Introduction
There are
currently more application-based motorcycle taxis (online motorcycle taxis), both on motorbikes and cars. This phenomenon is
inseparable from the efforts of road users to reach their destination faster,
more effectively, and efficiently. The problem then arises about the health
status of the online motorcycle taxi drivers, considering that �they are often
exposed to air pollution due to motor vehicle exhaust gases. In urban areas,
almost 70-80% of air pollution is caused by
exhaust gases from motorized vehicles, both four-wheeled and two-wheeled.
Several motor vehicle exhaust gases cause pollution and are hazardous to
health, including carbon monoxide (CO), hydrocarbon compounds (HC), various
oxides of nitrogen (NOx), sulfur (SOx) and
various dust particles, including lead (Pb). Gas released from motorized
vehicles enters the body through inhalation and, combined with other
substances, affects health �(Rinayu, 2013).
One of the
health problems that directly impacts air pollution is respiratory and
cardiovascular disorders such as acute or upper respiratory infections, lung
damage, and hypertension. Globally, cardiovascular diseases (CVD) are the
leading cause of death, accounting for 31% of all deaths (Isomura et al., 2021). Several
factors, including physical activity, smoking behaviors, and others, might
influence a person's cardiorespiratory fitness, which is tightly linked and
favorably linked to physical activity (Wibowo, 2021). Pollution due to hydrocarbons can cause lung cancer because
these substances are toxic and carcinogenic. Carbon monoxide gas, for example,
is a compound that, when inhaled into the lungs, will bind to hemoglobin
(COHb), 240 times stronger
than oxygen (Muslim, 2018). This will affect the
vital function of hemoglobin as an oxygen carrier. Another health problem
caused by nitrogen oxides (NOx) is lung damage. NOx released by motorized
vehicles will combine with the atmosphere to form nitrates that can penetrate
and damage lung tissue (source). Another dangerous pollutant is sulphur oxide
(SOx). This substance is in the form of an acid that can damage the epithelium
and attack the mucous membranes so that it can irritate the respiratory tract,
nose, throat, and lungs (Sugiarti, 2009).
Online
motorcycle taxi workers are one of the communities whose health must be
considered because they are often exposed to vehicle pollutants. Their health are
at risk because of �daily air pollution expose. There is no official data on
the number of online motorcycle taxi workers, but it is predicted to reach up
to million of people (Triatmojo, 2018). Health problems for a person can be recognized by
their heart's fitness level and respiration
(cardiorespiratory). Cardiorespiratory fitness is the ability of the heart and
lungs to circulate blood and oxygen throughout the body optimally during
continuous activity. Cardiorespiratory fitness can be determined by the maximal
oxygen uptake volume (VO2 max) value. VO2 max measures
how much oxygen the body can process to produce energy. It is measured in
millimetres of oxygen per kilogram of body weight per minute (Levine, 2008). VO2 max
results from maximal cardiac output and maximal O2 extraction by
tissues, and both increase with exercise. Changes that occur in skeletal muscle
with exercise increase the number of mitochondria and enzymes that play a role
in oxidative metabolism. There is an increase in capillaries with a better
distribution of blood to muscle fibres. The final effect is a complete O2
extraction and, consequently, a lower increase in lactate formation for the
same workload. The increase in blood flow to the muscles becomes lower, and
because of this, heart rate and cardiac output are less increased than in
untrained people (William & Ganong, 2003).
The level
of cardiorespiratory fitness in online motorcycle taxi workers is one indicator
of their health level to predict health problems that may occur. Besides, the
level of fitness of motorcycle taxi workers also dramatically affects the
safety of its passengers. Many factors affect
cardiovascular fitness, such as heart disease and cardiovascular disease. This
disease is closely related to smoking habits (Benjamin, 2010). Moreover, cigarette
smokers were more likely to acquire cardiovascular disease, including heart
disease, stroke, and peripheral artery disease (Ding et al., 2019).
The results
�from preliminary research in 2018 saw an increase in smokers among young
people from 7.2% to 9.1%. This condition is very worrying because of the
increase in disease caused by smoking, which reduces health status.
Cigarettes
contain tobacco, which has about 2,500 components. The elements �such as tar, nicotine, carbon monoxide gas, and
nitrogen monoxide are harmful to health. Nicotine, for example, can cause
addiction as well as heart and lung disorders �(Tirtosastro & Murdiyati, 2010).
Method
The design
of this study used a descriptive- analysis with a cross-sectional sampling
method. Data collection was carried out on online motorcycle taxi drivers. Data
were obtained through questionnaires and fitness level measurements. The
samples were 100 online motorcycle taxi drivers, both as single or side jobs.
Respondents filled out the questionnaire and then tested their fitness level
using the Balke method. Researchers made the criteria for smokers' respondents,
namely, respondents who smoked regularly every day or on a frequently-smoking
scale regardless of the amount. At the same time, non-smokers were respondents
who did not smoke or rarely smoked. Measurement of the level of
cardiorespiratory fitness was carried out by requesting respondents to run as
fast as possible for 15 minutes using a standing start. The results obtained
for 15 minutes are then recorded in meters. The calculation of VO2
max used the formula:
VO2
max = (total meters/ 15) -133) x 0.172 + 33,3).
The results of the VO2
Max measurement were then converted using the Heywood 1998 guidelines.
Therefore the cardiorespiratory fitness can be categorised to terrible, bad,
moderate, good, excellent, and perfect. However, the researcher only grouped
two parts to simplify the classification: bad and good. The measurement results,
terrible, and bad results are grouped as bad results while the other results
are grouped as good result. The research data were then analyzed using
univariate and bivariate statistics.
Results And Discussion
A. Results
1. Respondents�
characteristics
The
respondents in this study were online motorcycle taxi drivers, with the
characteristics of the respondents in this study being 98% males and 2% females.
The average age of respondents is 37 years old, the youngest age is 21 years old,
and the oldest age is 60 years old.
������� Respondents
who have a smoking habit have a poor fitness level of 67.2%, while those who do
not smoke have a poor fitness level of 32.8%.
According
to the results of the analysis, smoking habits showed an OR value of 3.336 and
p-value = 0.004. It can be concluded that smoking habits are significantly
related to the level of cardiorespiratory fitness. With an OR value of 3.336,
smoking habits contribute three times to the level of cardiorespiratory
fitness.
B. Discussion
�This
study showed that from 100 respondents, 55 respondents had a smoking habit. The
statistical tests obtained a p-value = 0.004 with a value of r = 3.336. This
indicates a significant relationship between smoking habits and the level of
cardiorespiratory fitness. The results of this study show the value of r, which
means that smoking contributes three times to the level of cardiorespiratory
fitness. The results of this study are under the results of research (Erawati, Azrin, & Yovi, 2014), which showed a
significant relationship between smoking habits and cardiorespiratory endurance
with a p-value = of 0.001.
From
a health perspective, smoking habits are considered harmful because they can
interfere health. Smoking can cause various impacts on the human body, such as
changes in the structure and function of the respiratory tracts and lung
tissues. While the
heart is a significant factor in cardiovascular disease, but also has an impact
on coronary heart disease, even the worst effects on cerebral and peripheral
blood vessels. Individuals who smoke will affect cardiovascular and aerobic
fitness. Smoking habits will affect the intake of oxygen into the body,
resulting in getting tired quickly (Windiar, 2014). Other studies have shown that young men who smoke
have decreased cardiovascular fitness and peripheral muscle function compared
to active young men and not smokers (Sperandio et al., 2014). The results of other studies show that there
is a significant effect of cardiorespiratory fitness between nonsmokers and
smokers. People who do not smoke have a higher VO2 max than people
who smoke
(de Borba et al., 2014).
Cigarettes
are one of the substances that contain many chemicals. When a cigarette is
burned, more than 4,000 chemicals contain toxic substances (Milner, 2004). The main toxic components of cigarettes are
acrolein, formaldehyde, carbon dioxide, nicotine, cotinine, phenol, and tar,
which can damage the respiratory tract epithelium (Tamashiro, Cohen, Palmer, & Lima, 2009). Toxic
substances from cigarettes enter the bronchi into the terminal bronchioles to
damage the cilia and mucosa of the respiratory tract and result in squamous
metaplasia, smooth muscle hypertrophy, and fibrosis. This situation triggers an
inflammatory response, namely the emergence of many antibodies such as
immunoglobulin M and immunoglobulin E (Milner, 2004). Inflammatory
processes in the respiratory tract can cause lung disease, which in turn can
reduce lung function. People who smoke many cigarettes can result in their
lungs containing high carbon monoxide levels and low oxygen levels. Carbon
monoxide is a gas with a stronger bond than oxygen with hemoglobin.
Smoking
can increase blood pressure and accelerate heart rate and coronary thrombosis
so that the heart's function as a blood pump decreases (Hammado, 2014). Toxic
substances in cigarettes also cause blood vessel damage and can stimulate
autonomic nerves, especially the heart. Inadequate heart and lung function will
result in decreased cardiorespiratory fitness.
Fitness
is the degree of adequacy of body functions. Cardiorespiratory fitness is one
indicator of health status in individuals because the heart and lungs are
essential organs that determine life. The cardiorespiratory fitness indicator
is determined by how much oxygen the body can take in to produce energy (VO2 max). The
heart is an organ that functions as a pump of blood throughout the body, while
the lungs play a role in taking in oxygen and removing carbon dioxide. Both
organs work together to meet the body's needs for oxygen, glucose,
electrolytes, and other important things.
Conclusion
The results of
statistical analysis illustrate a significant relationship between smoking and
non-smoking habits on the level of cardiorespiratory fitness. A study conducted
on 100 online motorcycle taxi drivers in Jakarta in 2017 showed that most (55%)
smoked, and only 45% did not smoke. Respondents who smoke tend to decrease
their cardiorespiratory fitness level by three times compared to non-smokers,
from this resarch we need conduct further research on cardiopulmonary health
for online motorcycle taxi drivers.
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CIGARETTE AND
CARDIORESPIRATORY FITNESS