Identification of the Factors Causing the Skin Disorder at

Rubber Processing Factory

Annisa Febriana Siregar

, Anggi Isnani Parinduri

, Irmayani

, and Samuel Marganda Manalu

Faculty of Public Health of Institut Kesehatan Medistra Lubuk Pakam, Deli Serdang, Sumatera Utara, Indonesia

Faculty of Public Health of Institut Kesehatan Deli Husada Deli Tua, Sumatera Utara, Indonesia

Keywords: Skin disorder, Rubber Workers, Printing Industry

Abstract: Skin disorder is disease because of work with amount around 22% off all disease from work. One of the

causes is chemicals often used in industry.The research is survey research analytic with cross sectional

design. The aim of the research was to analyze factors correlated with skin disorder in rubber processing

worker. The population was 51 workers and was taken by using a technique total sampling. Bivariate

analysis using Chi Square test with α=0,05. The results of a study of 51 workers in the production division

of the Rubber Processing Plant in 2019 showed that of the 22 workers who worked in direct work units,

there were 17 people (77.3%) workers who had skin problems and only 5 people (22.7 %) workers without

skin disorders.

1 INTRODUCTION

Indonesia is one of the largest rubber producing

countries with an area of 34 million hectares. The

rubber processing industry in its production process

uses chemicals such as fomiat acid or commonly

called ant cid which is used as a strong acid of

rubber coagulant to unite the rubber grains contained

in the latex liquid, so that it becomes a lump or

coagulant.

According to the International Labor

Organization (2000) every year 1.1 million deaths

occur due to illness or are caused by work. Around

300,000 deaths occur from 250 million accidents

and the rest are deaths due to occupational diseases

where an estimated 160 million diseases occur due

to new work relationships each year (Buchari, 2011).

Skin is a part of the human body that is quite

sensitive available various diseases. Occupational

dermatoses or occupational dermatoses are all skin

disorders caused by work. The disease occur when

or after the workforce performs work or caused by

factors that exist in the work environment. This

disease constitutes 50-60% of all occupational

diseases, most of which are caused because workers

come into contact with materials that are used,

processed, or generated by the work.

Occupational dermatitis is the second most

occupational occupational disease after

muscoluskeletal disease, with around 22% of all

occupational diseases. British data show 1.29 cases

per 1000 workers are occupational contact

dermatitis. More than 95% are contact dermatitis,

while others are other skin diseases such as acne,

contact urticaria, and skin tumors (Anies, 2014) .

Work-related skin disorders are abnormalities in

the skin felt by workers at work or after work. This

skin disorder is a symptom of an occupational

disease. Complaint skin disorders felt by workers

can give an idea about what types of skin diseases

are at risk of suffering by workers. Complaints of

Interference this skin can be itching, burning,

redness, swelling, small blisterson the skin, peeling

skin, dry skin, scaly skin, and thickening of the skin

(Anhar, 2016).

The percentage of occupational dermatoses from

all occupational diseases occupies the highest

portion of around 50-60%, therefore the disease is

on the place gets proportional attention. Besides the

high prevalence, occupational dermatoses whose

abnormalities are usually in the arms, hands and

fingers are very annoying sufferers do work so

influential on the productivity of his work.

Occupational skin diseases, such as inflammation

dryness, redness / erythema and scaling (scaly), 80%

of cases occur in hand skin, which is the point most

142

Siregar, A., Parinduri, A., Irmayani, . and Manalu, S.

Identiﬁcation of the Factors Causing the Skin Disorder at Rubber Processing Factory.

DOI: 10.5220/0009467701420148

In Proceedings of the International Conference on Health Informatics and Medical Application Technology (ICHIMAT 2019), pages 142-148

ISBN: 978-989-758-460-2

often in contact with hazardous materials while

working.

Based on research data in Indonesia 1985, which

was conducted by 14 Health Clinic centers, it was

reported that 90% of occupational skin diseases in

Indonesia were contact dermatitis due to chemicals

(Cahyono, 2010). One cause of contact dermatitis is

chemicals that are often used in industry, such as

one of the rubber processing industry companies that

use a lot of chemicals. These materials can cause

skin abnormalities in workers who come into direct

contact with the processing process.

Phosphoric acid is the molecular formula

HCOOH is a liquid chemical substance. These

chemicals can cause inflammation or sensitization

when in contact with moist body surfaces, such as

the skin, eyes, and respiratory tract (Cahyono, 2010).

According to NIOS Pocket Guide to Chemical

Hazards (2016) when acidic contact form with eyes,

skin and respiratory tract can cause effects on health

in the form of eye irritation, skin irritation, and nasal

irritations throat. Symptoms that arise are the skin

feels like burning, blisters, lacrimation (tears coming

out), blurred vision, redness of the eyes, rhinorrhea

(discharge of thin mucus from the nose), dyspnea

(difficulty breathing), nausea, pulmonary edema,

metabolic acidosis and unconsciousness. sore throat,

stomach ache, cramps, vomiting, diarrhea.

Skin inflammation that is characterized by

itching, scaly skin, redness, and sometimes blisters.

If exposed in the long term, it can cause severe skin

irritation. Inflammation of the eye is characterized

by redness, runny eyes, itching and inflammation of

the airways is characterized by coughing, choking

and shortness of breath.

Based on preliminary surveys and brief

interviews conducted with factory assistants and 5

production workers section, information was

obtained in rubber processing plant was one of the

rubber processing industries that used phomiic acid

in the coagulation or latex freezing process.

The aim of the research was to analyze factors

correlated with skin disorder in rubber processing

worker. According to 3 of the 5 workers, they

complained of experiencing skin disorders such as

dry skin, itchy skin, and hot skin at work and after

work

Figure 1. Workers not using PPE

Exposure to chemical carcinogens in rubber

manufacturing remains a serious occupational health

concern. Workers are exposed to these carcinogens

via skin or inhalation. Rubber manufacturing work is

associated with a high prevalence of dermatologic

diseases such as eczema, allergic contact dermatitis

and atopic dermatitis. The role that epidermal

exposure plays in the development of malignancies

historically associated with the rubber industry is

less certain. We present a case relevant to this

discussion and review the role of skin exposure in

the rubber industry, providing an overview of the

cutaneous and systemic manifestations of

occupational exposures in modern day rubber

workers.

2 RESEARCH METHODS

This research was conducted at the Rubber

Processing Plant. The sample in this study was 51

production workers taken by total sampling

technique. Data collection in this study was done by

collecting primary data and secondary data. Data

was done with SPSS.

Data shows that based on age, most workers in

the Rubber Processing Plant are included in the old

age group (≥ 35 years), which is 32 people (62.7%).

According to years of service, most workers are

long-term workers (> 2 years), which is 27 people

(52.9%). Based on work units, most workers work in

indirect work units, namely 29 people (56.9%), and

based on the use of personal protective equipment,

most workers wear incomplete personal protective

equipment, as many as 38 people (74.5%) people

(70.6%) do not have a history of previous skin

diseases.

Identiﬁcation of the Factors Causing the Skin Disorder at Rubber Processing Factory

143

Table 1: shows that the most workers, is 26 people

(51.0%) have skin diseases.

Skin

disorders

Frequency

(people)

Percentage

(%)

Yes

51,0

49,0

Jumlah 51 100,0

3 RESULTS

Table 2. shows that based on age, the most

workers in the Rubber Processing Plant belong to

the old age group (≥ 35 years), which is 32 people

(62.7%). When viewed based on years of service,

most workers are long-term workers (> 2 years),

which is 27 people (52.9%).

Based on work units, most workers work in

indirect work units, namely 29 people (56.9%) and

based on the use of personal protective equipment,

most workers used incomplete personal protective

equipment , as many as 38 people.

Apart from the fact that because the structure of

the skin has turned thin so it is more susceptible to

skin disorders, at the age of 35 years, workers

usually have a lot of experience related to their

work, especially if the work period is long. People

who have worked for long periods of time and have

a lot of experience tend to ignore the rules and act

more according to their experience, not even using

personal protective equipment because they feel

uncomfortable and uncomfortable.

Even though they work in units that are not in

direct contact with formic acid, but still have the risk

of feeling skin disorders because in these units the

possibility of latex still contains formic acid. In one

study, researchers found that there were 2 workers

who put formic acid into a latex solution and stirred

it without using personal protective equipment on

the grounds that they were accustomed to doing this

and did not feel any effect. This certainly causes

more frequent contact of formic acid to the skin of

work.

Table 3 shows that of the 32 people included in

the old age group, there were 21 people (65.5%)

who had skin problems and 11 (34.4%) had no skin

problems.

Respondent characteristics observed in this study

include age, years of service, work units and

personal protective equipment. The results showed

that based on age, the most workers in the Rubber

Processing Plant were included in the old age group

(≥ 35 years), as many as 32 people (62.7%).

Table 2: Workers characteristic

Characteristic Frequency

(person)

Precentage (%)

Age

Yes

51,0

49,0

Count

100,0

Years of service

New 24 47,1

Old 27 52,9

Count

100,0

Work Unit

Direct 22 43,1

Not direct 29 56,9

Amount

100,0

Using PPE

Using 13 25,5

Not Using 38 74,5

Count 51 100,0

When viewed based on years of service, most

workers are workers with long tenure (> 2 years),

which is as many as 27 people (52.9%). Based on

work units, most workers work in indirect work

units, namely as many as 29 people (56.9%), and

based on the use of personal protective equipment,

most workers use incomplete personal protective

equipment, as many as 38 people .

Age is one of the factors that influence the

occurrence of skin disorders in a person. Workers

with old age have skin that has changed its structure.

Their skin is less elastic, and has lost a layer of fat

on it so that their skin becomes dry and looks thin.

This causes their skin to be more susceptible to skin

disorders (Suryani, 2011).

Skin disorders are also influenced by the work

period of a worker. The working period is the length

of time a person is exposed to possible sources that

can cause skin disorders. According to (Suma'mur,

2009) the longer a person is at work, the more he has

been exposed to the dangers posed by the work

environment.

Researchers assume that in addition to

being due to the structure of the skin that has turned

thin making it more prone to skin disorders, at the

age of tahun 35 years workers usually have a lot of

experience related to their work, especially if the

working period is long. People who have worked for

long periods

time and have a lot of experience tend

to ignore the rules and act more according to their

experience.

ICHIMAT 2019 - International Conference on Health Informatics and Medical Application Technology

144

Table 3: Associations between variable and skin disorders

Variable

Skin Disorders

Yes No

N % n %

Age

Young

5 26,3 73,7 19 0,01

Old

21 65,6 34,4 32

Years of

Service

New

6 25,0 18 75,0 0,00

Old

20 74,1 7 25,9

Work Unit

Direct

17 77,3 5 22,7 0,00

Not Direct

9 31,0 20 69,0

History of

Skin

Disorder

14 38,9 22 61,1 0,01

Yes

12 80,0 3 20

Using PPE

0,00

Using

1 7,7 12 92,3

Not Using

25 65,8 13 34,2

At the time of the study, researchers found that

there were 2 workers who put formic acid into a

latex solution and stirred it without using personal

protective equipment on the grounds they were

accustomed to doing so and did not feel any effect.

This certainly causes more frequent contact of

formic acid to the skin of workers.

Work units can affect skin disorders. Workers

whose work is directly related to chemicals will be

more susceptible to skin diseases. Based on research

(Adillah, 2012) the specifications of the work done

by workers are proven to have a relationship with

the incidence of contact dermatitis. Workers whose

work is directly related to chemicals will be more

susceptible to skin diseases.

In this study the work unit is categorized into

two categories namely direct contact and not direct

contact with formic acid. Work units that are in

direct contact with formic acid are in the process of

freezing or coagulation. Formic acid dosage used is

7.5 - 9 kg / ton latex. In this unit formic acid is used

to freeze the latex into a lump or coagulum.

The results showed that most workers in the

Rubber Processing Plant worked in indirect work

units (56.9%) . Researchers assume that even though

they work in units that are not in direct contact with

formic acid, they still have the risk of feeling skin

disorders because in these units the possibility of

latex still contains formic acid.

In addition, skin disorders are also influenced by

other factors, such as the use of personal protective

equipment. The use of personal protective

equipment is very important for workers to protect

themselves from the risks of hazards that can arise in

the workplace, both occupational diseases and

occupational accidents. protection of the body or the

skin surface in the form of work clothes, work

gloves and work shoes can be used to prevent: k of

damage the skin due to an allergic reaction or

corrosive chemicals .

Complaints of skin disorders often occur in

workers who are in direct contact with formic acid

used in the freezing process. All workers who work

in the freezing unit feel complaints of skin disorders.

This matter shows that complaints of skin disorders

felt by workers occur because workers come in

contact with formic acid when doing work

processes.

In addition, in this study there are other factors

that support opportunities for complaints of skin

disorders, such as the use of tools incomplete

personal protection to all workers, a history of

illness skin on the worker, as well as the working

period ie the longer a person works then the more

often he is exposed and in contact with the

chemicals used (Anhar, 2016)

The use of personal protective equipment in this

study is the use of gloves made from vinyl or

neoprene and covering the arms, the use of boots,

and the use of long shirts and trousers. Researchers

assume that workers feel uncomfortable and

uncomfortable using personal protective equipment.

Based on interviews with workers obtained

information that there are 38 people (74.5%)

workers do not use complete personal protective

equipment. The average worker only uses personal

protective equipment boots and trousers. The clothes

used by workers are short-sleeved shirts because the

company only provides short-sleeved shirts. There is

availability of long-sleeved shirts because the

company only gets short-sleeve clothes from the

center for all employees. Workers more often do not

wear clothes provided by the company while

working. They more often wear short-sleeved shirts

and even wear sleeveless shirts when working. This

is because according to them the clothing provided

by the company feels hot and does not absorb sweat

when used while working.

Based on previous research in Rubber Processing

Factory at PTPN III Sei Silau there is 31 workers

had skin disorders and there is association between

age, years of service.

Identiﬁcation of the Factors Causing the Skin Disorder at Rubber Processing Factory

145

Workers in the sorting unit, workers wear gloves

made of cloth and only one worker in the

coagulation unit uses gloves made from vinyl or

neoprane. This is because workers are not

accustomed to working with gloves and wearing

gloves can slow down their work.

The history of skin diseases in this study were all

skin disorders experienced by workers before

working in the production section of the PTPN III

Kebun Pulau Mandi Rubber Processing Plant.

History of skin diseases is known based on

interviews using a questionnaire to workers. The

results showed that most workers did not have a

history of skin disease (70.6%).

Djuanda (2011) explains that individual factors

contribute to contact dermatitis. Difference of

Thickness of the skin in several places causing

permeability differences, race, gender, age, and skin

diseases is or ever experienced.

Based on interviews with workers obtained

information from 15 workers who have a history of

skin diseases, skin disorders that have been felt most

in the form of itching namely 14 workers, skin

peeling 8 workers and 12 workers feel dry skin. The

body parts that have been affected by the most skin

disorders in the palm of the hand are 12 workers, in

the legs of 10 workers, and in the arms of the hands

of 7 workers.

According to the researchers' assumptions,

workers who had a history of skin disease were more

likely to get occupational contact dermatitis, because

the skin's protective function had been reduced due

to previous skin disease. The palm of the hand is the

part of the body most often affected by skin

disorders due to direct contact with formic acid

without using complete personal protective

equipment.

Age is one of the factors that influence the

occurrence of skin disorders in a person. According

to Cronin (1980) cited by Lestari and Utomo (2007)

in the industrial world older workers become more

vulnerable to irritants. Often in the elderly there is a

failure in the treatment of contact dermatitis,

resulting in chronic dermatitis.

The results of a study of 51 workers in the

Rubber Processing Plant Production Year 20 19

showed that of 19 workers in the young age group,

there were 14 people (73.7%) workers who had no

skin problems and only 5 people (26.3% ) workers

who have skin disorders . While from 32 people

included in the old age group, there were 21 people

(65.5%) workers who had skin problems and 11

people (34.4%) workers who had no skin problems.

Based on the results of the study, there were still

5 people (26.3%) workers in the young age group

who had skin disorders and 11 people (34.4%)

workers in the old age group who had no skin

disorders. According to the researchers'

assumptions, skin disorders in workers can occur in

all age groups depending on the length of work and

frequent contact with irritants at work.

The results of the study showed that workers

with older age had more skin problems because they

had a longer working period. The working period of

the worker is at the age of 3 years and the maximum

is 19 years. Some workers with a young age also feel

skin disorders. This is because there are workers

with young age who have a work period of> 2 years.

The working period of workers at the youngest is 1

year and the maximum is 2 years.

According to a study by Garmini (2014) older

workers are at risk of developing irritant contact

dermatitis because it is thought that this group has a

skin condition that is more susceptible to infection

compared to younger ages. The length of service

also has an effect because older age has a longer

service life so there is a risk of developing irritant

contact dermatitis.

The results of the statistical test by using test of

chi square with 95% confidence level (α = 0.05)

showed the p value = 0.0 15, then this hypothesis is

accepted, which means there an association u nuts

with skin disorders

The results of this study are consistent with

research conducted by Budianto (2010) on printing

workers who showed that individuals aged 30-60

years were 7 times more likely to be affected by

DK-AK than individuals aged ≤ 30 years. . The

results of this study are also in accordance with the

results of research conducted by Suryani (2011) on

processing and filling workers PT. Cosmar

Indonesia Tangerang Selatan which shows that there

is a significant relationship between age and the

incidence of contact dermatitis. Statistical test results

obtained p value <0.05 which is 0.008.

Study of 51 workers at the processing plant

production 201 Year 9 shows that of 24 workers

with new work period, there were 18 (75.0%) of

workers who no skin disorders and 6 (25.0%) of

workers that there are skin disorders . While from 27

workers with long working periods, there were 20

people (74.1%) workers who had skin problems and

7 people (25.9%) workers who had no skin

problems.

Based on statistical test by using test of chi

square with 95% confidence level (α = 0.05) showed

the p value = 0.0 01 , then this hypothesis is

ICHIMAT 2019 - International Conference on Health Informatics and Medical Application Technology

146

accepted, which means theres an association tenure

with skin disorders in Rubber Processing Factory

2019.

Workers who have long years of service

experience more skin disorders because these

workers are longer exposed and repeatedly contact

with formic acid. Contact with formic acid

repeatedly can cause inflammation of the skin and

can even cause severe irritation to the skin

(dermatitis).

In accordance with the theory that the longer the

person's service life, the more often workers are

exposed and in contact with chemicals. The duration

of exposure and contact of chemicals will increase

the occurrence of occupational contact dermatitis

which is a skin disorder . The longer a person is at

work, the longer he has been exposed to the dangers

posed by the work environment (Suma'mur, 2009).

According to Taylor (2003) chemicals have different

abilities to cause irritant reactions. Some of them

will cause damage even with low concentration.

Strong irritants will cause dermatitis in almost all

individuals if adequate contact occurs.

The results of this study are in line with the

results of research conducted by Suryani (2011) on

the processing and filling workers at PT. Cosmar

Indonesia Tangerang Selatan which shows that is

significant relationship between the length of work

with the incidence of contact dermatitis. Workers

who experience contact dermatitis are workers who

have an average working period of 2 years, while

workers who do not experience contact dermatitis

are workers who have an average work period of 1

year.

According to Suryani (2011) the longer workers

come into contact with chemicals every day, plus a

long work period will aggravate the incidence of

contact dermatitis in workers. Workers who are

longer exposed to and come into contact with

chemicals cause damage to the outer skin cells, the

longer the exposure the more damaging the skin

cells to the inside and make it easier for dermatitis to

occur.

The results of a study of 51 workers in the

production division of the Rubber Processing Plant

in 2019 showed that of the 22 workers who worked

in direct work units, there were 17 people (77.3%)

workers who had skin problems and only 5 people

(22.7 %) workers without skin disorders. While 29

workers who work in indirect work units, there are

20 people (69.0%) who have no skin disorders and 9

people (31.0%) have skin disorders.

Work units that are in direct contact with formic

acid are in the process of freezing or coagulation.

Formic acid dosage used is 7.5 - 9 kg / ton latex. In

this unit formic acid is used to freeze the latex into a

lump or coagulum. Many workers feel skin disorders

because workers in this unit are exposed and in

direct contact with formic acid on an ongoing basis.

If seen based on the results of the study, there were

still 5 people (22.7%) workers in the direct work

unit without skin problems. This is assumed by

researchers to occur because workers use complete

personal protective equipment so they are not

exposed to formic acid.

The results also showed that there were still 9

people (31.0%) workers who did not come in direct

contact with formic acid but felt skin disorders.

Researchers assume workers who work in units that

are not in direct contact with formic acid also have

the risk of feeling skin disorders because in that unit

the possibility of latex still contains formic acid.

4 CONCLUSION

a) There is a relationship of working period

with skin disorders in production section

workers at the Rubber Processing Plant.

b) There is a relationship of work units with

skin disorders in production section

workers at the Rubber Processing Plant.

c) There is a relationship between the use of

personal protective equipment with skin

disorders in production section workers at

the Rubber Processing Plant.

d) There is a history of skin disease and skin

disorders in production workers at the

Rubber Processing Plant.

e) There is a relationship of age with skin

disorders in production section workers at

the Rubber Processing Plant.

5 SUGGESTION

a) Workers are advised to check the skin

disorders they feel to the dermatologist.

b) Workers should maintain a safe and

comfortable work ethic while working so

latex that contains formic acid does not

scattered and exposed to the body.

c) The company is expected to be able to

socialize to workers about the dangers of

formic acid when in contact with body parts

and conduct periodic health checks related

to skin disorders of workers.

Identiﬁcation of the Factors Causing the Skin Disorder at Rubber Processing Factory

147

d) For further research, researcher should do a

skin examination with involve a

dermatologist to find out which type of skin

disease felt by workers.

e) The company requires workers to use PPE

in full, if notused will be penalized. This is

to reduce the occurrence skin disorders felt

by workers.

REFERENCES

Afifah, A., 2012. Factors related to occurrence of contact

dermatitis due to work in laundry employees.

(Scientific papers). Faculty of

Medicine,DiponegoroUniversity. https://core.ac.uk/

download / files / 379 / 11735625.pdf (accessed

August 10, 2015).

Anies, 2014. Occupational Medicine, Ar-ruzz Media,

Yogyakarta.

Anhar, A, Lulu, 2016. Faktor-faktor yang berhubungan

dengan Gangguan Kulit dalam Penggunaan Asam

Formiat pada Pekerja Bagian Produksi Pabrik

Pengolahan Karet PTPN III Kebun Sei Silau. Fakultas

Kesehatan Masyarakat. Universitas Sumatera Utara.

http://repository.usu.ac.id/bitstream/handl.

e/123456789/58502//pdf.

Bangun, LG, 2012. Overview and Prevalence of Skin

Disorders in Motor Vehicle Repair Workers in Medan

Baru, Medan Selayang, and Medan Johor Districts in

2012 . (Scientific paper) Faculty of Medicine,

University of North Sumatra.

http://repository.usu.ac.id/ bitstream /

123456789/38937 / chapter% 20II.pdf (accessed

August 7, 2015) .

Buchari, 2007. Occupational diseases and occupational

diseases , USU repository.

Http://www.repository.usu.ac.id/bitstream/123456789/

1432/1/07002746.pdf (accessed August 7, 2015).

Cahyono, AB, 2004. Safety in chemicali industry .Gadjah

Mada University Press, Yogyakarta.

Dahlan, MS, 2013. Statitiska for medicine and health .

Salemba Medika, Jakarta.

de Vocht F, Vermeulen R, Burstyn I, Sobala W, Dost A,

Taeger D, et al. Exposure to inhalable dust and its

cyclohexane soluble fraction since the 1970s in the

rubber manufacturing industry in the European Union.

Occup Environ Med. 2008;65(6):384–91.

Garmini, R., 2014. Analisis Faktor Penyebab Dermatitis

Kontak Iritan pada Pekerja Pabrik Tahu Primkopti

Unit Usaha Kelurahan Bukit Sangkal Palembang,

(Skripsi). Fakultas Kesehatan Masyarakat, Universitas

Sriwijaya.

www.akademik.unsri.ac.id/paper12/download/paper/

TA_10101001025.pdf (diakses tanggal 21 Maret

2016).

Kurpiewska, J., J. Liwkowicz, and K. Benczek, 2011.A

Survey of Work-Relate Skin Diseases in Different

Occupational in Poland.International Journal of

Occupational Safety and ergonomics (JOSE), Vol. 17,

No. 2: 207-214. http://archiwum.ciop.pl/43478

(diakses 29 juli 2015).

NIOS. Pocket Guide to Chemical Hazards, 2016.

FormicAcid.http://www.cdc.gov/niosh/npg/npgd0296.

html

Occupational exposures in the rubber manufacturing

industry. IARC Monogr Eval Carcinog Risk Hum.

2102;100F:541–62.

Pancarini, C., 2014. Determinants of Irritant Contact

Dermatitis in Workers in the Production Section of PT

Sunan Rubber Palembang, (Journal). Faculty of Public

Health, Sriwijaya University.

www.akademik.unsri.ac.id/paper12/download/paper/T

A_10101001054.pdf (accessed August 7, 2015).

Situmeang, S. M. F., 2008. Analisa Dermatitis Kontak

Pada Pekerja Pencuci Botol Di PT X Medan, (Tesis).

Sekola Pasca Sarjana, Universitas Sumatera

Utara.http://repository.usu.ac.id/bitstream/123456789/

7047/1/08E00631. pdf (diakses 7 agustus 2015).

Suma’mur P.K., 2009. Higiene perusahaan dan kesehatan

Kerja (HIPERKES). CV Sagung Seto, Jakarta.

Suryani, F., 2011. Faktor-faktor yang berhubungan

dengan dermatitis kontak pada pekerja bagian

processing dan filling pt. cosmar indonesia tangerang

selatan, (skripsi). Fakultas kedokteran dan ilmu

kesehatan universitas islam negeri syarif

hidayatullah,Jakarta.http://repository.uinjkt.ac.id/dspac

e/bitstream/123456789/1821/1/FEBRIA%20SURYA

NI-fkik.pdf (diakses 7 agustus 2015).

Suuronen, K., K. Aalto-Korte, R. Piipari, T. Tuomi, and R.

Jolanki, 2007. Occupational dermatitis and allergic

respiratory diseases in finnish metalworking

machinists. Journal of Occupational Medicine: 277-

283.http://occmed.oxfordjournals.org/content/57/4

277.full (diakses 29 juli 2015).

Taylor S, Sood A., 2003. Occupational skin diseases. New

York: Mc Graw Hill Book co.

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