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Intensive agrochemical application in banana production has been documented in Ecuador, world’s largest exporter of bananas . This study assessed working conditions, wellbeing and health of farmworkers in conventional farming using biocides and in organic farming.In a cross-sectional epidemiological study exposed and non-exposed male farmworkers were interviewed based on standardised questionnaires about, inter alia, exposure history, pesticide application practices, health and wellbeing. Furthermore, swab samples of buccal cells were taken (Buccal Micronucleus Cytome Assay, BMCA), fixed, stained and later in the laboratory blindly evaluated for nuclear anomalies indicative of cytotoxic and genotoxic effects, according to standard protocols.In total, 68 farmworker participated (provinces Los Rios, El Oro). 87% resp. 78% of the pesticide exposed respondents did not use masks/gloves at all; 10% resp. 19% used masks/gloves all the time. Pesticide workers (n=31) showed significantly more often symptoms such as dizziness (OR=4.80), nausea/vomiting (OR=7.50), diarrhoea (OR=6.43), burning eyes (OR=4.10), skin irritation (OR=3.58). Furthermore, eight out of nine biomarkers of the BMCA were significantly more frequent among exposed workers (p<0.001) (micronucleited cells: OR=2.55; total micronuclei: OR=2.45; nuclear buds: OR=1.84; binucleated cells: OR=1.33; condensed chromatin: OR=1.38; karyorrhectic cells: OR=1.30; karyolytic cells: OR=1.19; broken eggs: OR=1.20).Our findings indicate that the impact of pesticide use is not restricted to acute effects on health and wellbeing, but also point to long-term health risks. BMCA results suggest that pesticide users have a higher risk of developing cancer. There is an urgent need for safety training and minimising application of pesticides.