larger scale it is not efficient because you have to use large amounts of clean water. The volume of water must be high, otherwise it may stir up dust particles and exacerbate the pollution.” (est)


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