On May 5, 2009 a 49-year-old male municipal laborer (victim) was fatally injured while performing the task of collecting refuse from private residences. The victim and a co-worker were riding on the rear step of a refuse collection truck while traveling from one residence to the next. The truck drove over a depression in the roadway causing the victim to fall from the back of the truck. The victim landed on the asphalt roadway with the back of his head striking the ground. The truck driver noticed the victim and stopped the truck. The co-worker climbed off the truck's rear step and ran to the closest house to call for emergency medical services (EMS). The truck driver stopped a passing motorist to help him attend to the victim. Within minutes EMS and the local police arrived at the incident location and the victim was transported to a local hospital where he died two days later from his injuries. The Massachusetts FACE Program concluded that to prevent similar occurrences in the future, employers should: (1) Ensure that employees are never positioned on refuse collection trucks' rear riding steps when the trucks are traveling faster than 10 miles per hour or traveling more than 0.2 mile; (2) Ensure that alternative transportation options are available for employees when there is not enough legal seating within a refuse collection truck's cab for all work crew members and the truck will be traveling faster than 10 miles per hour or further than 0.2 mile; (3) Consider adequate legal seating for the entire work crew inside a truck's cab when building and/or purchasing refuse collection trucks; (4) Help ensure employee safety on the road by developing a traffic safety program and promoting traffic safety principles; (5) Routinely provide employees with refresher trainings that are updated as needed; (6) Ensure that employees have access to a communication device that can be used during emergency situations; and (7) Consider the feasibility of implementing automated processes for refuse collection.