OCCUPATIONAL HEALTH STUDY OF WOMAN PORTERS IN BADUNG MARKET.

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OCCUPATIONAL HEALTH STUDY OF WOMAN PORTERS
IN BADUNG MARKET
Putu Ayu Sani Utami 1), Ika Widi Astuti 2), Francisca Shanti K 3),
Ni Luh Putu Eva Yanti 4)
1,2,3,4
Nursing Program, Faculty of Medicine, Udayana University, PB Sudirman Street,
Denpasar, 80232
Phone/Fax : (0361) 222510, E-mail : putuayusani@yahoo.com

ABSTRACT

Background: The traditional market is one of the tourist destinations in Bali both for
domestic and foreign tourists. Porters is one of the market participants who offer
services to bring the goods that have been purchased to the desired destination. A porter
is often overlooked but actually needed. Many women become porters with the aim to
sustain the needs of the household. Many of them have to work without leaving his role
as wife, mother of his children, and housewives at home resulting in a heavier workload
psychologically. Woman Porters is at risk of health problems due to high workload and
bad work behavior.

Purpose: The aim of this study is to describe the health of women porters working at
Pasar Badung includes the current position of the lift-haul, heavy load, mileage, work
load, knowledge of occupational health, the use of personal protective equipment and
experienced health problems related to work behavior.
Method: A descriptive analytic method using cross sectional survey and interview. The
sample used 114 woman porters in Pasar Badung using purposive sampling technique.
Result: The age of woman porters start from 7 to 68 years old. Most recent education is
elementary School (31.6%). The average monthly income is less than the minimum
wage amounted to 81.6%. The Category of average weight is very heavy duty (43.9%)
by mileage start from 7 meters to 1250 meters in around of Badung Market. Porters
workload of women in the category tolerated by 84.2%. The position of the lift-haul
porters women need repairs now 82.5%. The use of personal protective equipment is not
according to the standard 93%. Knowledge related to the health of women porters
working poor at 82.5%. Muskuloskletal problems that experienced by porters is pain.
According to the Nordic Body Map questionnaire, areas most complained experiencing
pain is knee (83.3%), calves (78.1%) and shoulder (71.9%).
Conclusion: Occupational health of women porters in Badung market need to be
followed up with the health programs and given nursing interventions so that they can
work productively and become a support in market activity.


Keywords : Woman porters, occupational health, traditional markets

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1. BACKGROUND
Mostly, Bali are well known by its tourist destinations. One of them is the traditional
market which provides cultural ecperiences for domestic and foreign tourists. The
traditional market is a meeting place between buyers and sellers that provide goods and
services. Nielsen survey results (2013) in Latif (2014) describes the number of people in
the Indonesian market has decreased. The market in 2007 amounted to 13,550 people,
while in 2009 shrank to 13,450, and in 2011 it amounted to 9,950. Despite the existence of
traditional markets rivaled by the existence of modern markets, many people have to
choice traditional markets because of the bargaining process in the purchase of goods and
services. Traditional market in Bali spread across eight districts. Denpasar city with the
highest population density has some great markets such as Badung Market, Kumbasari
market, Sanglah Market, Batu Kandik Market and Kreneng Market. Badung Market is the
biggest wholesale market operates 24 hours a day, so that a lot of traders and buyers came
to this market for interaction (PDPasar, 2015b).

Traditional markets are in the informal sector, so that everyone has an opportunity to get a

job, because it does not need special conditions to be able to get a job here. Porters is one
of the market workers who sell services to transport goods to the place of destination.
Women are becoming porters for the demands of the state to meet the economic needs of
their families, while women have a primary responsibility as a housewife. This role is
certainly severe enough to require extra energy.

The work as porters have its own risks, especially for women because the female body are
the reproductive organs are quite prone to be used to lift a heavy load, especially in the
uterus, back and neck (Marviana & Indrawati, 2014). The market environment is also a
separate stressor for the health of women porters because the density of the number of
people who interact with the background of each health and environmental hygiene market
itself. Another factor affecting the health of women working porters is knowledge of
occupational health, transport lift position, the use of Personal Protective Equipment (PPE)
at work, weight, mileage carrying the burden and workload.

Porters at risk of health problems due to high workload, health conditions and behaviors
that are less good. Awareness of the importance of occupational health caused by

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knowledge and information held relating to occupational risks and health. Heinrich (2004)
explain the causes of accidents is unsafe behavior by 88%, conditions unsafe environment
by 10%, or two of the above occur simultaneously. Improper work behavior can lead to the
onset of health problems that affect the decline in labor productivity.

Preliminary studies conducted on February 8, 2015 against 4 people porters woman said
that the goods are transported on their heads sometimes there is even a very light weight.
They also say that often have complaints such as back pain, shoulder pain, headache, and
itching both in the head and legs. Handling is done to solve the problem usually is spread
by wind oil and liniment. When feeling tired they rest for a moment on the porch store.
Four people porters also said he has given information about the disease is experienced as
well as medical examination of the officer, but no information was obtained regarding
occupational health as porters. When ill they go to the health center or hospital Wangaya.
The good health of market participants, especially women porters absolutely necessary
because it can support activities in market activity. In addition, the service provided porters
woman to buyers and tourists to be prima.

The purpose of this study is to describe the characteristics, heavy duty, mileage, work load,
position lift transport, personal protective equipment used, the knowledge of occupational
health and related health problems experienced in the occupational health of women

porters at Pasar Badung.

2. METHODS
2.1 Research design
This study uses an observational design. Descriptive research is intended to gather
information about the status of an existing symptoms, symptoms according to what their
circumstances at the time the research was conducted and is useful to define the
circumstances which may be present in certain situations (Nursalam, 2008). The research
method used was survey and interview.

2.2 Population and Sample
The population in this study were women porters in badung Market totaled 159 (Arnatha,
2014). The samples used were 114 women porters at Pasar Badung with purposive

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sampling technique. Data were collected for 3 months starting from June to September
2015.

2.3 Research ethics

Ethics were used in this study include the provision of informed consent before choosing
porters women as respondents. Respondents were given an explanation of the purpose of
the study, the time required, the procedures performed and the advantages and
disadvantages of the procedure to be performed. Respondents are entitled to reject and stop
the study if they feel uncomfortable. Respondents have the right to obtain treatment in
accordance with procedures established by researchers in the research process.

2.4 Tools and Data Collection Procedures
Collecting data using observation sheets and questionnaires include an overview of the
characteristics (age, education, income), heavy duty, mileage, work load, position lift
transport, personal protective equipment used, the knowledge of occupational health and
health problems experienced health-related work, Questionnaire-lift transport position
using OWAS (Ovako Working Posture Analysis System) and health problems experienced
using NBM (Nordic Body Map) which has been internationally accepted and has been
tested for reliability and validity. Data was taken from before the respondent carry, during
and after the respondent respondents transporting transports. To obtain more in depth data
related to motivation and behavior of health porters willingness of women was adjusted
with time respondents housed in Pasar Badung and home of respondents.
2.5 Processing and Data Analysis
Data were collected and processed using univariate analysis where data analyzed by

describing the collected data are presented in the form of frequency distributions and
reinforced by data from interviews.

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3. RESULTS AND DISCUSSION
3.1 Result
Characteristics of research subjects
Table 1. Characteristics of Respondents by Age, Education and Income last month.
Characteristics

Frequency
(n)

Percentage
(%)

Total
(N)


7
17
80
5
5

6,1
14,9
70,2
4,4
4,4

27

23,7

36
35
16


31,6
30,7
14

114

93
21

81,6
18,4

114

Age
Child (5-11 years)
Adolescents (12-25 years)
Adults (26-45 years)
Early Elderly (46-59 years)
Elderly (≥ 60 years)

Education
No school / not completed
primary school
Elementary School
Junior high school
Senior High School
Income
< Rp. 1.621.172
≥ Rp. 1.621.172

114

Heavy Load
Table 2. Heavy duty porters women at Pasar Badung
Variables
Heavy Load
Normal
moderate
Weight
Very heavy


Frequency
(n)

Percentage
(%)

16
22
26
50

14
19,3
22,8
43,9

Total
(N)

114

Results of research payload weight distribution porters women, the lowest weight being
transported is 2 kg and the highest weight is 106 kg for one haul.

Mileage
Table 3. Mileage women porters carry goods in Pasar Badung
Variables

Meter

Total (N)

7
1250
141,9

114

Mileage
Min
Max
Mean

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Workload
Table 4. The workload of women porters in Pasar Badung
Variables
Workload
Tolerated workload
High workload

Frequency
(n)

Percentage
(%)

Total
(N)

96
18

84,2
15,8

114

Lift Transports Position
Table 5. The position of women porters lift transport at Pasar Badung
Variables
Lift Transports Position
No need improvement
The position needs improvement
The position needs a quick fix
The position needs improvement
now

Frequency
(n)

Percentage
(%)

Total
(N)

7
5
8
94

6,1
4,4
7
82,5

114

Personal Protection Equipment
Table 6. Personal protective equipment used porters woman in Pasar Badung
Variables
Personal Protection Equipment
According to the standard
Not according to the standard

Frequency
(n)

Percentage
(%)

Total
(N)

8
106

7
93

114

Knowledge about Occupational Health
Table 7. Knowledge of occupational health of women porters in Pasar Badung
Variables
Knowledge
Good
Enough
Less

Frequency
(n)

Percentage
(%)

Total
(N)

2
18
94

1,8
15,8
82,5

114

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Occupational Health Problems
Table 8. Complaints of musculoskeletal problems experienced by women porters in Pasar
Badung
Variables
Complaints of musculoskeletal problems
mild
moderate

Frequency
(n)

Percentage
(%)

Total
(N)

97
17

85,1
14,9

114

Complaints of musculoskeletal problems experienced porters is pain. According to the
questionnaire Nordic Body Map, the area most complained of experiencing pain is knee
(83.3%), calves (78.1%), shoulder (71.9%), waist (71.1%), the neck (58 , 8%), the upper
arm (42.1%), ankle (31.6%), elbow (28.9%), wrist (18.4%), and palms (5.3%) , Based on
the interview, other health problems complained of porters is itching (41.2%) and injuries
(30.7%).

3.2 Discussion
Women in running their lives has a dual role. The dual role is a role that a woman at the
same time. The role of a woman is as wife and husband's partner in the care of the
household, a mother and child care, providing household needs and run a career outside the
home (Suryadi, 2004). Moreover, in the area of Bali has another role that women
participate in social activities mores Bali. In running the household life and carrying out its
role needs to be supported by a stable economy, but often the income derived by the
husband as breadwinner is less than the daily needs of households that require women to
contribute to the family economy.

Being a porter in traditional markets is one of a woman's choice because it does not require
special conditions in the work. Badung traditional market is a market that has been chosen
because it is a wholesale market that operates 24 hours with trading activities are ongoing
and often become tourist arrivals from both inside and outside the country. The results
showed women who worked as porters tidk know the age, from children to seniors there
who works as porters with the same goal which is to meet the needs of daily living. A
woman's age most be porters aged adults (70.2%). Children are also already being porters
who range in age from 7 to 11 years by 6.1%. Whereas in Law No. 13 Year 2003 on
Manpower has been arranged that the minimum age a person is allowed to work a

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minimum of 13 years with specific criteria or 18 years without criteria. Around the area of
Pasar Badung had been no ban on the age of children to work, but there are still children
who worked as porters on the grounds they are working to help parents pay for her sister to
school and buy the goods they want such as clothing, accessories , shoes and even a mobile
phone. To avoid any abuse in the employment of child labor, it is good for service users
porters not to use children in transporting goods. This is because, in addition to conflict
with the Act, also provide health risks for children who carry a heavy burden for the
growth and development of the body. In addition, the elderly are also there being a porter
by 4.4% with a reason to send their grandchildren and to finance day-to-day life.

Individual physical strength began to decline at the age of 39. At the age of 50-60 years of
muscle strength only reached 75-85% compared with those aged 25-45 years (Pheasant,
1991). Age is one factor that contributed to the onset of musculoskeletal complaints such
as pain. Research by Sang (2011) states that workers over the age of 35 years 9 times
greater risk of experiencing musculoskeletal complaints compared to workers aged less
than 35 years. This is because at the age of 35 years and over due to the activity of bone
mass making more frequent. In addition, the storage does not increase bone mass and result
in osteoporosis. The average at the age of 35 years, most of the workers complain of back
pain the first time as a result of the work and the level of fatigue will continue to increase
with age. At the age of adolescence, strength and endurance so that the muscles begin to
decrease the risk of complaints increased.

Lowest educational porters is no school / not completed primary school while the highest
level of education is high school. Last educational women working as porters Most are
elementary ie 31.6%. But many are also porters who did not get an education that is 23.7%.
The results of the interview, obtained 71.4% of children working as porters are not in
school. They just follow the formal education held at Pasar Badung Foundation every two
times a week. Although through informal education, children can still learn because
education can influence the acceptance of an update. Green (2000) describes the
knowledge has a great fair in the acceptance of individuals to information. The higher a
person's education level, the more easily receive health-related information.

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The average income per day is the lowest respondents Rp. 3,000, the highest was Rp.
150.000, - and the average monthly income of less than the minimum wage amounted to
81.6%. Income is useful to meet the everyday lives of individuals. The lack of income
resulting, individuals to work harder to earn a decent income and as needed. Results of
interviews with porters, the result that income derived from work used to eat daily fee,
tuition fees, boarding fees and the cost of traditional ceremonies. For other needs such as
clothing is very rarely met. Women porters also explained that they work as porters is to
help her husband earn a living, even the husband of porters who are not working or
working odd jobs and income are not sure that the porters women become the main
breadwinner in her family.

The position adopted by porters haul ergonomic as evidenced from the results of using
OWAS with porters position result harmful and need refurbishing now as much as 82.5%.
Improper position in transporting goods can lead to musculoskeletal disorders. Pain
complaints submitted by porters to the percentage of knee pain (83.3%), calves (78.1%),
shoulder (71.9%), waist (71.1%), lower neck (58.8%), the upper arm (42.1%), ankle
(31.6%), elbow (28.9%), wrist (18.4%), and palms (5.3%). Porters lift transports women
when work will often confronted with circumstances that forced to do work that is varied
positions such as bending, standing with hands that should sustain the burden that has been
transported, squatting, carrying, walking, and so forth. This situation, if not done in an
ergonomic position would lead to the risk of musculoskeletal complaints. Granjen (in
Budiman, 2015) states that the working position is unnatural is working attitude that causes
parts of the body moving away from its natural position. The further the position of the
center of gravity of the body, the higher the skeletal muscle complaints occur. Work
attitude is not natural in general because of incompatibility work to the capabilities of
workers. This condition is also dangerous to the health of the elderly who become porters,
which are physiologically during the elderly already decreasing function of every organ
system primarily muskuloskletal system played a major role in the process of liftingtransport of goods which can lead to bone fragility fractures in the elderly even.

Porters women in work frequently bent position for lifting and lowering loads that
sometimes exceed the normal capacity, and the need to uphold the average load for 5-15
minutes so that it can suppress the neck muscles, blood circulation and nerves. A decrease

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in blood circulation increases the incidence of anaerobic metabolism. This improves the
anaerobic metabolism of carbon dioxide and lactic acid accumulation, resulting in muscle
fatigue and cause musculoskeletal complaints such as pain and muscle cramps (Arnatha,
2014)

Results of research payload weight distribution porters women, the lowest weight being
transported is 2 kg and the highest weight is 106 kg for one haul. The National
Occupational health and safty Commissions (Work Safe Australia), 1996 (in Nurmianto,
2004) stated weight limit of normal load by means of transport is