The Indonesian Journal of Community and Occupational Medicine

Return-to-Work Assessment for Traditional Tin Miners with Tuberculosis and Pneumoconiosis: A Case Report Using PERDOKI’s 7-Step Fit-to-Work Method

Heru Alfares — 2026-03-27

Background: Workers involved in Indonesia’s traditional tin mining face significant risks of developing pneumoconiosis, primarily due to persistent exposure to ore dust. Striking a balance between maintaining productivity and safeguarding worker health is essential. Implementing structured return-to-work evaluations becomes crucial for monitoring health outcomes and ensuring safer working conditions.
Case: A 38-year-old male with a one-year history of surface tin mining presented with a persistent cough and worsening shortness of breath. Imaging revealed bilateral nodular opacities, findings consistent with pneumoconiosis. Spirometry demonstrated a restrictive ventilatory defect. No significant comorbidities were identified.
Methods: The seven-step PERDOKI protocol was used to assess fitness to work (FTW): (1) task analysis, (2) job demand assessment, (3) medical status evaluation, (4) disability evaluation, (5) risk analysis, (6) environmental tolerance evaluation, and (7) final FTW decision.
Results: The miner does not meet the required 7.9 METs threshold for physical capacity. Consequently, he has been classified as “temporarily unfit as a miner.” Medical recommendations include ongoing treatment and a gradual return-to-work schedule, along with regular pulmonary assessments.
Conclusion: The PERDOKI 7-step protocol serves as a structured, evidence-based approach to assessing whether a tin miner with pneumoconiosis is ready to return to work. Rather than a one-size-fits-all solution, this protocol emphasizes careful health monitoring and tailored job modifications.

Risk of Burnout among Younger Health Quarantine Workers in Indonesia

Ratih Catur Sholihah — 2026-03-27

Introduction: Burnout is a work-related stress condition commonly associated with long working hours and high job demands, making health quarantine workers particularly vulnerable. Evidence on the role of age in burnout is inconsistent, although older workers are often assumed to be at higher risk. This study investigates the relationship between age and burnout among health quarantine workers to determine which age group is more prone to burnout and to provide evidence that can guide early preventive interventions.
Methods: A cross-sectional study was conducted in September–October 2025 using secondary data from a survey by PT Y. Burnout was measured using the Maslach Burnout Inventory (MBI) questionnaire.
Results: Burnout prevalence among health quarantine workers was 25.4%. Multivariate analysis showed a p-value of 0.049 for age. Statistical tests showed p-values > 0.05 for the relationships between gender, education level, marital status, having children under five years old, work patterns, length of service, work area, employment status, or commuting distance with overall burnout.
Conclusion: More than one-fourth of health quarantine workers experienced burnout, with younger workers showing the highest risk. Age was the strongest predictor of burnout, indicating greater vulnerability among younger staff. Targeted support for early-career workers is essential to reduce burnout risk and strengthen workforce well-being.

Prevalence and Departmental Variations of Work-Related Musculoskeletal Disorders among Electricity Distribution Workers

Omotunde Muyiwa — 2026-03-27

Introduction: Electricity distribution workers are exposed to occupational hazards that may cause Work-related Musculoskeletal Disorders (WMSDs). However, studies are sparse on the departmental variation of the prevalence of WMSDs among the electricity workers in Nigeria.
Objective: To examine the prevalence and departmental variations of WMSDs among Ibadan Electricity Distribution Company (IBEDC) employees.
Method: A descriptive cross-sectional survey was conducted among 240 employees from three different departments across five service hubs of IBEDC. Demographic and WMSDs data were collected using a standardised Nordic musculoskeletal questionnaire. Data were analysed using percentages, descriptive statistics, and regression at to examine departmental variations.
Result: Customer service worker reported highest WMSDs prevalence in the past 7days and 12months at lower back (10.9 and 23.0%), knees (9.6 and 20.4%), hips/thighs (8.3 and 17.8%), ankles/feet (7.4 and 16.5%), and neck (7.4 and 16.5%), respectively, followed by technical, and then administrative staff. The body areas that prevented most of the employees from working were the lower back, knees, upper back, and ankles/feet across departments. The findings revealed a statistically significant (p<0.05) difference between departments in variations of prevalence of the WMSDs among the workers.
Conclusion: The prevalence of work-related musculoskeletal disorders was found to be common among customer service workers but significantly varied across the three departments. Ergonomic interventions, job redesign, and health education programs based on the department are required to minimise musculoskeletal symptoms.

The Association of Hydration Status and Other Occupational Factors with Attention, Concentration, and Working Memory among Mine Workers

Adrian Cristianto Yusuf — 2026-03-27

Background: Hot work environments and poor hydration status may impair workers’ cognitive functions, particularly attention, concentration, and working memory, increasing the risks of operational errors and unsafe behaviors. In open-pit coal mining, heat exposure, high workload, and operational demands contribute to elevated incident rates.
Objective: This study aimed to examine the association between hydration status and occupational factors with attention, concentration, and working memory among mine workers at PT. X.
Methods: This analytic observational study employed a cross-sectional design among 90 morning-shift coal miners at PT. X, East Kalimantan, recruited using convenience sampling. Cognitive function was assessed using the Digit Span Test, with the Forward Digit Span (FDS) subtest assessing attention and concentration and Backward Digit Span (BDS) subtest assessing working memory. Hydration status was assessed using Urine Specific Gravity (USG) to determine hydration trends over three consecutive days, and perceived stress was measured using the Perceived Stress Scale-10 (PSS-10).
Results: The result showed significant associations between hydration status and attention and concentration (p=0.023), as well as working memory (p=0.019). Job type, workload, and work climate were also significantly associated with attention, concentration, and working memory. No change in hydration status trends were observed during the three-day measurement period, with a consistent median USG value of 1,018, indicating mild dehydration.
Conclusion: Hydration status, job type, workload, and hot work climate were significantly associated with attention, concentration, and working memory, whereas age, sex, health status, and perceived stress did not show consistent associations with cognitive outcomes.

Stratum Corneum as a Sampling Matrix for Biomarker-Based Assessment of Solar Ultraviolet Exposure among Outdoor Workers

Freade Akbar — 2026-03-27

Introduction: Outdoor workers experience substantial solar ultraviolet radiation (UVR) exposure, yet related occupational skin diseases remain under-recognized. Early identification of biological changes induced by UVR is important for prevention. The stratum corneum (SC), the outermost epidermal layer, contains biochemical components responsive to UVR and can be sampled non-invasively, suggesting its potential as a biomarker source.
Methods: We conducted a structured literature review using major scientific databases focusing on UVR exposure, occupational health, and SC-based biomarkers. Papers describing the physiology of UVR exposure, established measurement methods, occupational risk profiles, and potential SC biomarkers, including urocanic acid (UCA) isomers and immunological mediators, were evaluated based on relevance and methodological rigor.
Results: Solar UVR, classified as a Group 1 carcinogen, induces acute and chronic skin effects. Outdoor workers receive cumulative UVR doses two to four times higher than indoor workers. Tape stripping enables minimally invasive SC collection suitable for biochemical, microscopic, and immunological analysis. Among potential markers, the trans- to cis-urocanic acid isomerization ratio demonstrates consistent UVR-dose responsiveness and correlates with exposed anatomical sites. Several cytokines involved in inflammation and UVR-induced immunomodulation may complement UCA analysis, although their consistency across studies varies.
Conclusion: The SC provides a practical matrix for assessing solar UVR exposure among outdoor workers. UCA isomer ratios represent the most promising SC biomarker, supported by mechanistic and empirical evidence. Standardization of sampling, analysis, and interpretation is required before incorporation into occupational surveillance programs.