Volume
5, No. August 8, 2024
p ISSN 2723-6927-e ISSN 2723-4339
Analysis of Handler
Hygiene with Coliform Content at Drinking Water Depots in the Former Maospati District, Magetan Regency in 2024
Alvyani Novita Sari1*, Riska Ratnawati2, Karina Nur R3
Environmental Health Specialization, Bachelor of
Public Health Study Program, Stikes Bhakti Husada
Mulia Madiun, Indonesia1*23
Email:
alvyanins@gmail.com1*, riskaratnawati@yahoo.com2,
karinanur46@gmail.com3
Abstract
This study aims to analyze
the relationship between handler hygiene and the content of coliform bacteria
in drinking water depots in the former Maospati
District, Magetan Regency in 2024. Coliform bacteria
are used as an indicator of fecal contamination in drinking water, which can
pose serious health risks for consumers. The research method used is analytical
observational with a cross-sectional approach. Sampling was carried out at
simple random from 52 drinking water depots, with a total of 19 samples
analyzed using the Most Probable Number (MPN) method to determine the
concentration of coliform bacteria. The research results showed that the
majority of drinking water depots (59%) had poor handler hygiene, while the
remaining 41% had good hygiene. Microbiologically, 51.3% of water samples did
not meet the requirements because they contained coliform bacteria, while 48.7%
met the requirements. Statistical analysis showed a significant relationship
between poor handler hygiene and high levels of coliform content (p = 0.001),
with a relative risk 12.2 times higher. This study makes an important
contribution to knowledge about drinking water safety in the region,
highlighting the importance of sanitation and hygiene monitoring in drinking
water depots to reduce public health risks. Recommendations from this research
include increased supervision and training for drinking water depot managers,
as well as the need to strengthen regulations and implement stricter sanitation
hygiene standards.
Keywords: Handler Hygiene, Coliform Content, Drinking
Water Depot, Magetan
INTRODUCTION
Coliform is a group of bacteria that is used as an indicator of fecal pollution and unfavorable
conditions for water, food, milk and dairy products. Coliforms as a group are
characterized as a group of rod-shaped, gram-negative, non-spore-forming,
facultative aerobilic bacteria that ferment lactose
by producing acid and gas within 48 hours at 370C. The presence of coliform
bacteria in food and drink indicates the possibility of enteropathogenic and
toxigenic microbes that are dangerous to health. The availability of good
quality water sources is very limited due to the lack of public awareness of
environmental pollution. One of the microbiological pollutions that occurs in
waters is the abundance of coliform bacteria and microorganisms which indicate
contamination by pathogenic bacteria. For this reason, it is necessary to check
the content of coliform bacteria in waters used for the management of these waters
and the management of waste disposal for industrial and industrial activities.
household. The higher the coliform content in water, the higher the presence of
other pathogenic bacteria. This can cause health problems for humans as a
result of these waters if this water source is used for human activities. .(Kurahman, Rohama and Saputri, 2022)
Drinking water depots are industries that manage raw water so that
it can be consumed directly and sold to consumers. Refillable drinking water
usually goes through a purification process either by ultraviolet irradiation,
ozonation, or both so that it can be drunk directly. The drinking water depot
business has huge opportunities in marketing because it can make big profits
with little capital. Apart from that, consumers consider drinking water depots
to be relatively cheap compared to branded bottled drinking water and can make
work easier so there is no need to boil drinking water. Drinking water needs to
be tested for drinking water quality in a laboratory recommended by the
Regency/City Government or that has been accredited. Drinking water quality testing
is carried out at least once every six months.(Chandra et al., 2024)
According to Minister of Health Regulation No. 43 of 2014,
sanitation hygiene requirements in drinking water management include aspects of
place, equipment and handlers. The depot location is in an area that is free
from environmental pollution and disease transmission. Then there is a strong,
clean and safe building, the floors and walls of the depot are made of
water-resistant materials. The roof and ceiling of the depot must be strong and
easy to clean(Permenkes, 2014). According to(Selomo et al., 2018)Environmental hygiene and sanitation
influence the presence of coliform bacteria contamination in refilled drinking
water. Hygiene and sanitation are health efforts to reduce factors that cause
contamination of drinking water and the facilities used for processing, storing
and marketing drinking water.
According to WHO, in developed countries each person needs between
60-120 liters of water per day, while in developing
countries, including Indonesia, each person needs between 30-60 liters of water per day (Muthaz
et al., 2017). One of the main needs of humans is drinking water. Humans cannot
live without water. Humans can live up to two months without eating, but humans
can only survive for two to three days without drinking. Drinking water that
meets established health requirements should not be contaminated by pathogens
or other substances that could be harmful to human health.(Badun, 2021)
According to Riskesdas 2018, the water
sources used by households in Indonesia as drinking water are: protected dug
wells (24.7%), tap water (14.2%), drilled wells/pumps (14.0%), and DAM
(Drinking Water Depot) water (13.8%). Based on where you live, both in urban
and rural areas, the main source of drinking water is quite varied, in urban
areas households use water from drilled wells/pumps (32.9%), and tap water/PDAM
(28.6), while in rural areas more use wells. sheltered dig. The national need
for water at the household level in Indonesia reaches 2 L per day and can even
be 100 L per day(MZ, EG and MU, 2022)
Based on the health profile of Magetan
Regency in 2021, the data reported regarding drinking water depots in the Magetan Regency area is 242 drinking water depots with a
total of 22 health centers in Magetan
Regency. With a percentage of 88.9% that meets health quality requirements.
Meanwhile, data on the health profile of Magetan
district in 2023 has 268 registered drinking water depots with a percentage of
94.0% that are suitable for sanitary hygiene.
Data on drinking water depots in Maospati
District, there are 101 drinking water depot facilities in 2024, including the
working areas of Tebon Health Center, Kartoharjo Health Center, Sukomoro Health Center, Karangrejo Health Center, Ngujung Health Center, Taji
Health Center, Maospati
Health Center, Rejomulyo
Health Center.
Permits to open DAM businesses in various provinces are issued by
the local regional government, usually through an integrated licensing agency
which will ask for recommendations from the local Health Service, based on
sanitation inspections and laboratory examination results including the POM Center, Environmental Health Engineering Center (BTKL). The existence of DAM continues to increase
in line with the dynamics of the community's need for quality drinking water
that is safe for consumption, although not all DAM products are guaranteed
safe. This happens because of weak supervision from the relevant agencies.
Insufficient supervision of the DAM resulted in the production process not
being properly supervised. One of the health impacts due to inadequate
sanitation hygiene is diarrhea. Diarrhea
in Indonesia is still a health problem when viewed from the morbidity and
mortality rates it causes.(Health et al., 2019)
Coliform bacteria are bacteria that live in the human intestine,
so if drinking water contains coliforms, then this is an indicator that the
drinking water has been contaminated by feces. This
situation may be caused by the poor health of the handlers, the physical
quality of the DAMIU, poor raw water sources or inadequate sanitation hygiene
and sanitation facilities, all of which are interrelated and cannot be
separated. Environmental hygiene and sanitation influence the presence of
coliform bacteria contamination in refilled drinking water. Hygiene and
sanitation are health efforts to reduce or eliminate factors that cause
contamination of drinking water and the facilities used for processing, storing
and marketing drinking water.
Hygiene sanitation in health efforts to reduce or eliminate
factors that cause contamination of drinking water and the facilities used for
processing, storing and distributing drinking water. Hygiene sanitation of
refill drinking water depots includes premises, equipment, raw water sources
and handlers(Chandra et al., 2024).
In Indonesia, the quality of refill drinking water began to be
questioned after the POM carried out inspections of several refill drinking
water depots in large urban areas. The results of the examination found colliform bacteria in the water produced by the refill
drinking water depot. The bacteria found in refillable drinking water do not
cause a reaction in a short time. However, over a certain period of time it can
cause a number of diseases, such as diarrhea. The
presence of colliform bacteria in refillable drinking
water is caused by imperfect hygiene in the production of refillable drinking
water(Nurkholis, 2019).
The positive impact of having a drinking water depot is, providing
safe and healthy quality water for users, individuals and communities,
providing water that meets the quantity, providing water continuously, easily
and cheaply to support individual and household hygiene. On the other hand, the
development of refill drinking water depots has the potential to have a
negative impact on consumer health, if there is no effective regulation. The
issue that is currently emerging is the low-quality assurance of the drinking
water produced. If not controlled optimally, drinking water depots have the
potential to cause harm to health, for example persistent chemical poisoning or
the spread of water-borne diseases.
There is a very continuous impact on society, namely the decline
in drinking water related to the high increase in population, problems of
poverty and pollution, while the addition of facilities and limited drinking
water coverage. to end poverty, reduce inequality and protect the environment.
One of the goals is to ensure the availability and sustainable management of
clean water and sanitation for all by setting the target by 2030 to achieve
universal and fair access to safe and affordable drinking water for all.(Zarifah, Navianti and Yulianto, 2022)
Previous research conducted in various cities in Indonesia showed
variations in the presence of bacteria in refilled drinking water. The results
of research conducted by(Selomo et al., 2018)Hygiene and sanitation conditions of 9
refill drinking water depots in Campalagian District,
Polewali Mandar Regency, namely 5 depots or 55.56%
meet physical feasibility. This means that as many as 4 depots or 44.44% do not
meet physical feasibility. Important aspects to pay attention to are aspects of
cleanliness and behavior of handlers as well as the
availability of basic sanitation facilities, including: waste water disposal
facilities (SPAL), rubbish dumps, and hand washing facilities. Other research conducted
by(Zarifah, Navianti and Yulianto, 2022)The results of the microbiological
quality test at the refill drinking water depot contained one that did not meet
the microbiological requirements because it was positive for Coliform bacteria.
refill drinking water and there are 15 DAMIUs that do not have a DAMIU
sanitation hygiene certificate. Meanwhile, from the sanitation hygiene
requirements for the management of refillable drinking water, it was found that
the majority of workers and those holding certificates were in the category of
not meeting health requirements.
Based on reports regarding Drinking Water Depots in Magetan Regency, several depots do not meet health quality
requirements and have not been certified in terms of hygiene. To overcome this
problem, an intensive program of coaching and supervision of Refill Drinking
Water Depots is needed, including training on hygiene and sanitation for depot
managers and employees. This aims to minimize drinking water pollution due to
the physical condition of the depot and unhygienic behavior.
This background encourages research on "Analysis of Sanitation Hygiene
with Coliform Content at Drinking Water Depots in the Sukomoro
Health Center Working Area in 2024". The
benefits of this research include contributions to literature and science for
STIKES Bhakti Husada Mulia Madiun,
as well as as a reference and source of information
for researchers and Drinking Water Depot managers, as well as evaluation for
related health agencies to improve guidance and supervision of drinking water
quality.
RESEARCH METHODS
Research design
This research is a type of analytical observational research with
a cross-sectional approach. Total Coliform bacteria examination was carried out
on drinking water samples using laboratory tests at the Surabaya D3 Sanitarian
Polytechnic, Magetan Campus, which was carried out in
June 2024. The results were adjusted based on guidelines from Minister of
Health Regulation No. 492 of 2010 concerning drinking water quality
requirements. The population in this study was the drinking water depots in the
working areas of Sukomoro Community Health Center, Tebon Community Health Center,
Kartoharjo Community Health Center,
Rejomulyo Community Health Center,
totaling 52 depots with sampling using Simple Random
Sampling, totaling 19 depots with 100ml water
sampling. Data collection by direct observation at DAMIU using questionnaire
observation sheets and laboratory examinations using the Most Probable Number
(MPN) Method
Population and Sample
(Salsabila, P and Nugraha, 2023)put forward a definition of
population, namely as "A generalized area consisting of: objects or
subjects that have certain qualities and characteristics determined by the
researcher to be studied and then conclusions drawn". Population is not just
people, but also other natural objects. Population is also not just the number
of objects or subjects, but includes all the characteristics or properties of
the object or subject.
The population in this study was the drinking water depots in the
working areas of Sukomoro Health Center,
Tebon Health Center, Kartoharjo
Health Center, Rejomulyo
Health Center, Ngujung
Health Center, Maospati
Health Center, Karangrejo
Health Center, Taji Health Center
totaling 101 depots using Simple Random Sampling. totaling 29 depots with 100ml water sampling. The
independent variable in this research is handler hygienewhile the dependent variable in this study is
coliform content.This research looks at and studies the hygiene
factors of handlers at DAMIU in Maospati District, Magetan Regency.
The sample is a part or representative that has representative
characteristics of the population. To be able to determine or determine the
right sample, researchers need a good understanding of sampling, both
determining the number and determining which samples to take. Errors in
determining the population will result in inaccurate data being collected so
that the research results are not of good quality, are not representative, and
do not have good generalization power. The researcher's understanding of the
population and sample is essential because it is one of the determinants in
collecting research data.(Amin et al., 2023)
The sample in this study used a random sampling technique using
the Slovin formula
Sampling Techniques
Sampling is a method used to take samples that are truly in
accordance with the overall research object. The sampling technique in this
research is random sampling carried out randomly.(Amin et al., 2023). Proportional
random sampling technique was used with the aim of obtaining a representative
sample by looking at the population of the drinking water depots of the Ex Dostrik Maospati Magetan so that each community health center
working area was still taken as a sample.
How to take samples to check the quality of refill drinking water
bacteriologically is explained in detail. The tools and materials needed
include test tubes, Durham tubes, Bunsen tubes, matches, label paper,
stationery, incubator, water samples, 70% alcohol, and media such as TSL, SSL,
and BGLB. The sampling procedure is carried out by sterilizing the equipment,
taking a refillable drinking water sample of 10 ml, and marking the label where
the sample was taken for identification. Data processing uses editing, coding,
entry, cleaning and tabulating techniques. The test was carried out using the
MPN Coliform laboratory test method 511 to identify the content of Coliform
bacteria in drinking water. The research location is in the former Maospati District, Magetan
Regency, in 2024. The data collection process involves observation, direct
interviews, and the use of questionnaires to collect primary and secondary
data. In addition, the importance of research ethics with the principle of
informed consent is emphasized so that the rights of respondents are respected
at every stage of this research.
RESULTS AND
DISCUSSION
A. Research result
1.
General Description of Research Locations
This research was
conducted in the Maospati District, Magetan Regency, where there are 8 health centers, namely the working area of the Maospati health center, the
working area of the Sukomoro health center, the working area of the Tebon health center, the working area of the Taji health center, the working area of the Kartoharjo
health center, the working area of the Karangrejo working health center,
the working area of the Ngujung Community Health Center, the working area of Rejomulyo
health center. The total population of drinking water
depots in the former Maospati District is 101 DAM.
2. Univariate Analysis
a. Handler Hygiene
The results of research on the hygiene variables of handlers at drinking
water depots in the former Maospati District, Magetan Regency in 2024 were obtained from the results of
questionnaire observations of depot owners/managers as seen in table 3 below:
Table 1. Sanitation Analysis of Production
Sites at Drinking Water Depots in the Former Maospati
District, Magetan Regency.
Handler Hygiene Frequency(N) Percent (%)
Bad 23 59.0%
Good 16 41.0%
Total 39 100.0%
Source: Primary Data and Research Results for July
Based on table 3, it is known that the variable of handler hygiene is
poor with a fairly high percentage, namely 23 drinking water depots with a
percentage of 59.0% compared to good handler hygiene of only 41.0% totaling 16
drinking water depots.
b. Coliform Content
The research results obtained from the MPN Coliform Test of drinking
water depots show that the number of bacteria found in the owners/managers of
drinking water depots in Maospati District, Magetan Regency can be seen in table 2 below:
Table 2. Analysis of Coliform Content in
Drinking Water Depots in the Former Maospati
District, Magetan Regency in 2024
Content Frequency(N) Percent (%)
Coliforms
Not eligible 20 51.3%
Qualify 19 48.7%
Total 39 100.0%
Source: Primary Data and Research Results for July
Based on table 2 above, it shows that 51.3% of all samples taken did not
meet the requirements of all water samples and 19 samples did not meet the
requirements with a percentage of 48.7%.
3.
Bivariate Analysis
Analysis of the Relationship between Handler Hygiene
and Coliform Content in Drinking Water Depots
The results of research
regarding the analysis of the relationship between handler hygiene and coliform
content in the drinking water depot of the Former Maospati
District, Magetan Regency are as follows:
Table 3. Analysis of the Relationship between
Handler Hygiene and Coliform Content at Drinking Water Depots
|
Handler Hygiene |
Coliform content meets requirements |
Coliform content does not meet
requirements |
95%CI |
P |
||
|
N |
% |
N |
% |
(2.57-58.5) |
0.001 |
|
|
Bad |
6 |
15.4% |
17 |
43.6% |
|
|
|
Good |
13 |
33.3% |
3 |
7.7% |
||
|
Amount |
19 |
48.7% |
20 |
51.3% |
||
Source: Primary Data and Research Results for July
From table 6 it can be seen that the majority of handlers' hygiene was
poor, namely 53.8%, while good handlers' hygiene was 0.0%, the coliform content
did not meet the requirements. Based on the results of the chi square test with
a significant p value of 0.001 because p = 0.001 < 0.05, H0 is rejected. So it means that there is a relationship between handler
hygiene and the coliform content of Ex Maospati
District, Magetan Regency with RP 12.2 (95% CI
2.57-58.5). Because RP > 1, handler hygiene is a risk factor for coliform
content. Drinking water depots with poor equipment sanitation have a 12.2 times
risk of being contaminated with coliform bacteria.
B.
Discussion
Based on univariate analysis, it is
known that the majority of drinking water depots with a percentage of 79.5%
have poor user hygiene, while the percentage of drinking water depots with good
equipment sanitation is 20.5%.
Hygiene Handlers are one of the factors that can cause bacterial
contamination of drinking water. The water treatment process at refillable
drinking water depots is not entirely done automatically, so it can affect the
quality of the water produced because humans are warm-blooded creatures, so
microorganisms can proliferate in the human body quickly, especially if they
don't practice. All operators of refilled drinking water production again have
the responsibility to maintain personal cleanliness, pay attention to hygiene,
practice food and drink safety, and be given training.(Kepmenperindag, 2004)
Based on the results of observations
that have been made, all drinking water depot handlers do not use handscoons during the water refill process and do not carry
out regular health checks but instead buy medicine. Apart from that, not all
drinking water depots have hygiene education certificates to improve the
sanitation hygiene knowledge and skills of owners and handlers.It is best for the operator in charge or
depot owner to take a sanitation hygiene course organized by the Regency or
City Department in order to get correct and clear sources regarding the
sanitation hygiene of drinking water depots.
Based on research
that has been carried out on drinking water depots in the Maospati
District, Magetan Regency, covering the working areas
of the Maospati Community Health Center,
Tebon Community Health Center, Karangrejo
Community Health Center, Kartoharjo
Community Health Center, Rejomulyo
Community Health Center, Sukomoro
Community Health Center, Ngujung
Community Health Center, it is known that there are
39 drinking water depots from the Community Health Center.
that there is coliform content from laboratory test results. Of the 39 refill
drinking water samples, 20 samples or 51.3% did not meet the requirements of
Ministerial Decree NO 492 of 2010. And 19 samples or 48.7% met the
requirements.
Coliformsis a group of
bacteria that is used as an indicator of dirt pollution and unfavorable
conditions for water, food, milk and milk products. Coliforms as a group are
characterized as a group of rod-shaped, gram-negative, non-spore-forming,
facultative aerobilic bacteria that ferment lactose
by producing acid and gas within 48 hours at 370C. The presence of coliform
bacteria in food and drinks indicates the possibility of enteropathogenic and
toxigenic microbes that are dangerous to health. .(Kurahman, Rohama and Saputri, 2022)
Based on
research, it can be seen that the coliform content in drinking water depots is
caused by several factors, namely sanitation of the production site, sanitation
of production equipment and poor hygiene of handlers, which will cause the
quality of drinking water depots to get worse or the coliform content to increase.
3. The
Relationship Between Handler Hygiene and Coliform Content at Drinking Water
Depots in Maospati District, Magetan
Regency
From the statistical test results,
it was concluded that handler hygiene had a relationship with coliform content
(p= 0.001) where the coliform test result was 43.6% which did not meet the
requirements. The magnitude of the risk of coliform content can be seen from
the RP value = 12.2, which means that poor handler hygiene has a risk of
coliform content in drinking water depots that is 12.2 times greater than good
handler hygiene and the coliform content meets the requirements.
The research results are
strengthened by(Hidayati, 2022)In testing the
relationship between personal hygiene and Coliform bacterial contamination of
refilled drinking water using the ChiSquare test, a
correlation of p-value = 0.017 was obtained, because p <0.05 means that
there is a relationship between personal hygiene and bacterial contamination.
The habit of not washing your hands after handling objects and not wearing
clean work clothes has the potential to cause bacterial contamination of
drinking water. This is also confirmed by research(Zarifah, Navianti and Yulianto, 2022)Based on the results of interviews
conducted with each refill drinking water depot owner, 3 DAMIUs had
certificates of having taken a refill drinking water depot sanitation hygiene
course and 15 DAMIUs had never taken a refill drinking water depot sanitation
hygiene course. According to research results at DAMIU in Lahat Regency, it was
reported that the majority of handlers did not receive training.
It is known that the results of
researchers' observations show that handler hygiene is poor with a coliform
content that does not meet the requirements of 43.6%. This is caused by several
other factors, namely not washing your hands with soap using running water and
not using handscoon during the water filling process
which can trigger bacteria to appear. And if you are sick, just buy medicine
and don't do an examination. There are several depots that do not yet have a
hygienic certificate to improve the sanitation hygiene knowledge and skills of
owners and handlers.
CONCLUSION
Conclusions from research conducted at
drinking water depots in Maospati District, Magetan Regency in 2024 show that some depots do not meet
the requirements for Coliform content and the hygiene of most handlers is poor.
There is a significant relationship between handler hygiene and the coliform
content in these depots. Based on these results, it is recommended that
drinking water depot owners routinely check drinking water samples, provide
sterile gloves for employees, and implement the habit of washing hands before
serving consumers. Health agencies, such as the Health Service or Community
Health Center, are also advised to carry out regular
sanitation supervision of depots, check employee health, and carry out regular
sanitation inspections. It is hoped that these steps can prevent pollution and
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Copyright Holder: Alvyani Novita Sari, Riska Ratnawati, Karina Nur R (2024) |
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First Publication Right: Jurnal Health Sains |
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