Occupational Health and Industrial Hygiene Commons^™

Research Personnel Exposure To Carbon Dioxide During Euthanasia Procedures, Devon Nealer, Felicia Reibstein, Jennifer Bendorf, Emily Lafferty, Stephanie Ramborger, Taylor Swift, Jacqueline O'Malley, Thomas Boyle

Rowan-Virtua Research Day

Carbon dioxide (CO2) is a commonly used euthanasia agent in animal facilities. This procedure is carried out by replacing oxygen with carbon dioxide in animal cages, thus providing a quick and painless method of euthanasia. Unfortunately, there has been limited research on the potential effects of human exposure to CO2 during euthanasia procedures.

Following a previous carbon dioxide exposure study in the vivarium at Rowan SOM in 2016, the CO2 cylinders and euthanasia chambers have been relocated to room 153 Science Center and the vivarium has adopted a localized exhaust that helps remove the contaminant at the source.

While the …

Effects Of Occupationally Military-Relevant Particle Mixtures (Sio2, Cdo, Cr2O3) On A549 Human Pulmonary Epithelial Cells, Isabella M. Muffoletto

Theses and Dissertations

In the course of maintaining a safe, mission-ready aircraft fleet and operational runways, United States Airmen experience a range of occupational risks. These risks include inhalable hazards generated from oft-used maintenance practices, such as blasting which emits silica from the media abrasives as well as contaminants from the exterior coatings. Additional inhalation hazards range from engine and fuel emissions, chemical agents, radiation, and explosives, to naturally occurring and human-manufactured biopathogens. Of notable concern are emissions in forward-deployment areas, including urban pollution, particulates released from runway construction and maintenance activities, and combustion from burn pits containing hazardous and unknown combinations of …

Presidential Vote Share And Covid-19 Vaccination Rate In Indonesia: A District-Level Cross-Sectional Ecological Study, Gede Benny Setia Wirawan, Ni Luh Zallila Gustina, Ivy Cerelia Valerie, I Gusti Ayu Indah Pradnyani Rs, Muchamad Zaenal Arifin, Pande Putu Januraga

Kesmas

Political affiliation has been reported as a determinant of COVID-19 vaccine acceptance in some countries, although few studies have examined the Asian context. This study aims to fill this gap by employing an ecological study design using Indonesian regions as data points. Political affiliation was represented by incumbent President Jokowi’s vote share in the 2019 presidential election. Potential confounders included population density, human development index, availability of hospitals and primary health care, 2019–2020 economic growth, COVID-19 mortality rate, and proportion of Muslims in the population. The final analysis included 201 out of 501 districts and cities in Indonesia. Controlling for …

Oxidative Stress Levels Of Fine Particulate Matter (Pm2.5) And Urinary Glutathione Of Microbus Drivers, Purnama Sidebang, Agustin Kusumayati, Budi Haryanto

Kesmas

Urinary glutathione levels are known to be an early indicator of oxidative stress in travelers. This study analyzed the association between particulate matter (PM2.5) exposure on the road and urine glutathione levels in Jakarta’s microbus drivers. This cross-sectional study involved 96 microbuses (one of Jakarta’s public transportations) drivers of nine routes in Kampung Melayu Bus Station, Jakarta, Indonesia. An anthropometric assessment and a structured questionnaire were employed. Along with the participants driving on the road, real-time personal equipment measuring PM2.5 exposure concentrations was used. Total glutathione levels were measured using a colorimetric method. A correlation test and linear regression analysis …

Information-Motivation-Behavioral Skill In Diabetes Self-Management Using Structural Equation Modeling Analysis, Dien Kurtanty, Adang Bachtiar, Cicilya Candi, Alya Pramesti, Almira Fanny Rahmasari

Kesmas

Diabetes is the “mother” of various diseases increasing the risk of morbidity and mortality. Diabetes self-management, an effort made by patients to control blood sugar levels, is an important part of the management strategy. Therefore, this study analyzed information, motivation, and behavioral skills associated with diabetes self-management. Data were collected in the Special Capital Region of Jakarta, with 277 diabetic patients selected using a questionnaire by a systematic random sampling method. The analyzed variables were information (with indicator variables of information on physical activity, nutritional intake, drug consumption, and blood sugar monitoring); sociodemographic (age, sex, occupation, education level, and duration …

Job Satisfaction Model Of Primary Health Care Midwives Based On Indonesian Workforce Research In The Health Sector, Mieska Despitasari, Adang Bachtiar, Harimat Hendarwan, Besral Besral, Yuyun Yuniar

Kesmas

Promotive, preventive, curative, and rehabilitative efforts that are comprehensive, integrated, and sustainable are employed to enhance the health state of the global population. Within this context, however, the quality of primary health care depends on job satisfaction, which leads to the happiness of human resources in the health sector. Therefore, this study aimed to analyze and formulate a job satisfaction model among primary health care midwives in Indonesia. This study was an advanced secondary data analysis of a cross-sectional study conducted in 2017 by the National Institute of Health Research and Development, Ministry of Health of the Republic of Indonesia. …

The Effect Of Covid-19-Related Occupational Stress And Burnout In Referral Hospital Nurses, Yulastri Arif, Masyithah Fadhani

Kesmas

Nurses' continuous contribution to patient health makes them prone to occupational stress, which has been exacerbated during the COVID-19 pandemic. Occupational stress that lasts for a long time and is not resolved may cause burnout. Burnout experienced by nurses can impact patients, hospital services, and themselves. This study aimed to determine the effect of occupational stress on the incidence of nurse burnout during the COVID-19 pandemic. It used a quantitative approach with a cross-sectional design. The study sample was 235 nurses in six COVID-19 referral hospitals in West Sumatra from a proportional random sampling technique. Data were collected using a …

Developing A New Tool For Early Detection Of The Nutritional And Health Risk Factors Of Urban Workers’ Productivity, Hildagardis Meliyani Erista Nai, Arimbi Karunia Estri, Christina Ririn Widianti

Kesmas

Nutrition and health play vital roles in work productivity. This study aimed to develop a risk self-assessment tool called Early Detection of the Nutritional and Health Risk Factors on the productivity of urban workers. This study was conducted in two stages: 1) the development of the tool to determine the nutritional and health risk factors that affect productivity based on literature reviews and scoring systems and 2) the testing of validity and reliability. Finally, the tool contained 63 items, including 28 items on nutritional risk factors and 35 on health risk factors. The validity of the tool was assessed using …

Obesity And Asthma Risk In Indonesian Adults: Findings From The 2018 Indonesia Basic Health Research, Hoirun Nisa

Kesmas

Obesity and asthma are both global public health challenges. Mounting evidence suggests that obesity may increase asthma risk in adults; however, the association by sex remains uncertain. This study examined the association of obesity with asthma risk in Indonesian adult men and women. Data were obtained from the 2018 Indonesia Basic Health Research. The analysis included 299,837 men and 333,218 women aged ≥18 years. Asthma was identified by the self-report of a doctor’s diagnosis. Obesity was defined as a body mass index ≥30 kg/m2. A logistic regression was used for data analysis. Asthma prevalence was 2.7% (2.5% in men and …

Maternal And Child Health Handbook Utilization, Quantity And Quality Of Antenatal Services, And Maternal Emergency Rates In Padang City In 2022, Rena Afri Ningsih, Yusrawati Yusrawati, Joserizal Serudji

Kesmas

This study analyzed the relationship between the utilization of the Indonesian Ministry of Health’s Maternal and Child Health Handbook and the quantity and quality of antenatal care to maternal emergency levels. This study applied mixed methods with a consecutive sampling technique and included 108 mothers undergoing maternal emergencies at a central general hospital (quantitative) and eight mothers, seven midwives, and five cadres at primary health cares (qualitative) as informants. The result showed a relationship between the utilization of the Maternal and Child Health Care Handbook (p-value = 0.043), the quantity of antenatal care (p-value

The Determinants Of Stunting In The Under-Five In Three Municipalities In The Special Capital Region Of Jakarta, Tria Astika Endah Permatasari, Chairunnisa Chairunnisa, Hernani Djarir, Lily Herlina, Munaya Fauziah, Andriyani Andriyani, Yudi Chadirin

Kesmas

The COVID-19 pandemic has impacted the global decline in public health status. This study aimed to analyze the determinants of stunting in the under-five in three municipalities in the Special Capital Region of Jakarta, Indonesia. A cross-sectional study was conducted in August-December 2020 with 460 pairs of mothers and children selected by simple random sampling. Stunting was measured using a conventional anthropometric index (length/height-for-age), and anthropometric failure was measured using the Composite Index of Anthropometric Failure. The prevalence of stunting, underweight, and wasting was 41.5%,35%, and 19.8%, respectively, and 62% of the under-five experienced anthropometric failure. The dominant factor associated …

Développement De Stratégie Visant À Contrôler Le Niveau De Contamination Des Piscines Par Les Sous-Produits De Désinfection, Maximilien Debia, Elham Ahmadpour, Isabelle Valois, Sami Haddad, Robert Tardif, Stéphane Hallé, Hélène Proulx, Manuel Rodriguez, François Proulx, Ianis Delpla, Jean Sérodes, Sabrina Simard

Rapports de recherche scientifique

La présence de sous-produits de désinfection dans l’eau et l’air des piscines intérieures est une problématique de santé publique et de santé au travail. L’exposition aux sous-produits de désinfection et notamment à la trichloramine est associée à différents effets délétères comme l’irritation des voies respiratoires, l’irritation oculaire et l’hyperréactivité bronchique. La présence des sous-produits de désinfection résulte des réactions chimiques qui surviennent entre les agents désinfectants ajoutés et les matières organiques ou azotées présentes naturellement dans l’eau ou qui y sont amenées par les baigneurs.

L’objectif général de recherche visait à améliorer les connaissances sur les pratiques de gestion et …

Biomonitoring Of Exposure To Multiple Metal Components In Urine, Hair And Nails Of Apprentice Welders Performing Shielded Metal Arc Welding (Smaw), Jairo Buitrago-Cortes, Philippe Sarazin, Denis Dieme, Jonathan Côté, Capucine Ouellet, Naïma El Majidi, Michèle Bouchard

Études primaires

Welding fumes are associated with various diseases. Increased air levels of metals were reported during welding. However, few multielement biomonitoring studies were conducted to assess the actual dose of metal components absorbed in apprentice welders in a learning environment. This research aimed to establish the nature and level of exposure to welding fumes and their metallic components in apprentice welders performing ‘Shielded Metal Arc Welding’ (SMAW), based on multi-element and multi-matrix analyses. A total of 86 apprentice welders were recruited in three different schools in Montreal, Québec, Canada. Twenty-one elements were measured in urine, hair, fingernail, and toenail samples collected …

Ultrahigh-Performance Liquid Chromatography–Tandem Mass Spectrometry Quantitation Of O-Cresol In Hydrolyzed Human Urine To Assess Toluene Exposure, Eric Langlois, Sébastien Gagné

Études primaires

Rationale

Toluene is a volatile organic compound used in domestic and industrial applications. The main routes of workplace exposure to toluene are inhalation and dermal contact. As toluene exposure can cause severe nervous system damage, its quantification is crucial to prevent occupational illness. Toluene is metabolized mainly as hippuric acid, S-benzylmercapturic acid and epoxides. These are rapidly converted to o-/p-cresol, which is then excreted in the urine as conjugated glucuronides and sulfates. o-Cresol and its conjugates can be chemically hydrolyzed to form free o-cresol, which can then serve as a urinary biomarker of toluene exposure. Current …

Keeping Employees Safe During Health Crises: The Effects Of Media Exposure, Hr Practices, And Age, Shuqi Li, Henry R Young, Majid Ghorbani, Byron Y Lee, Daan Van Knippenberg, Russell E Johnson

Faculty, Staff and Student Publications

Occupational health and safety are critical in promoting the wellness of organizations and employees. The COVID-19 pandemic is one of the most life-threatening viruses encountered in recent history, providing a unique opportunity for research to examine factors that drive employee safety behavior. Drawing from terror management theory, we propose and test a moderated mediation model using data collected from employees working during a peak of the pandemic. We identify two sources of influence - one external (i.e., media exposure), and one internal (i.e., HR practices) to the organization - that shape employees' mortality salience and safety behaviors. We find that …

Validation Of An Emg Submaximal Method To Calibrate A Novel Dynamic Emg-Driven Musculoskeletal Model Of The Trunk: Effects On Model Estimates, Amir H. Eskandari, Farshid Ghezelbash, Aboulfazl Shirazi-Adl, Denis Gagnon, Hakim Mecheri, Christian Larivière

Études primaires

Background

Multijoint EMG-assisted optimization models are reliable tools to predict muscle forces as they account for inter- and intra-individual variations in activation. However, the conventional method of normalizing EMG signals using maximum voluntary contractions (MVCs) is problematic and introduces major limitations. The sub-maximal voluntary contraction (SVC) approaches have been proposed as a remedy, but their performance against the MVC approach needs further validation particularly during dynamic tasks.

Methods

To compare model outcomes between MVC and SVC approaches, nineteen healthy subjects performed a dynamic lifting task with two loading conditions.

Results

Results demonstrated that these two approaches produced highly correlated results …

Étude Visant À Mieux Guider L’Évaluation Des Risques Des Travailleurs Exposés Aux Nanoparticules (Np) : Existe-T-Il Différentes Propriétés Inflammatoires Des Np Liées Au Sexe?, Marion Vanharen, Abdelaziz Saafane, Alexanne Léveillé, Thomas Mahbeer, Denis Girard

Rapports de recherche scientifique

Les nanotechnologies offrent un important potentiel d’exploitation dans des secteurs industriels variés, pour lequel les bénéfices financiers ne sont pas négligeables. À l’instar des provinces canadiennes et de nombreux pays industrialisés, le Québec voit un nombre grandissant de compagnies produisant des nanomatériaux et des nanoparticules (NP) se développer, sans oublier celles qui introduisent de plus en plus de NP dans leurs produits. Le nombre de travailleurs québécois œuvrant dans la fabrication et dans la synthèse des NP augmentera dans les années à venir. De plus, le nombre de travailleurs appelés à manipuler et à transformer des NP dans les domaines …

Élimination Des Vapeurs Toxiques Par Oxydation : Développement De Procédures D'Évaluation Des Systèmes De Purification De L'Air Des Conduits De Ventilation, Chang-Seo Lee, Fariborz Haghighat, Alireza Haghighat Mamaghani, Zahra Shayegan, Ali Bahloul, Mélanie Huard, Lexuan Zhong, Mitra Bahr

Rapports de recherche scientifique

L'exposition à des composés organiques volatils (COV) dans les lieux de travail peut avoir des effets aigus, notamment sous forme d'irritation de la peau, des yeux, de la bouche et du nez. Certains produits peuvent également provoquer des effets chroniques, comme l'asthme et le cancer. La prévention de tels effets nocifs sur la santé des travailleurs par l'adoption et la mise en œuvre de mesures visant à en éliminer ou à tout le moins réduire le risque s'avère importante. Parmi les approches développées à ce jour pour réduire l'exposition aux polluants de l'air intérieur – dont les COV –, la …

Removal Of Toxic Vapors By Oxidation: Development Of Laboratory Test Procedures For In-Duct Air Cleaning Systems, Chang-Seo Lee, Fariborz Haghighat, Alireza Haghighat Mamaghani, Zahra Shayegan, Ali Bahloul, Mélanie Huard, Lexuan Zhong, Mitra Bahr

Rapports de recherche scientifique

L'exposition à des composés organiques volatils (COV) dans les lieux de travail peut avoir des effets aigus, notamment sous forme d'irritation de la peau, des yeux, de la bouche et du nez. Certains produits peuvent également provoquer des effets chroniques, comme l'asthme et le cancer. La prévention de tels effets nocifs sur la santé des travailleurs par l'adoption et la mise en œuvre de mesures visant à en éliminer ou à tout le moins réduire le risque s'avère importante. Parmi les approches développées à ce jour pour réduire l'exposition aux polluants de l'air intérieur – dont les COV –, la …

Mise Au Point Et Validation D’Une Approche Terrain De Prédiction Des Chargements Au Dos Basée Sur Des Données De Laboratoire, Alain Delisle, François Thénault, André Plamondon, Hakim Mecheri

Rapports de recherche scientifique

Les troubles musculosquelettiques (TMS) et particulièrement ceux au bas du dos affectent de nombreux travailleuses et travailleurs chaque année au Québec (Vézina et al., 2011). Le chargement mécanique au bas dos est reconnu comme un facteur de risque pouvant mener au développement de maux de dos, et la manutention de charges peut occasionner des chargements importants et répétés. La façon habituelle de quantifier le chargement au dos des individus est d’estimer le moment qui s’exerce à l’articulation lombo-sacrée (L5/S1). L’estimation de ce moment se fait généralement en laboratoire et nécessite la connaissance de la position et de l’orientation de …

Protecting Cattle Feedyard Workers In The Central States Region: Exploring State, Regional, And National Data On Fatal And Nonfatal Injuries In Agriculture And The Beef Production Sector, Athena K. Ramos, Suraj Adhikari, Risto Rautiainen, Aaron Yoder

Journal of Extension

Working in agriculture can be dangerous. Despite ongoing efforts of Extension, animal production worker safety has not been adequately addressed. We present state, regional, and national counts and rates on fatal and nonfatal injuries in agriculture and animal production using publicly available data from the Bureau of Labor Statistics. We found that animal production had a high number of fatal injuries and a higher rate of nonfatal injuries than the average within agriculture. More needs to be done to protect livestock workers from injury. Extension professionals can play a key role in increasing safety knowledge and changing behaviors.

Mesures À Haute Sensibilité Du Passage De Contaminants Nanométriques À Travers Les Gants De Protection Par Imagerie Médicale, Mahmoud Mohamed Omar, Amélie Augé, Myriam Laprise-Pelletier, Ludovic Tuduri, Marc-André Fortin

Rapports de recherche scientifique

Les gants de polymère sont utilisés comme équipements de protection individuels dans de nombreux secteurs d’activité professionnelle où les risques chimiques sont présents. Leur efficacité à bloquer le passage de certains contaminants doit être mesurée par des méthodes d’essais précises et standardisées. Les mesures de résistance chimique sont généralement effectuées en utilisant une cellule de perméation, un petit appareil contenant deux réservoirs séparés par la membrane dont on veut mesurer le potentiel-barrière : l’un contient le contaminant, l’autre contient un milieu collectant le contaminant après que celui-ci ait passé à travers la membrane. Au fur et à mesure de l’expérience, …

Spatial Analysis For Enhancing The Use Of Health Data Availability From Different Sources To Help The Decision-Making Process, Tris Eryando

Kesmas

Spatial analysis in public health has become a common method used by researchers to understand the distribution of public health aspects related to the surrounding environment. It can also be used to analyze individual information in the form of a dot and the location or line of aggregated information in a specific area of study. Another benefit is the possibility of using different data sources to be analyzed in one statistical model analysis, as long as the identification area is sufficiently clear as a key variable. Spatial analysis can show an object's distribution on a locational map and explain the …

Sars-Cov-2 Antibody Seroprevalence In Jakarta, Indonesia, Iwan Ariawan, Hafizah Jusril, Muhammad N Farid, Pandu Riono, Wiji Wahyuningsih, Widyastuti Widyastuti, Dwi Oktavia T L Handayani, Endang Sri Wahyuningsih, Rebekka Daulay, Retno Henderiawati, Safarina G. Malik, Rintis Noviyanti, Leily Trianty, Nadia Fadila, Khin Saw Aye Myint, Frilasita A. Yudhaputri, Neeraja Venkateswaran, Kodumudi Venkateswaran, Venkatachalam Udhayakumar, William A. Hawley, Juliette Morgan, Paul M. Pronyk

Kesmas

The SARS-CoV-2 transmission dynamics in low- and middle-income countries remain poorly understood. This study aimed to estimate the SARS-CoV-2 antibodies seroprevalence in Jakarta, Indonesia, and to increase knowledge of SARS-CoV-2 transmission in urban settings. A population-based serosurvey among individuals aged one year or older was conducted in Jakarta. Employing a multistage sampling design, samples were stratified by district, slum, and non-slum residency, sex, and age group. Blood samples were tested for IgG against three different SARS-CoV-2 antigens. Seroprevalence was estimated after applying sample weights and adjusting for cluster characteristics. In March 2021, this study collected 4,919 respondents. The weighted estimate …

A Stunting Prevention Risk Factors Pathway Model For Indonesian Districts/Cities With A Stunting Prevalence Of ≥30%, Nina Fentiana, Endang L. Achadi, Besral Besral, Abram Kamiza, Trini Sudiarti

Kesmas

The prevalence of stunting in Indonesian children aged 0-23 months is a public health problem caused by direct and indirect factors. This study aimed to discover the path of the relationship between various risk factors and the stunting prevalence of ≥30% in 165 districts/cities in Indonesia. Data were obtained from the 2018 National Basic Health Research, National Socioeconomic Survey, and the Statistics Indonesia with a cross-sectional approach. The secondary data on stunting and risk factors were aggregated at the district/city level from individual data; children aged 0-23 months. The path analysis used to determine a stunting prevention model showed that …

Determinants Of Type 2 Diabetes Mellitus Among Passive Smokers, Adinda Rahma Triyaniarta, Santi Martini, Kurnia Dwi Artanti, Sri Widati, Rizma Dwi Nastiti

Kesmas

Type 2 diabetes mellitus (T2DM) leads to complications of other diseases. The modifiable risk factors for T2DM are overweight, physical activity, hypertension, unhealthy diet, and smoking. This study aimed to analyze determinants of T2DM incidence in passive smokers among various factors. This study was conducted at Hospital X in Surabaya City, East Java Province, Indonesia, from September 2019 to April 2020. The variables were univariate, bivariate, and multivariate. Case samples were T2DM patients and passive smokers, while control samples were non-T2DM patients and passive smokers, with 52 respondents per group, of 104 total respondents. Variables statistically significant related to the …

The Effect Of Health Promotion Program On Perceived Self-Efficacy And Self-Care Practices Among Elderly With Multimorbidity In Chiang Mai, Thailand, Jukkrit Wungrath, Nuttida Khumai, Phinphot Phrommasen

Kesmas

Multimorbidity in the elderly is a major public health issue with serious consequences. This study investigated the effects of health promotion programs on perceived self-efficacy and self-care practices among the elderly with multimorbidity using a quasi-experimental study design from February to July 2021. The study samples were the elderly from Doi Saket District, Chiang Mai Province, Thailand, selected by a multistage random sampling technique. The experimental and control groups each comprised 40 elderlies with multimorbidity. All elderly participants took part in a 12-week health promotion program. The perceived self-efficacy and self-care practices of the study samples were assessed using interviews, …

Predictors Of Anxiety Toward Covid-19 Delta Variant: A Cross- Sectional Study Among Healthcare Providers In Java And Bali, Indonesia, I Ketut Swarjana, I Gede Putu Darma Suyasa, I Kadek Nuryanto

Kesmas

Health facilities are experiencing overcapacity, oxygen scarcity, and a limited number of healthcare providers due to the coronavirus disease 2019 (COVID-19), thus impacted on anxiety. This study aimed to determine predictors of anxiety among healthcare providers toward the Delta variant of COVID-19 in Indonesia. A cross-sectional study was conducted with 371 healthcare providers in Java and Bali Islands, and the snowball sampling technique was used. Data were collected using a questionnaire and distributed through social media (WhatsApp), then analyzed using univariate analysis, bivariate analysis (Chi-square test), and multivariate analysis (multiple logistic regression). The results showed that 81 (21.8%) respondents experienced …

Perspectives On Reproductive Health Education Among Javanese Parents, Bagoes Widjanarko, Ratih Indraswari, Aditya Kusumawati, Novia Handayani

Kesmas

This study aimed to investigate the perspectives of reproductive health education among Javanese parents of children aged 9-11 years. This cross-sectional study was conducted with 12,306 parents in Semarang City, Central Java Province, Indonesia, using a purposive sampling technique. Some parents agreed that reproductive health education at home was unnecessary (29.5%), taboo (45%), difficult (73.1%), and awkward (41.5%). Most parents (72.7%) were not transparent in providing reproductive health information to their children by using other terms to name the genitals, considering the politeness aspect. Good practices of providing reproductive health information are slightly more common in mothers (54.2%), unemployed parents …

Spatial Analysis Of Seven Islands In Indonesia To Determine Stunting Hotspots, Tiopan Sipahutar, Tris Eryando, Meiwita Budiharsana

Kesmas

Indonesia is a vast country struggling to reduce its stunting prevalence. Hence, identifying priority areas is urgent. In determining areas to prioritize, one needs to consider geographical issues, particularly correlations among areas. This study aimed to discover whether stunting prevalence in Indonesia occurs randomly or in clusters; and, if it occurs in clusters, which areas are the hotspots. This ecological study used aggregate data from the 2018 National Basic Health Research and Poverty Data and Information Report from the Statistics Indonesia. This study analyzed 514 districts/cities across 34 provinces on seven main islands in Indonesia. The method used was the …