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Gema Lingkungan Kesehatan
Published by Polilteknik Kesehatan Kemenkes Surabaya
ISSN : 16933761     EISSN : 24078948     DOI : 10.36568
Core Subject : Health, Science, Social,
Environmental Science Health Professions Immunology & microbiology Public Health
Jurnal GEMA Lingkungan Kesehatan [e-ISSN: 2407-8948 | DOI: 10.36568] is a journal aims to be a leading peer-reviewed platform and an authoritative source of information. We publish original research papers, review articles and case studies focused on environmental health or public health as well as related topics that has neither been published elsewhere in any language, nor is it under review for publication anywhere. This following statement clarifies ethical behavior of all parties involved in the act of publishing an article in this journal, including the author, the editor, the reviewer, and the publisher (Jurusan Kesehatan Lingkungan Poltekkes Kemenkes Surabaya).
Arjuna Subject : Ilmu Lingkungan (semua ketegori) - Kesehatan, Toksikologi dan Mutasi Gen
Articles 172 Documents
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Case Study: Physiotherapy Program in Down Syndrome Patients with Neuro Development Treatment Intervention at Dustira Hospital Monica, Rizqy Dimas
Gema Lingkungan Kesehatan Vol. 23 No. 3 (2025): Gema Lingkungan Kesehatan
Publisher : Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/gelinkes.v23i3.324

Abstract

Down Syndrome is a genetic disorder in which there is an extra chromosome on chromosome 21. This extra chromosome results in excessive amounts of certain proteins, which can interfere with the body's normal growth and cause changes in brain development. This case study report aims to determine the effect of physiotherapy intervention with Neuro Developmental Treatment (NDT) on improving motor skills in Down Syndrome children. This case study report was carried out in the children's growth and development clinic at the hospital Dustira Cimahi on January 15, 2024 to February 1, 2024. The intervention used is Neuro Development Treatment through a stimulation and facilitation approach. The results of the Early Growth and Development Detection examination from T1 to T6 showed increased developmental achievements in aspects of fine motor skills, observation and speech. The evaluation results of the Gross Motor Functional Measurement examination showed a total score at T1: 11% and T6: 18%, there was an increase in gross motor skills of 7%. Conclusion: Intervention using Neuro Development Treatment is a therapy that has been proven to be effective in improving the motor skills of Down Syndrome children
Effect of Turmeric Ethanol Extract (Curcuma Longa Linn) on IL-6, IL-10 Levels and Skin Moisture Anggraeni, Gilda Putri; Sumarawati, Titiek; Chodidjah; Wibowo, Joko Wahyu; Zulaikah, Siti Thomas; Trisnadi, Setyo
Gema Lingkungan Kesehatan Vol. 23 No. 3 (2025): Gema Lingkungan Kesehatan
Publisher : Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/gelinkes.v23i3.330

Abstract

Ultraviolet B (UVB) radiation is known to induce skin damage, including erythema, roughness, sagging, wrinkles, and reduced skin moisture, contributing to premature aging. Turmeric (Curcuma longa Linn.) contains curcumin, an active compound with potent anti-inflammatory properties. This study investigated the effect of turmeric ethanol extract on IL-6 and IL-10 levels, as well as skin moisture, in UVB-exposed rats. A total of 24 Wistar rats were randomly divided into four groups: healthy controls (K1), UVB-exposed without treatment (K2), UVB-exposed treated with turmeric ethanol extract at 100 mg/kg BW (K3), and 200 mg/kg BW (K4). The extract was administered orally for 14 days. IL-6 and IL-10 levels were measured using ELISA, and skin moisture was assessed macroscopically. Statistical analysis was performed using one-way ANOVA. Rats in groups K2, K3, and K4 exhibited very dry skin, redness, visible wrinkles, and peeling following UVB exposure. IL-6 levels were significantly lower in treated groups, with the lowest levels observed in K4 (1.85 ± 0.24 ng/L), compared to K1 (4.36 ± 0.75 ng/L) and K2 (4.46 ± 0.74 ng/L) (p = 0.000). IL-10 levels increased in the treated groups, notably in K3 (376.48 ± 78.24 pg/mL) and K4 (351.06 ± 78.24 pg/mL), compared to K1 (285.34 ± 45.54 pg/mL) and K2 (306.89 ± 45.54 pg/mL) (p = 0.001). These findings suggest that oral administration of turmeric ethanol extract modulates inflammatory responses by reducing IL-6 and enhancing IL-10 in UVB-exposed skin, although significant dryness persists.
Effect of Turmeric Ethanol Extract (Curcuma Longa Linn.) on Tumor Necrosis Factor alpha (TNFα) and the extent of wound lesions (Experimental Study on Wistar Rats Exposed to UVB Rays) Rahim, Denasa Dwi Sopandita; Sumarawati, Titiek; Chodidjah; Zulaikhah, Siti Thomas; Priyantini, Sri; Trisnadi, Setyo
Gema Lingkungan Kesehatan Vol. 23 No. 3 (2025): Gema Lingkungan Kesehatan
Publisher : Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/gelinkes.v23i3.331

Abstract

Continuous exposure to ultraviolet B (UVB) radiation can induce photoaging and accelerate premature skin aging. Turmeric (Curcuma longa) is a medicinal plant that contains curcumin, an active compound known for its anti-inflammatory properties and its role in accelerating wound healing. This study aimed to evaluate the effect of turmeric ethanol extract on TNF-α levels and wound lesion areas in Wistar rats exposed to UVB radiation. A post-test-only control group design was employed, involving 24 Wistar rats divided into four groups: a healthy control group (K1), a negative control group (K2), and two treatment groups receiving oral turmeric ethanol extract at doses of 100 mg/kg BW (K3) and 200 mg/kg BW (K4) for 14 days, with concurrent UVB exposure. TNF-α levels were assessed using one-way ANOVA followed by Tukey's post hoc test, while wound lesion areas were analyzed using the Kruskal–Wallis test followed by the Mann–Whitney U test. The results showed that the highest TNF-α levels were observed in the healthy control group (129.14 ng/L), although no statistically significant differences were found between groups (p = 0.538). In contrast, a significant difference was observed in wound lesion areas (p < 0.001), with the largest lesions occurring in the negative control group. In conclusion, oral administration of turmeric ethanol extract did not significantly affect TNF-α levels but was effective in reducing the area of wound lesions caused by UVB exposure.
The Role of PPAR in Liver Cirrhosis: An Update Review Sholihah, Mentari Maratus; Pramana, Triyanta Yuli; Hanif, Muhammad Ifham
Gema Lingkungan Kesehatan Vol. 23 No. 3 (2025): Gema Lingkungan Kesehatan
Publisher : Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/gelinkes.v23i3.346

Abstract

Liver cirrhosis is the final stage of various chronic liver diseases characterized by fibrosis and nodule formation in the liver. The pathophysiology of liver cirrhosis involves a complex process, in which the role of peroxisome proliferator-activated receptors (PPAR) is very important. PPARα, which is mainly expressed in the liver, plays an important role in the regulation of hepatic lipid metabolism. In cirrhosis, PPARα expression is decreased, resulting in impaired fatty acid oxidation and increased lipogenesis. This contributes to the accumulation of fat in the liver, which is one of the characteristics of NAFLD that can progress to cirrhosis. PPARγ, although better known for its role in adipose tissue, also has important functions in the liver. In cirrhosis, PPARγ plays a role in inhibiting the activation and proliferation of HSCs, and modulating macrophage polarization. PPARγ activation can reduce liver inflammation and fibrosis, and increase insulin sensitivity. Recent studies have shown that PPARγ agonists can improve steatosis, reduce inflammation, and significantly improve the response to hepatitis viruses. PPARδ, which is widely expressed in various tissues including the liver, plays a role in lipid metabolism and liver inflammation. Moreover PPARs role in viral hepatitis induced liver chirrosis is still remain controversial. Although research on PPARδ in the context of liver cirrhosis is still limited, several studies have shown its potential anti-fibrotic effects. Thus, a deeper understanding of the role of PPARs in the pathophysiology of liver cirrhosis opens up new opportunities for the development of more effective therapies to treat this chronic liver disease.
Design and Performance Evaluation of a Digital Chlorinator for Domestic Wastewater Disinfection in Healthcare Facilities Suyanto, Beny; Jayadi, Hurip
Gema Lingkungan Kesehatan Vol. 23 No. 3 (2025): Gema Lingkungan Kesehatan
Publisher : Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/gelinkes.v23i3.412

Abstract

Domestic wastewater from healthcare facilities such as hospitals, community health centres, and polyclinics contains organic loads, toxic chemical compounds, and pathogenic microorganisms that have the potential to cause environmental pollution and pose a risk to public health if not treated adequately. Various conventional treatment methods, including UV, ozonation, aeration, and biofiltration, have been used to reduce pollutants, but cost limitations, high energy requirements, and technical reliability make chlorination the preferred option because it is relatively inexpensive, easy to implement, and produces disinfectant residues that provide continued protection. However, uncontrolled use of chlorine can lead to excessive residues, disinfection by-products (DBPs), and operational inefficiencies. To address these challenges, this study aims to design and evaluate the performance of a digital chlorinator equipped with an automatic control system with dual energy source flexibility (AC/DC and solar panels). This study used a one group pre-test and post-test design with domestic wastewater samples from hospitals, health centres, and polyclinics in Magetan Regency. The water quality parameters analysed included pH, BOD, COD, ammonia, chlorine demand, residual chlorine, and total coliforms. Initial measurements showed BOD of 105–145 mg/L, COD of 198–260 mg/L, ammonia of 13–18 mg/L, and total coliform of 8.5 × 10⁵ to 1.2 × 10⁶ MPN/100 mL, far above the national quality standards. After treatment using a digital chlorinator with an optimum dose of 200 ppm, BOD decreased by 77–82%, COD by 72–78%, ammonia by 75–80%, and total coliforms by more than 99%, while the pH remained stable in the range of 7.1–7.3 and the chlorine residue was maintained at 0.2–0.5 mg/L according to the recommended standard. A comparison of energy sources showed that the effectiveness of solar cells was almost equivalent to that of AC/DC, with a small difference in the reduction of BOD and COD that was not statistically significant. The results of this study conclude that digital chlorinators are effective, adaptive, and have the potential to be an innovative solution in improving the quality of domestic waste treatment in health facilities, especially in areas with limited access to electricity, and can support the achievement of sustainable environmental health goals.
Biodigesters for Wastewater Treatment and Biogas Generation in Poultry Slaughterhouses Suwerda, Bambang; Narto, Narto; Rois, Ibnu; Murti, Aliya Nugrafitra
Gema Lingkungan Kesehatan Vol. 23 No. 4 (2025): Gema Lingkungan Kesehatan
Publisher : Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/gelinkes.v23i4.355

Abstract

This study evaluates the integration of a biodigester reactor into the wastewater treatment system at a poultry slaughterhouse to improve effluent quality and produce biogas as an alternative energy source. Wastewater samples were collected before and after biodigester treatment, and the parameters analyzed included Chemical Oxygen Demand (COD), Biological Oxygen Demand (BOD), Total Suspended Solids (TSS), oil and grease, and pH stability. Biogas production was also monitored daily. The results showed significant reductions in COD (from 350 mg/L to 148 mg/L), BOD (from 225 mg/L to 82.4 mg/L), and TSS (from 180 mg/L to 32 mg/L), with average decreases of 57.83%, 63.38%, and 82.1%, respectively. Oil and grease levels decreased by 89.5%, although this reduction did not reach statistical significance (p=0,197). The pH values remained stable within the range of 6.0 to 9.0, supporting optimal microbial activity. Biogas production averaged 7.48 m³/hour in the morning and 6.70 m³/hour in the afternoon, demonstrating the biodigester’s capacity to generate renewable energy. The findings confirm that integrating a biodigester enhances organic pollutant removal efficiency, reduces reliance on fossil fuels, and minimizes wastewater pollution, offering both economic and environmental benefits. However, further optimization is needed to effectively reduce oil and grease concentrations. This study highlights the potential of biodigester technology as a sustainable solution for managing poultry slaughterhouse wastewater, contributing to environmental protection and energy recovery
Holistic Approach: Emotional Touch Intervention (Kissing and Hugging) and Macronutrient Nutrition in Stunting Prevention in Early Childhood) Fitriahadi, Enny; Daryanti, Menik Sri; Nuzuliana, Rosmita; Mufdlilahi; Satriyandari, Yekti; Nguyen, Thuy Hong
Gema Lingkungan Kesehatan Vol. 23 No. 4 (2025): Gema Lingkungan Kesehatan
Publisher : Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/gelinkes.v23i4.326

Abstract

Stunting can lead to complications such as decreased intelligence and impaired growth, which may further deteriorate development into adulthood. This study aimed to examine the effectiveness of maternal kissing, hugging, and macronutrient intake in the prevention of stunting. A randomized clinical trial was conducted involving 170 mothers with toddlers aged 6 to 60 months who were at risk of stunting in 2024. Participants were randomly assigned to intervention and control groups. In both groups, parenting behaviors involving maternal hugging and kissing were measured using a structured questionnaire, while macronutrient intake, particularly protein-rich intake, was assessed using microtoise and length boards. The results showed a significant improvement in the intervention group compared to the control group (p < 0.001). The incidence of stunting was significantly lower in the intervention group than in the control group (p < 0.001). Additionally, the effectiveness of the Emotional Touch Intervention (Kissing and Hugging) and Macronutrient Nutrition (a local playful interaction technique) was statistically significant with a p-value of 0.000 (< 0.05). These findings indicate that maternal kissing, hugging, and adequate macronutrient intake are beneficial strategies in stunting prevention among toddlers. This study contributes to health innovations by promoting a combined approach of affectionate parenting and nutritional support to enhance toddler health and well-being.
Association Between Community-Based Total Sanitation (CLTS) Pillars and Diarrhea Incidence in Wetland Communities of South Indralaya Trisnaini, Inoy; Pratiningsih, Widya Ayu; Putri, Dini Arista; Juniarni, Annisa; Febriana, Dwita; Safana, Hanifaus; Firdaus, Amirarosa
Gema Lingkungan Kesehatan Vol. 23 No. 4 (2025): Gema Lingkungan Kesehatan
Publisher : Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/gelinkes.v23i4.363

Abstract

Diarrhea remains a major global health problem and a leading cause of mortality among children under five, often exacerbated by inadequate sanitation and limited access to clean water. Community-Led Total Sanitation (CLTS) represents a national strategy for preventing environment-based diseases, including diarrhea. However, researchers have not comprehensively studied the effectiveness of each CLTS pillar within specific geographical contexts, such as wetland areas. This study aims to identify the relationship between sanitation factors of Community-Led Total Sanitation (CLTS) pillars and diarrhea incidence in the South Indralaya wetland community. This quantitative research employed a cross-sectional design and selected 100 respondents using a purposive sampling technique. Data were collected through questionnaires and analyzed using chi-square test for bivariate analysis and logistic regression for multivariate analysis. Our results indicated a diarrhea prevalence of 45% among total respondents. Multivariate analysis revealed that two CLTS pillars significantly associated with diarrhea incidence. Pillar 1, concerning latrine availability, showed that households without latrines had a 3.4 times higher risk of experiencing diarrhea (OR = 3.400; 95% CI: 1.037–11.155). Pillar 4, regarding unsafe waste management, also served as a strong predictor, increasing diarrhea likelihood up to 3.296 times (P-value = 0.008; Exp(B) = 3.296; 95% CI: 1.359–7.996). We found that latrine type (P = 0.053) acted as a confounder, which influenced the risk estimation of the main variables in the model. This study concludes that CLTS pillars 1 and 4, related to feces and solid waste management, are key determinants of diarrhea incidence in South Indralaya. Interventions focusing on improving access to and quality of latrines, as well as safe waste management practices, are crucial for reducing diarrhea incidence in the region.
Respiratory and Neurological Health Effects of Chromium and PM Exposure among Troso Woven Fabric Workers: A Cross Sectional Study in Jepara Darundiati, Yusniar Hanani; Joko, Tri; Setiani, Onny; Raharjo, Mursid; Nurjazuli, Nurjazuli; Rahman, Muhammad Auliya
Gema Lingkungan Kesehatan Vol. 23 No. 4 (2025): Gema Lingkungan Kesehatan
Publisher : Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/gelinkes.v23i4.371

Abstract

The Troso weaving industry in Jepara, Indonesia, is a traditional craft sector that relies on synthetic dyes and manual production, thereby exposing workers to chromium (Cr) and particulate matter (PM2.5 and PM10) with potential respiratory and neurological risks. This study aimed to analyze their association with respiratory and neurological disorders among workers. A cross-sectional design was applied involving 101 weaving workers from four production sites. Environmental sampling measured Cr concentrations in wastewater and PM2.5/PM10 in the ambient air, while worker characteristics and health complaints were assessed using the ECSC-87 and Q18 questionnaire. Data were analyzed using chi-square tests and odds ratios. Cr concentrations in wastewater ranged from <0.010 to 0.104 mg/L, remaining below the effluent quality standard of 1.0 mg/L but confirming the continuous use of chromium-based dyes discharged without treatment. Average PM2.5 and PM10 levels were 108.75 µg/m³ and 117.75 µg/m³, both exceeding national air quality standards (55 and 75 µg/m³). Bivariate analysis showed that respiratory disorders were significantly associated with exposure duration ≥40 hours/week (OR=7.333; p=0.0001) and working period >5 years (OR=20.935; p=0.0001), whereas dye type, dyeing frequency, and PPE use were not significant. Neurological disorders were significantly associated with exposure duration (p=0.001), working period (p=0.001), type of dye (p=0.0001), frequency of dyeing (p=0.018), and PPE use (p=0.0001). Environmental monitoring confirmed elevated PM levels and chromium-based dye use, while statistical analysis showed that prolonged exposure and long working periods associated with respiratory disorders, and neurological disorders were linked to multiple occupational factors.
Evaluation of Hospital Sustainability Initiatives in South-east Asia Nurfikri, Ari; Purwana, Rachmadhi; Soesilo, Tri Edhi Budhi; Danial Kesa, Deni
Gema Lingkungan Kesehatan Vol. 23 No. 4 (2025): Gema Lingkungan Kesehatan
Publisher : Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/gelinkes.v23i4.372

Abstract

The increasing growth of hospitals in South-east Asia has not been in line with awareness and commitment to sustainability in healthcare facilities. Hospitals play an important role in maintaining public health and contributing to environmental sustainability. However, due to the region's vulnerability to the impacts of climate change, hospitals in South-east Asia have not yet fully transformed into green healthy hospital. This study compares the sustainability of each hospital in South-east Asia that is a member of the Global Green Healthy Hospital (GGHH) based on ten sustainability agendas. This study employs secondary data analysis sourced from the official GGHH website and utilises descriptive quantitative design techniques that include frequency and percentage calculations. The highest percentage of sustainability agenda implementation in the South-east Asia region is waste (72.3%), energy (63.49%), and leadership (52.48%). The lowest percentages are transportation (16.77%), pharmacy (24.92%), and chemicals (31.20%). Hospitals in South-east Asia show a low level of awareness about the implementation of green and healthy hospital practices. Only two countries, the Philippines and Indonesia, have healthcare facilities capable of implementing ten sustainability agendas.

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