Background Acute pesticide intoxication has an important public health significance in Ethiopia, but there is limited information about the risk factors of API. Flower farm and small-scale farm workers may have increased risk of pesticide exposure from pesticides used at their work place. This study investigates the risk factors of API among flower farm workers and small-scale farmers, in Ethiopia.

Methods A cross-sectional survey involving 516 persons was conducted. Participants were grouped according to their jobs; flower farm workers and small-scale farmers. In a structured interview, participants were asked about possible work-related risk factors of API defined as at least two health symptoms within 48 hours of pesticide exposure the last year. Prevalence ratio was calculated using binomial regression model, adjusted for age; Fishers exact test was used to compare dichotomous variables having small numbers; and Mantel-Haenszel statistics was used to compare the association between the respective risk factors and API between flower farm and small-scale farmers.

Results The mean age of the study participants was 30 years. Flower farm workers had higher risk of API than small-scale farmers (PR = 4.5, 95% CI: 3.20, 6.35). Among small-scale farmers none of the risk factors were significantly associated with API. Lack of safety training, not following pesticide lable instruction and bathing after pesticide use were significant risk factors for API among flower farm workers. The association between these risk factors and API was significantly different between flower farm and small-scale farmers (p < 0.05).

Conclusion Work at flower farm was a significant predictor of API. Lack of pesticide safety training, not following pesticide labels and poor hygiene measures were the risk factors associated with API among flower farm workers, but not among small-scale farmers.