On July 7, 2008, a 58-year-old male volunteer fire fighter (the victim) was fatally injured after the engine he was driving left the roadway and overturned several times. The victim was en route to a vehicle fire and was approximately 1.4 miles from the fire station when the incident occurred. The engine left the roadway shoulder after misjudging the clearance to a large farm tractor stopped in the oncoming lane. The victim was not wearing a seat belt and was ejected from the vehicle. Another fire fighter onboard the apparatus crawled from the wreckage and began administering first aid to the seriously injured victim. The victim was airlifted to a medical center and was later pronounced dead. It was later determined that the victim was driving with a blood alcohol level in excess of the legal limit. Key contributing factors identified in this investigation include driving with a blood alcohol level in excess of the legal limit, not wearing seat belts, incorrectly judging the passing clearance when approaching a stopped vehicle, failure to keep the apparatus on the road surface, overcorrecting during the recovery maneuver, and limited experience with the incident apparatus. The NIOSH investigator concluded that, in order to minimize the risk of similar occurrences, fire departments should: 1. Enforce standard operating procedures on a "zero-tolerance policy" for alcohol use while engaged in any fire department activity. 2. Enforce standard operating procedures that require mandatory use of seat belts in all vehicles. 3. Consider additional driver training for fire fighters on safe driving and apparatus operations. 4. Train apparatus driver/operators in regaining control when the right-side wheels leave the road surface.