Sanitation Worker Struck by Backing Refuse Truck – North Carolina

NIOSH FACE Report 2021-01
May 16, 2022


On February 14, 2020, at 8:40 a.m., an employee of a city public works department was engaged in manual garbage pickup on a refuse truck on a residential route. The three-person crew included an operator and two sanitation workers who rode on the outside step of the truck as it moved from one stop to the next. The sanitation worker riding on the outside step of the refuse truck was startled by a pick-up truck backing up from an adjacent residence towards him and the backing refuse truck. The sanitation worker jumped off the refuse truck, ran behind the refuse truck and was fatally struck by the refuse truck.


Occupational injuries and fatalities are often the result of one or more contributing factors or key events in a larger sequence of events that ultimately result in the injury or fatality. NIOSH investigators identified the following unrecognized hazards as key contributing factors in this incident:

  • Riding on an outside step of backing refuse equipment
  • Lack of situational awareness of driver and sanitation workers
  • Lack of written standard operating procedures for driving and riding positions on refuse trucks
  • Lack of communication with ground workers


NIOSH investigators concluded that, to help prevent similar occurrences, employers should:

    • Select refuse equipment that reduce struck-by injury hazards for employees
    • Install worker detection and operator notification devices on refuse equipment
    • Develop policies and procedures and provide training on safe driving and riding positions on refuse trucks


Sanitation Worker Struck by Backing Refuse Truck – North Carolina [PDF 1,386KB] Report Visual Extension [1,420 KB]


The National Institute for Occupational Safety and Health (NIOSH), an institute within the Centers for Disease Control and Prevention (CDC), is the federal agency responsible for conducting research and making recommendations for the prevention of work-related injury and illness. In 1982, NIOSH initiated the Fatality Assessment and Control Evaluation (FACE) Program. FACE examines the circumstances of targeted causes of traumatic occupational fatalities so that safety professionals, researchers, employers, trainers, and workers can learn from these incidents. The primary goal of these investigations is for NIOSH to make recommendations to prevent similar occurrences. These NIOSH investigations are intended to reduce or prevent occupational deaths and are completely separate from the rulemaking, enforcement and inspection activities of any other federal or state agency. Under the FACE program, NIOSH investigators interview persons with knowledge of the incident and review available records to develop a description of the conditions and circumstances leading to the deaths in order to provide a context for the agency’s recommendations. The NIOSH summary of these conditions and circumstances in its reports is not intended as a legal statement of facts. This summary, as well as the conclusions and recommendations made by NIOSH, should not be used for the purpose of litigation or the adjudication of any claim. For further information, visit the program website at or call toll free at 1-800-CDC-INFO (1-800-232-4636).

Page last reviewed: May 26, 2022