{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T16:45:49Z","timestamp":1793724349757,"version":"4.6.1"},"reference-count":73,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T00:00:00Z","timestamp":1777766400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":72,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    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\u2019s exact tests, t-tests, ANCOVA, one-way ANOVA, and multivariate logistic regression, with significance set at\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05. Floriculture workers had significantly higher ALT (27.71\u2009\u00b1\u20090.44 U\/L vs. 22.71\u2009\u00b1\u20090.47 U\/L; MD\u2009=\u20094.99 [95% CI: 3.72, 6.25];\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), AST (28.46\u2009\u00b1\u20090.68 U\/L vs. 20.69\u2009\u00b1\u20090.73; MD\u2009=\u20097.77 [95% CI: 5.98, 9.74];\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001), TBL ( 0.831\u2009\u00b1\u20090.028\u00a0mg\/dL vs. 0.362\u2009\u00b1\u20090.030\u00a0mg\/dL; MD\u2009=\u20090.47 [95% CI: 0.39, 0.55];\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001), and DBL (0.298\u2009\u00b1\u20090.012\u00a0mg\/dL vs. 0.170\u2009\u00b1\u20090.021\u00a0mg\/dL; MD\u2009=\u20090.13 [95% CI: 0.09, 0.17];\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) compared with controls. Conversely, total protein (7.385\u2009\u00b1\u20090.058\u00a0g\/dL vs. 7.624\u2009\u00b1\u20090.098\u00a0g\/dL; MD\u2009=\u2009\u2212\u20090.24 [95% CI: \u22120.46, \u2212\u20090.01];\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.038), albumin (4.255\u2009\u00b1\u20090.052\u00a0g\/dL vs. 4.623\u2009\u00b1\u20090.088\u00a0g\/dL; MD\u2009=\u2009\u2212\u20090.37 [95% CI: \u22120.57, \u2212\u20090.17];\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), A\/G ratio (1.394\u2009\u00b1\u20090.040 vs. 1.580\u2009\u00b1\u20090.067; MD\u2009=\u2009\u2212\u20090.19 [95% CI: \u22120.34, \u2212\u20090.03];\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.018), and BChE (5105\u2009\u00b1\u2009141 U\/L vs. 6699\u2009\u00b1\u2009239 U\/L; MD\u2009=\u2009\u2212\u20091594 [95% CI: \u22122142.66, \u2212\u20091045.39];\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) 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 &lt;\u20095 years and 5\u201310 years (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05). Overall, prolonged pesticide exposure was associated with significant alterations of liver function and BChE among floriculture workers.\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-51363-8","type":"journal-article","created":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T08:23:52Z","timestamp":1777796632000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effect of pesticide exposure on liver function tests and serum cholinesterase levels among floriculture industry workers in Bahirdar, Ethiopia: a comparative cross-sectional study"],"prefix":"10.1038","volume":"16","author":[{"given":"Habtamu Molla","family":"Gietie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gobena","family":"Dedefo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mekdes","family":"Alem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Getachew","family":"Wolde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Aliye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abditsion","family":"Disani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wessene","family":"Habtu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genet","family":"Ashebir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edmealem","family":"Minlarg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tilahun","family":"Bitew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abebe","family":"Edao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mistire","family":"Wolde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,3]]},"reference":[{"issue":"1","key":"51363_CR1","doi-asserted-by":"publisher","first-page":"1791462","DOI":"10.1080\/23311843.2020.1791462","volume":"6","author":"B Agmas","year":"2020","unstructured":"Agmas, B. & Adugna, M. Attitudes and practices of farmers with regard to pesticide use in NorthWest Ethiopia. Cogent Environ. Sci. 6 (1), 1791462 (2020).","journal-title":"Cogent Environ. Sci."},{"key":"51363_CR2","first-page":"1","volume-title":"Farmers\u2019 exposure to pesticides: toxicity types and ways of prevention","author":"CA Damalas","year":"2016","unstructured":"Damalas, C. A. & Koutroubas, S. D. Farmers\u2019 exposure to pesticides: toxicity types and ways of prevention 1 (MDPI, 2016)."},{"issue":"4","key":"51363_CR3","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1080\/03601234.2012.640913","volume":"47","author":"HM Abdou","year":"2012","unstructured":"Abdou, H. M., Hussien, H. M. & Yousef, M. I. Deleterious effects of cypermethrin on rat liver and kidney: Protective role of sesame oil. J. Environ. Sci. Health B 47(4), 306\u2013314 (2012).","journal-title":"J. Environ. Sci. Health B"},{"key":"51363_CR4","unstructured":"Tostado L, Bollmohr S. Pesticide Atlas-Facts and figures about toxic chemicals in agriculture. Heinrich-B\u00f6ll-Stiftung, Friends of the Earth Europe, Bund f\u00fcr Umwelt und &#8230."},{"issue":"1","key":"51363_CR5","doi-asserted-by":"publisher","first-page":"1875","DOI":"10.1186\/s12889-020-09939-0","volume":"20","author":"W Boedeker","year":"2020","unstructured":"Boedeker, W., Watts, M., Clausing, P. & Marquez, E. Retracted article: The global distribution of acute unintentional pesticide poisoning: Estimations based on a systematic review. BMC Public Health 20(1), 1875 (2020).","journal-title":"BMC Public Health"},{"issue":"4\u20135","key":"51363_CR6","doi-asserted-by":"publisher","first-page":"373","DOI":"10.3233\/EPL-200239","volume":"50","author":"BT Mengistie","year":"2021","unstructured":"Mengistie, B. T. Ethiopia: the environmental aspects of policy and practice in the Ethiopian floriculture industry. Environ. Policy Law. 50 (4\u20135), 373\u2013390 (2021).","journal-title":"Environ. Policy Law"},{"issue":"1","key":"51363_CR7","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/1745-6673-2-9","volume":"2","author":"JL Del Prado-Lu","year":"2007","unstructured":"Del Prado-Lu, J. L. Pesticide exposure, risk factors and health problems among cutflower farmers: a cross sectional study. J. Occup. Med. Toxicol. 2 (1), 9 (2007).","journal-title":"J. Occup. Med. Toxicol."},{"issue":"1","key":"51363_CR8","first-page":"1006","volume":"2","author":"BT Mengistie","year":"2016","unstructured":"Mengistie, B. T. Policy-practice nexus: Pesticide registration, distribution and use in Ethiopia. SM J. Environ. Toxicol. 2(1), 1006\u20131019 (2016).","journal-title":"SM J. Environ. Toxicol."},{"issue":"1","key":"51363_CR9","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1179\/1077352512Z.0000000002","volume":"18","author":"J Breilh","year":"2012","unstructured":"Breilh, J., Pagliccia, N. & Yassi, A. Chronic pesticide poisoning from persistent low-dose exposures in Ecuadorean floriculture workers: toward validating a low-cost test battery. Int. J. Occup. Environ. Health. 18 (1), 7\u201321 (2012).","journal-title":"Int. J. Occup. Environ. Health"},{"key":"51363_CR10","unstructured":"Hemalatha, T., UmaMaheswari, T., Krithiga, G., Sankaranarayanan, P. & Puvanakrishnan, R. Enzymes in clinical medicine: an overview. (2013)."},{"issue":"4","key":"51363_CR11","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1053\/gast.2002.36060","volume":"123","author":"AG Association","year":"2002","unstructured":"Association, A. G. American Gastroenterological Association medical position statement: evaluation of liver chemistry tests. Gastroenterology 123 (4), 1364\u20131366 (2002).","journal-title":"Gastroenterology"},{"issue":"1\u20134","key":"51363_CR12","first-page":"139","volume":"47","author":"P Sipos","year":"2003","unstructured":"Sipos, P. Some effects of lead contamination on liver and gallbladder bile. Acta Biol. Szeged. 47(1\u20134), 139\u201342 (2003).","journal-title":"Acta Biol. Szeged."},{"issue":"2","key":"51363_CR13","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1179\/oeh.2005.11.2.144","volume":"11","author":"T Mourad Abu","year":"2005","unstructured":"Mourad Abu, T. Adverse impact of insecticides on the health of Palestinian farm workers in the Gaza Strip: A hematologic biomarker study. Int. J. Occup. Environ. Health 11(2), 144\u20139 (2005).","journal-title":"Int. J. Occup. Environ. Health"},{"issue":"1\u20132","key":"51363_CR14","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.cccn.2004.09.019","volume":"352","author":"LG Costa","year":"2005","unstructured":"Costa, L. G., Cole, T. B., Vitalone, A. & Furlong, C. E. Measurement of paraoxonase (PON1) status as a potential biomarker of susceptibility to organophosphate toxicity. Clin. Chim. Acta. 352 (1\u20132), 37\u201347 (2005).","journal-title":"Clin. Chim. Acta"},{"key":"51363_CR15","doi-asserted-by":"publisher","DOI":"10.1684\/abc.2011.0531","author":"M Araoud","year":"2011","unstructured":"Araoud, M. et al. Factors influencing plasma butyrylcholinesterase activity in agricultural workers. Ann. Biol. Clin. (Paris) https:\/\/doi.org\/10.1684\/abc.2011.0531 (2011).","journal-title":"Ann. Biol. Clin. (Paris)"},{"key":"51363_CR16","first-page":"454","volume":"13","author":"K Brice","year":"2017","unstructured":"Brice, K., Patricia, A., Norbert, N. T. & Mpoame, M. Environmental and human health assessment in relation to pesticide use by local farmers and the Cameroon Development Corporation (CDC), Fako Division, South-West Cameroon. Eur. Sci. J. 13, 454\u201373 (2017).","journal-title":"Eur. Sci. J."},{"key":"51363_CR17","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/j.pestbp.2015.03.012","volume":"124","author":"I-B Dhouib","year":"2015","unstructured":"Dhouib, I.-B., Lasram, M. M., Annabi, A., Gharbi, N. & El-Fazaa, S. A comparative study on toxicity induced by carbosulfan and malathion in Wistar rat liver and spleen. Pestic. Biochem. Physiol. 124, 21\u20138 (2015).","journal-title":"Pestic. Biochem. Physiol."},{"issue":"2","key":"51363_CR18","first-page":"446","volume":"21","author":"P Rasgele","year":"2015","unstructured":"Rasgele, P., Oktay, M., Kekecoglu, M. & Muranli, F. The histopathological investigation of liver in experimental animals after short-term exposures to pesticides. Bulg. J. Agric. Sci. 21(2), 446\u2013453 (2015).","journal-title":"Bulg. J. Agric. Sci."},{"issue":"3","key":"51363_CR19","doi-asserted-by":"publisher","first-page":"72","DOI":"10.4236\/odem.2016.43009","volume":"4","author":"Y El-Nahhal","year":"2016","unstructured":"El-Nahhal, Y. Biochemical changes associated with long term exposure to pesticide among farmers in the Gaza Strip. Occupational Diseases and Environmental Medicine 4(3), 72\u201382 (2016).","journal-title":"Occupational Diseases and Environmental Medicine"},{"issue":"8","key":"51363_CR20","doi-asserted-by":"publisher","first-page":"707","DOI":"10.3390\/toxics11080707","volume":"11","author":"S Bunsri","year":"2023","unstructured":"Bunsri, S., Muenchamnan, N., Naksen, W. & Ong-Artborirak, P. The hematological and biochemical effects from pesticide exposure on Thai vegetable farmers. Toxics 11 (8), 707 (2023).","journal-title":"Toxics"},{"key":"51363_CR21","doi-asserted-by":"publisher","DOI":"10.36103\/ijas.v51i5.1145","author":"BA Othman","year":"2020","unstructured":"Othman, B. A. & Kakey, E. S. Environmental pesticide residues and health biomarkers among farmers from greenhouses of Erbil cucumber crops. Iraqi J. Agric. Sci. 1357-1366 https:\/\/doi.org\/10.36103\/ijas.v51i5.1145 (2020).","journal-title":"Iraqi J. Agric. Sci."},{"issue":"23","key":"51363_CR22","doi-asserted-by":"publisher","first-page":"29291","DOI":"10.1007\/s11356-020-09203-3","volume":"27","author":"LV Cestonaro","year":"2020","unstructured":"Cestonaro, L. V. et al. Biochemical, hematological and immunological parameters and relationship with occupational exposure to pesticides and metals. Environ. Sci. Pollut. Res. 27(23), 29291\u2013302 (2020).","journal-title":"Environ. Sci. Pollut. Res."},{"issue":"9","key":"51363_CR23","doi-asserted-by":"publisher","DOI":"10.1002\/jbt.22367","volume":"33","author":"RK Kori","year":"2019","unstructured":"Kori, R. K., Hasan, W., Jain, A. K. & Yadav, R. S. Cholinesterase inhibition and its association with hematological, biochemical and oxidative stress markers in chronic pesticide exposed agriculture workers. J. Biochem. Mol. Toxicol. 33(9), e22367 (2019).","journal-title":"J. Biochem. Mol. Toxicol."},{"issue":"1\u20132","key":"51363_CR24","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1016\/j.cccn.2005.02.015","volume":"358","author":"SM Khan","year":"2005","unstructured":"Khan, S. M., Sobti, R. & Kataria, L. Pesticide-induced alteration in mice hepato-oxidative status and protective effects of black tea extract. Clin. Chim. Acta 358(1\u20132), 131\u20138 (2005).","journal-title":"Clin. Chim. Acta"},{"key":"51363_CR25","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1016\/j.envres.2014.07.023","volume":"134","author":"J Kumar","year":"2014","unstructured":"Kumar, J. et al. Persistent organic pollutants and liver dysfunction biomarkers in a population-based human sample of men and women. Environ. Res. 134, 251\u20136 (2014).","journal-title":"Environ. Res."},{"key":"51363_CR26","unstructured":"Bandyopadhyay, U., Das, D. & Banerjee, R. K. Reactive oxygen species: oxidative damage and pathogenesis. Curr. Sci. 7.658\u2013666. (1999)."},{"issue":"3","key":"51363_CR27","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1016\/j.toxlet.2007.05.004","volume":"171","author":"O L\u00f3pez","year":"2007","unstructured":"L\u00f3pez, O. et al. Changes in antioxidant enzymes in humans with long-term exposure to pesticides. Toxicol. Lett. 171(3), 146\u201353 (2007).","journal-title":"Toxicol. Lett."},{"issue":"1","key":"51363_CR28","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1016\/j.taap.2007.10.027","volume":"227","author":"JF Muniz","year":"2008","unstructured":"Muniz, J. F. et al. Biomarkers of oxidative stress and DNA damage in agricultural workers: A pilot study. Toxicol. Appl. Pharmacol. 227(1), 97\u2013107 (2008).","journal-title":"Toxicol. Appl. Pharmacol."},{"issue":"1","key":"51363_CR29","volume":"2012","author":"S Marchi","year":"2012","unstructured":"Marchi, S. et al. Mitochondria-ros crosstalk in the control of cell death and aging. J. Signal Transduct. 2012(1), 329635 (2012).","journal-title":"J. Signal Transduct."},{"issue":"5","key":"51363_CR30","doi-asserted-by":"publisher","first-page":"302","DOI":"10.3923\/ajava.2014.302.311","volume":"9","author":"A Baghaei","year":"2014","unstructured":"Baghaei, A. et al. On the protection of ALP cardiovascular toxicity by a novel mixed herbal medicine; role of oxidative stress and cellular ATP. Asian J. Anim. Vet. Adv. 9(5), 302\u201311 (2014).","journal-title":"Asian J. Anim. Vet. Adv."},{"issue":"19","key":"51363_CR31","doi-asserted-by":"publisher","first-page":"16168","DOI":"10.1074\/jbc.M010120200","volume":"276","author":"S-H Jo","year":"2001","unstructured":"Jo, S.-H. et al. Control of mitochondrial redox balance and cellular defense against oxidative damage by mitochondrial NADP+-dependent isocitrate dehydrogenase. J. Biol. Chem. 276(19), 16168\u201376 (2001).","journal-title":"J. Biol. Chem."},{"issue":"1","key":"51363_CR32","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1111\/j.1749-6632.2003.tb07469.x","volume":"991","author":"G Fiskum","year":"2003","unstructured":"Fiskum, G., Starkov, A., Polster, B. M. & Chinopoulos, C. Mitochondrial mechanisms of neural cell death and neuroprotective interventions in Parkinson\u2019s disease. Ann. N. Y. Acad. Sci. 991 (1), 111\u2013119 (2003).","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"51363_CR33","volume-title":"Central Statistical Agency population projection of Ethiopia for all regions at Woreda level from 2014\u20132017","author":"Ethiopia FDRo","year":"2013","unstructured":"Ethiopia FDRo. Central Statistical Agency population projection of Ethiopia for all regions at Woreda level from 2014\u20132017 (Federal Democratic Republic of Ethiopia, 2013)."},{"key":"51363_CR34","unstructured":"Korn, D. A. Ethiopia, the United States and the Soviet Union. (No Title). (1986)."},{"key":"51363_CR35","unstructured":"Lewoyehu, M. Analysis Of The Level Of Selected Environmental Pollutants In The Effluent Discharges Of Tana Flora Floriculture Industry. Amhara Region, Ethiopia, Nat Prod Chem Res. 9. (2021)."},{"key":"51363_CR36","unstructured":"Heide Fz. Feasibility study for a Lake Tana biosphere reserve (Deutschland\/Bundesamt f\u00fcr Naturschutz, 2012)."},{"issue":"1","key":"51363_CR37","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1186\/s12887-022-03283-5","volume":"22","author":"MT Bayih","year":"2022","unstructured":"Bayih, M. T., Arega, Z. & Motbainor, A. Nutritional status of 6\u201359 months of age children is not significantly varied between households with and without home gardening practices in Zege, North West Ethiopia, 2020: Community based comparative study. BMC Pediatr. 22(1), 221 (2022).","journal-title":"BMC Pediatr."},{"issue":"7","key":"51363_CR38","first-page":"497","volume":"24","author":"H Bergmeyer","year":"1986","unstructured":"Bergmeyer, H., Horder, M. & Rej, R. Approved recommendation (1985) on IFCC methods for the measurement of catalytic concentration of enzymes. Part 2. IFCC method for aspartate aminotransferase (l-aspartate: 2-Oxoglutarate aminotransferase, EC 2.6. 1.1). J. Clin. Chem. Clin. Biochem. 24(7), 497\u2013508 (1986).","journal-title":"J. Clin. Chem. Clin. Biochem."},{"issue":"9","key":"51363_CR39","doi-asserted-by":"publisher","first-page":"1439","DOI":"10.1515\/CCLM.2011.621","volume":"49","author":"G Schumann","year":"2011","unstructured":"Schumann, G. et al. IFCC primary reference procedures for the measurement of catalytic activity concentrations of enzymes at 37 C. Part 9: Reference procedure for the measurement of catalytic concentration of alkaline phosphatase: International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Scientific Division, Committee on Reference Systems of Enzymes (C-RSE) 1. Clin. Chem. Lab. Med. 49(9), 1439\u201346 (2011).","journal-title":"Clin. Chem. Lab. Med."},{"issue":"3_ts","key":"51363_CR40","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1093\/ajcp\/16.3_ts.40","volume":"16","author":"CT Weichselbaum","year":"1946","unstructured":"Weichselbaum, C. T. An accurate and rapid method for the determination of proteins in small amounts of blood serum and plasma. Am. J. Clin. Pathol. 16(3_ts), 40\u20139 (1946).","journal-title":"Am. J. Clin. Pathol."},{"key":"51363_CR41","first-page":"11","volume":"29","author":"W Aw","year":"1972","unstructured":"Aw, W. Modification of the Malloy-Evelyn method for a simple, reliable determination of total bilirubin in serum. Scand. J. Clin. Lab. Invest. 29, 11\u20132 (1972).","journal-title":"Scand. J. Clin. Lab. Invest."},{"issue":"2","key":"51363_CR42","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1016\/S0021-9258(18)74392-5","volume":"119","author":"HT Malloy","year":"1937","unstructured":"Malloy, H. T. & Evelyn, K. A. The determination of bilirubin with the photoelectric colorimeter. J. Biol. Chem. 119(2), 481\u201390 (1937).","journal-title":"J. Biol. Chem."},{"issue":"1","key":"51363_CR43","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1016\/0009-8981(71)90365-2","volume":"31","author":"BT Doumas","year":"1971","unstructured":"Doumas, B. T., Watson, W. A. & Biggs, H. G. Albumin standards and the measurement of serum albumin with bromcresol green. Clin. Chim. Acta 31(1), 87\u201396 (1971).","journal-title":"Clin. Chim. Acta"},{"key":"51363_CR44","first-page":"163","volume":"30","author":"E Schmidt","year":"1992","unstructured":"Schmidt, E. Proposal of standard methods for the determination of enzyme catalytic concentrations in serum and plasma at 37\u2103, II. Cholinesterase. Eur. J. Clin. Chem. Clin. Biochem. 30, 163\u201370 (1992).","journal-title":"Eur. J. Clin. Chem. Clin. Biochem."},{"key":"51363_CR45","unstructured":"Organization, W. H. Obesity: preventing and managing the global epidemic: report of a WHO consultation. (2000)."},{"key":"51363_CR46","doi-asserted-by":"publisher","first-page":"639855","DOI":"10.3389\/fmed.2021.639855","volume":"8","author":"Y Lv","year":"2021","unstructured":"Lv, Y. et al. Abnormal Liver Function Tests Were Associated With Adverse Clinical Outcomes: An Observational Cohort Study of 2,912 Patients With COVID-19. Front. Med. (Lausanne). 8, 639855 (2021).","journal-title":"Front. Med. (Lausanne)"},{"key":"51363_CR47","doi-asserted-by":"crossref","unstructured":"Blaauwen Dd, Poppe, W. & Tritschler, W. Cholinesterase (EC 3.1. 1.8) mit Butyrylthiocholin-iodid als Substrat: Referenzwerte in Abh\u00e4ngigkeit von Alter und Geschlecht unter Ber\u00fccksichtigung hormonaler Einfl\u00fcsse und Schwangerschaft. (1983).","DOI":"10.1515\/cclm.1983.21.6.381"},{"issue":"1","key":"51363_CR48","first-page":"64","volume":"27","author":"A Defar","year":"2013","unstructured":"Defar, A. & Ali, A. Occupational induced health problems in floriculture workers in Sebeta and surrounding areas, West Shewa, Oromia, Ethiopia. Ethiop. J. Health Dev. 27(1), 64\u201371 (2013).","journal-title":"Ethiop. J. Health Dev."},{"issue":"1","key":"51363_CR49","doi-asserted-by":"publisher","first-page":"65","DOI":"10.5296\/jbls.v9i1.12461","volume":"9","author":"P Agnandji","year":"2018","unstructured":"Agnandji, P. et al. Influence of pesticide on biochemical and hematological parameters in Beninese vegetable farmers. J. Biol. Life Sci. 9 (1), 65\u201377 (2018).","journal-title":"J. Biol. Life Sci."},{"issue":"4","key":"51363_CR50","doi-asserted-by":"publisher","first-page":"179","DOI":"10.3923\/rjet.2009.179.185","volume":"3","author":"A Al-Sarar","year":"2009","unstructured":"Al-Sarar, A., Abo Bakr, Y., Al-Erimah, G., Hussein, H. & Bayoumi, A. Hematological and biochemical alterations in occupationally pesticides-exposed workers of Riyadh municipality, Kingdom of Saudi Arabia. Res. J. Environ. Toxicol. 3(4), 179\u201385 (2009).","journal-title":"Res. J. Environ. Toxicol."},{"issue":"1","key":"51363_CR51","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1539\/joh.Q9003","volume":"52","author":"P Kachaiyaphum","year":"2010","unstructured":"Kachaiyaphum, P., Howteerakul, N., Sujirarat, D., Siri, S. & Suwannapong, N. Serum cholinesterase levels of Thai chilli-farm workers exposed to chemical pesticides: Prevalence estimates and associated factors. J. Occup. Health 52(1), 89\u201398 (2010).","journal-title":"J. Occup. Health"},{"key":"51363_CR52","unstructured":"Organization, W. H. The WHO recommended classification of pesticides by hazard and guidelines to classification 2019. The WHO recommended classification of pesticides by hazard and guidelines to classification 20192020."},{"issue":"2","key":"51363_CR53","doi-asserted-by":"publisher","first-page":"1","DOI":"10.9734\/ARJA\/2017\/31884","volume":"4","author":"MA Kassa","year":"2017","unstructured":"Kassa, M. A. Review on environmental effects of Ethiopian floriculture industry. Asian Res. J. Agric. 4(2), 1\u201313 (2017).","journal-title":"Asian Res. J. Agric."},{"key":"51363_CR54","doi-asserted-by":"publisher","DOI":"10.1177\/1178630217715237","volume":"11","author":"EJ Mrema","year":"2017","unstructured":"Mrema, E. J., Ngowi, A. V., Kishinhi, S. S. & Mamuya, S. H. Pesticide exposure and health problems among female horticulture workers in Tanzania. Environ. Health Insights 11, 1178630217715237 (2017).","journal-title":"Environ. Health Insights"},{"issue":"4","key":"51363_CR55","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1080\/19338244.2013.853645","volume":"70","author":"VM Hanssen","year":"2015","unstructured":"Hanssen, V. M., Nigatu, A. W., Zeleke, Z. K., Moen, B. E. & Br\u00e5tveit, M. High prevalence of respiratory and dermal symptoms among Ethiopian flower farm workers. Arch. Environ. Occup. Health. 70 (4), 204\u2013213 (2015).","journal-title":"Arch. Environ. Occup. Health"},{"key":"51363_CR56","volume-title":"Goodman and Gilman\u2019s the pharmacological basis of therapeutics","author":"LS Goodman","year":"1996","unstructured":"Goodman, L. S. Goodman and Gilman\u2019s the pharmacological basis of therapeutics (McGraw-Hill, 1996)."},{"issue":"2","key":"51363_CR57","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1081\/DCT-120030725","volume":"27","author":"K Jamil","year":"2005","unstructured":"Jamil, K., Shaik, A. P., Mahboob, M. & Krishna, D. Effect of organophosphorus and organochlorine pesticides (monochrotophos, chlorpyriphos, dimethoate, and endosulfan) on human lymphocytes in-vitro. Drug Chem. Toxicol. 27 (2), 133\u2013144 (2005).","journal-title":"Drug Chem. Toxicol."},{"issue":"5","key":"51363_CR58","doi-asserted-by":"publisher","first-page":"2310","DOI":"10.3390\/ijerph18052310","volume":"18","author":"MN Leonel Javeres","year":"2021","unstructured":"Leonel Javeres, M. N. et al. Chronic exposure to organophosphates pesticides and risk of metabolic disorder in cohort from Pakistan and Cameroon. Int. J. Environ. Res. Public Health. 18 (5), 2310 (2021).","journal-title":"Int. J. Environ. Res. Public Health"},{"issue":"1","key":"51363_CR59","doi-asserted-by":"publisher","first-page":"21041","DOI":"10.1038\/s41598-025-04295-8","volume":"15","author":"VJK Nanhah","year":"2025","unstructured":"Nanhah, V. J. K. et al. Neurological and organ health risks associated with pesticide mixture exposure in banana farm workers in Moungo Division, Cameroon. Sci. Rep. 15 (1), 21041 (2025).","journal-title":"Sci. Rep."},{"key":"51363_CR60","doi-asserted-by":"crossref","unstructured":"Mahmoud Abdul_Aal, A. A. & Mahmoud, K. W. Assessment of hematological, biochemical and oxidative stress parameters on agricultural pesticides application workers in Egypt. Arab. Universities J. Agricultural Sci. 27(2), 1619\u20131625 (2019).","DOI":"10.21608\/ajs.2019.14002.1050"},{"issue":"6","key":"51363_CR61","doi-asserted-by":"publisher","first-page":"5846","DOI":"10.3390\/ijerph120605846","volume":"12","author":"S Aroonvilairat","year":"2015","unstructured":"Aroonvilairat, S. et al. Effect of pesticide exposure on immunological, hematological and biochemical parameters in Thai orchid farmers\u2014A cross-sectional study. Int. J. Environ. Res. Public Health 12(6), 5846\u201361 (2015).","journal-title":"Int. J. Environ. Res. Public Health"},{"issue":"1","key":"51363_CR62","doi-asserted-by":"publisher","first-page":"13","DOI":"10.3390\/toxics6010013","volume":"6","author":"N Ahmadi","year":"2018","unstructured":"Ahmadi, N. et al. Hematological abnormality, oxidative stress, and genotoxicity induction in the greenhouse pesticide sprayers; investigating the role of NQO1 gene polymorphism. Toxics 6 (1), 13 (2018).","journal-title":"Toxics"},{"issue":"1","key":"51363_CR63","first-page":"2305764","volume":"2020","author":"FPT Manfo","year":"2020","unstructured":"Manfo, F. P. T. et al. Evaluation of the effects of agro pesticides use on liver and kidney function in farmers from Buea. Cameroon J. Toxicol. 2020 (1), 2305764 (2020).","journal-title":"Cameroon J. Toxicol."},{"issue":"4","key":"51363_CR64","doi-asserted-by":"publisher","DOI":"10.3390\/toxics4040025","volume":"4","author":"WB Manyilizu","year":"2016","unstructured":"Manyilizu, W. B. et al. Association of long-term pesticide exposure and biologic parameters in female farm workers in Tanzania: A cross sectional study. Toxics 4(4), 25 (2016).","journal-title":"Toxics"},{"issue":"4","key":"51363_CR65","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1515\/JBCPP.2009.20.4.335","volume":"20","author":"JA Patil","year":"2009","unstructured":"Patil, J. A., Patil, A. J., Sonttake, A. & Govindwar, S. P. Occupational pesticides exposure of sprayers of grape gardens in western Maharashtra (India): Effects on liver and kidney function. Journal of basic and clinical physiology and pharmacology 20(4), 335\u201356 (2009).","journal-title":"Journal of basic and clinical physiology and pharmacology"},{"issue":"5","key":"51363_CR66","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1093\/annhyg\/mew004","volume":"60","author":"B Negatu","year":"2016","unstructured":"Negatu, B., Kromhout, H., Mekonnen, Y. & Vermeulen, R. Use of chemical pesticides in Ethiopia: A cross-sectional comparative study on knowledge, attitude and practice of farmers and farm workers in three farming systems. Ann. Occup. Hyg. 60(5), 551\u2013566 (2016).","journal-title":"Ann. Occup. Hyg."},{"issue":"3","key":"51363_CR67","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17030964","volume":"17","author":"MG Shentema","year":"2020","unstructured":"Shentema, M. G. et al. Pesticide use and serum acetylcholinesterase levels among flower farm workers in Ethiopia\u2014a cross-sectional study. International journal of environmental research and public health 17(3), 964 (2020).","journal-title":"International journal of environmental research and public health"},{"issue":"8","key":"51363_CR68","doi-asserted-by":"publisher","first-page":"2038","DOI":"10.1080\/10807039.2021.1944050","volume":"27","author":"E Sombatsawat","year":"2021","unstructured":"Sombatsawat, E., Barr, D. B., Panuwet, P., Robson, M. G. & Siriwong, W. Pesticide-induced changes in cholinesterase activity and chronic kidney disease of unknown etiology among farmers in Nakhon Ratchasima, Thailand. Human and Ecological Risk Assessment: An International Journal 27(8), 2038\u201350 (2021).","journal-title":"Human and Ecological Risk Assessment: An International Journal"},{"issue":"2","key":"51363_CR69","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1080\/19338244.2010.506496","volume":"66","author":"Z Sutoluk","year":"2011","unstructured":"Sutoluk, Z., Kekec, Z., Daglioglu, N. & Hant, I. Association of chronic pesticide exposure with serum cholinesterase levels and pulmonary functions. Arch. Environ. Occup. Health. 66 (2), 95\u201399 (2011).","journal-title":"Arch. Environ. Occup. Health"},{"key":"51363_CR70","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/5563759","volume":"2022","author":"RO Sule","year":"2022","unstructured":"Sule, R. O., Condon, L. & Gomes, A. V. A common feature of pesticides: Oxidative stress-the role of oxidative stress in pesticide-induced toxicity. Oxid Med Cell Longev 2022, 5563759 (2022).","journal-title":"Oxid Med Cell Longev"},{"issue":"2","key":"51363_CR71","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1016\/j.envint.2008.06.011","volume":"35","author":"AP Remor","year":"2009","unstructured":"Remor, A. P. et al. Occupational exposure of farm workers to pesticides: Biochemical parameters and evaluation of genotoxicity. Environ. Int. 35(2), 273\u20138 (2009).","journal-title":"Environ. Int."},{"issue":"2","key":"51363_CR72","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1038\/jes.2009.13","volume":"20","author":"DA Khan","year":"2010","unstructured":"Khan, D. A., Shabbir, S., Majid, M., Naqvi, T. A. & Khan, F. A. Risk assessment of pesticide exposure on health of Pakistani tobacco farmers. J. Expo. Sci. Environ. Epidemiol. 20 (2), 196\u2013204 (2010).","journal-title":"J. Expo. Sci. Environ. Epidemiol."},{"issue":"2","key":"51363_CR73","doi-asserted-by":"publisher","first-page":"138","DOI":"10.3109\/1354750X.2015.1118545","volume":"21","author":"FZ Madani","year":"2016","unstructured":"Madani, F. Z. et al. Hemostatic, inflammatory, and oxidative markers in pesticide user farmers. Biomarkers 21 (2), 138\u2013145 (2016).","journal-title":"Biomarkers"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-51363-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-51363-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-51363-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:03:01Z","timestamp":1783987381000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-51363-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,3]]},"references-count":73,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["51363"],"URL":"https:\/\/doi.org\/10.1038\/s41598-026-51363-8","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,3]]},"assertion":[{"value":"27 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The study was conducted in accordance with the Declaration of Helsinki guidelines and regulations. Ethical clearance was obtained from the research and ethics committees of the Department of Medical Laboratory Science, Addis Ababa University, with reference number DRERC\/773\/24\/MLS\/, and a Permission letter was obtained from the manager of Tana Flora Floriculture Industry, and Amhara Public Health Institute (APHI). Written informed consent to voluntarily participate was obtained from all study participants after explaining the purpose of the study. The confidentiality of the data was also assured. Additionally, the study participants\u2019 right to refuse participation was communicated to them. Study participants with abnormal LFT results and reduced BChE levels were informed of their findings, and appropriate referrals were made through floriculture management to nearby health facilities for further clinical evaluation and treatment.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}}],"article-number":"21885"}}