Effect of pesticide exposure on liver function tests and serum cholinesterase levels among floriculture industry workers in Bahirdar, Ethiopia: a comparative cross-sectional study.

Workers in the floriculture industry are exposed to various classes of pesticides through skin contact, inhalation, and ingestion. Although many pesticides are known to exert hepatotoxic effects and inhibit serum butyrylcholinesterase (BChE), no prior studies have been conducted in Ethiopia, particularly in the Amhara region. This study aimed to assess the effects of pesticide exposure on liver function tests and BChE among floriculture workers in Bahir Dar, Ethiopia. A comparative cross-sectional study was conducted from February 8, 2025, to May 28, 2025, including 103 floriculture workers and 51 community controls from Zege town. Sociodemographic and clinical data were collected using structured questionnaires, and venous blood samples were analyzed using the Cobas 6000 analyzer. Data were entered in Epidata 4.7 and analyzed in SPSS version 27. Statistical analyses included chi-square/Fisher's exact tests, t-tests, ANCOVA, one-way ANOVA, and multivariate logistic regression, with significance set at p < 0.05. Floriculture workers had significantly higher ALT (27.71 ± 0.44 U/L vs. 22.71 ± 0.47 U/L; MD = 4.99 95% CI: 3.72, 6.25; p < 0.001), AST (28.46 ± 0.68 U/L vs. 20.69 ± 0.73; MD = 7.77 95% CI: 5.98, 9.74; P < 0.001), TBL ( 0.831 ± 0.028 mg/dL vs. 0.362 ± 0.030 mg/dL; MD = 0.47 95% CI: 0.39, 0.55; P < 0.001), and DBL (0.298 ± 0.012 mg/dL vs. 0.170 ± 0.021 mg/dL; MD = 0.13 95% CI: 0.09, 0.17; p < 0.001) compared with controls. Conversely, total protein (7.385 ± 0.058 g/dL vs. 7.624 ± 0.098 g/dL; MD = - 0.24 95% CI: -0.46, - 0.01; p = 0.038), albumin (4.255 ± 0.052 g/dL vs. 4.623 ± 0.088 g/dL; MD = - 0.37 95% CI: -0.57, - 0.17; p < 0.001), A/G ratio (1.394 ± 0.040 vs. 1.580 ± 0.067; MD = - 0.19 95% CI: -0.34, - 0.03; p = 0.018), and BChE (5105 ± 141 U/L vs. 6699 ± 239 U/L; MD = - 1594 95% CI: -2142.66, - 1045.39; p < 0.001) were significantly lower among floriculture workers compared to control. Workers with more than 10 years of exposure showed markedly elevated ALT, AST, TBL, DBL, and globulin, while reduced albumin, A/G ratio, and BChE with < 5 years and 5-10 years (p < 0.05). Overall, prolonged pesticide exposure was associated with significant alterations of liver function and BChE among floriculture workers.