TOYOHASHI UNIVERSITY OF TECHNOLOGHY

ANALYSIS OF INFECTIOUS RESPIRATORY

DISEASE CASES IN INDONESIA AND HIS
RELATIONSHIP TO INDOOR AIR QUALITY
REPORT OF INDOOR AIR QUALITY
JODY SETIAWAN

The definition of indoor air quality, and analysis of cases of respiratory tract
infection cases in Indonesia and its relevance to the indoor air quality

Definition of Indoor air quality

Indoor air quality (IAQ) is a condition of the content of the air in the room that could affect health and
comfort of occupants. When a room is used, sometimes there is a variety of human activities (breathing,
smoking, cooking) and the release of other compounds (new paint, dust, camphor, VOCs) from certain
objects. When the clean air polluted by those elements which passed the threshold, it can interfere the
comfort and health of human. The good indoor air quality can be achieved if the room or building has
good air circulation.
The Indoor air pollution occurs because of the process of the gases or particles discharge into the air from
the source. Generally, air pollution from the outside can enter the room due to bad infiltration and
ventilation systems. Sources of outdoor air pollution can be derived from various types of combustion
processes while source of indoor air pollutants can come from building materials and broken furnishings,
products containing insulating asbestos material, damp carpets, pressed wooden furniture, cleaning
products and personal care, freezer, stove, humidifier, etc.
Analisis of several cases of respiratory tract infection disease in Indonesia and its relevance to the
indoor air quality
Approximately four million people have died from respiratory tract infection disease annually. The very
high mortality rate occurred in infants, children, and elderly people, especially those in countries with low
and middle income per capita. Respiratory tract infection disease was ranked first out of 10 diseases in
Indonesia for more than two decades. The reason is that the low air quality through physical, chemical,
and biological both in the home and outside house. Respiratory tract infection disease is also a disease
that often occurs due to bad indoor air quality.
Respiratory tract infection disease is the occurrence of severe infection in the sinuses, throat, air channels
or lungs. The infections that occurs more often caused by a virus although the bacteria can also cause this
condition. This condition cause respiratory function becomes impaired. If not immediately treated, can
spread throughout the respiratory system. The body could not get enough oxygen due to an infection that
occurs and this condition can be fatal, perhaps even deadly.
A person can be infected with acute respiratory infection when the person is breathing air that contains
viruses or bacteria. Virus issued by people with respiratory tract infections through sneezing or coughing.
In addition, the liquid containing the virus or bacteria that attach to the surface of the object can be
infectious to others when they touch it. This is referred to as indirect contacts. Respiratory tract infection
disease itself will be more easily infect people who have problem with their lungs. The vulnerable
population to pneumonia are children aged less than 2 years old and the elderly over 65 years old.
The house condition is strongly associated with the risk of air pollution. Indoor air pollution is harmful to
health. Indoor air pollution can be caused by several factors, namely due to physical, chemical or
biological of indoor air. Condition of the house where the air does not meet health requirements are also
influenced by environmental factors that are not good against air pollution, on the other hand houses with
many occupants would lead to bad consequences on the health and be a potential source of the spread of
respiratory tract infection diseases.

The existence of microorganisms in a house is also a potential source of the spread of respiratory disease,
it is caused by many fungi and bacteria. In the house environment, mold spores and bacteria become the
root cause of the air-borne diseases and scattered everywhere. Both can get into the house caused by
passive ventilation or inadequate ventilation systems. Many microorganisms in house can also come from
animals, flower pots and trash. Air sirculation that do not qualify can cause proliferation of growth of
microorganisms that cause health problems in humans and potentially cause respiratory tract infection
disease.
Acute respiratory tract infections in one of districts in Indonesia (Bogor Regency) always ranked first
occurs in infants. In addition, based on the traffic data reports of respiratory tract infection disease
patients in two health units health centers which are health unit Sadeng health centers and health units
health centers Sadeng Market, respiratory tract infection disease is the highest rank disease of 10 list of
high rate diseases. This is due to the low healthy homeownership of people in the district Leuwisadeng
affecting to air microbiology quality in the house so that it can be a risk factor for the incidence of
respiratory tract infection disease in infants. Floating microorganisms in the air with the support of
inadequate environmental factors can infect the nasal mucosa, trachea, and bronchi. Infection of these
microorganisms can cause respiratory tract infections disease.
Based on observation show that the conditions of hygiene and poor sanitation in a house can cause the
incidence of acute respiratory infections. Unhealthy house and unsanitary living behavior can lead to a
high number of colonies of bacteria in the house, where the number of pathogenic microorganisms is
higher in the house than in the outside air. The average of total bacterial colonies had a significant
association with the risk of acute respiratory infections in infants. During the winter, the number of
bacteria in the home will be more than outdoors. The high number of bacterial colonies in the case of
group homes can be due to population density, unhealthy home, unhygienic behavior, and the inadequate
ventilation. Residential density and individual activities are closely related to the concentration of
microorganisms in the air in the room.
Total colony of microorganisms in the house space is also influenced by environmental factors. The high
relative humidity cause microorganisms such as fungi can survive in non-living material such as dust.
Fungal spores are also found in all types of environments in the home, one of which is the home material.
Home material and furniture provide enough nutrients for fungal species and also the fungus can grow a
lot in room with adequate humidity. Traditional house that has a water leak in the roof caused by rainy
weather or water pipe leakage is often become a favorite place for mold growth.
The behavior of the occupants were assessed consisted of behavior of open window of the room and the
family room, the behavior of house cleaning, throwing feces of infants and toddlers to the toilet, and
behavioral dispose of waste in place can be a determining factor of growth of fungi and spores, which will
cause respiratory tract infection disease.
On the other hand, a low socio-economic conditions such as the size of the house, the number of family
groups in one house, a rented house, and the high cost of housing is also a determining factor of growth of
fungi and spores, which will cause acute respiratory infections disease. Residential density that do not
meet health requirements Ministry of Health of Indonesia ( 8 m 2/person) mostly caused by the large
number of families living in one house can increase the likelihood of respiratory tract infection disease for

toddler, for example, one house there are two or three families even more. Overcrowded house can
facilitate the transmission of disease to other occupants.
High amount of house in Indonesia that use firewood for cooking because of lower socio-economic
factors are also the cause of respiratory tract infections disease in Indonesia. This happens because the
fumes of combustion of wood fuel with high concentrations can damage the lungs. Burning smoke
contains various particles and chemical substances such as lead, iron, manganese, arsenic, cadmium
which can cause irritation to the respiratory tract mucosa so that is susceptible to infection. The particles
in the air which enter through the respiratory tract will cause damage epithelial and ciliary cells and so
that foreign objects or incoming particles can not be removed. Smoke or particles of combustion of fuel
should be removed through the kitchen smoke hole or kitchen ventilation. Therefore, the house that is not
equipped with a kitchen vent and location of the kitchen adjacent to a toddler bed can increase exposure
to wood smoke with a high concentration. It was hard to stop because of the needs and socio-economic
conditions.
Wildfires are also a major cause of respiratory tract infection disease occurred in Indonesia. In 2015,
Indonesia's National Disaster Management agency (BNPB) reported that patients with acute respiratory
tract infection disease from smoke haze forest fires in Indonesia reached 556,945 people.
From the description above can be concluded that the high amount of patients with respiratory tract
infections disease in Indonesia has a strong link between indoor air quality and outdoor air quality. This
happens because it is influenced by social factors, economic factors, lifestyle factors, and damaged
environment caused by forest fires by elements which deserve to be severely punished.