On September 27, 1999, one male volunteer fire fighter died after being struck by a tractor trailer truck. He was part of a volunteer fire department (Volunteer Fire Department #2) that had been called out to provide assistance for another local volunteer fire department (Volunteer Fire Department #1). Volunteer Fire Department #1 was dispatched to a reported wreck involving a tractor trailer truck on a four-lane highway approximately 1 mile south of the North Carolina state line. The victim arrived on scene to provide assistance with traffic control for the fire fighters attending to the tractor trailer wreck. After arriving on scene, the victim was told to set up for traffic control in the southbound lanes. The victim then drove Rescue Unit 205 (R-205) northbound on the outer emergency lane of the southbound lanes, facing oncoming traffic, to an area that provided the most visibility and warning to oncoming traffic (Figure 1). Rescue Unit 205 was positioned 1/2 mile north, around a curve, and in the lanes opposite the tractor trailer wreck. After being on scene for approximately 40 minutes, the fire fighters from both departments and one highway patrol officer heard a truck applying brakes and then saw the tractor trailer, in the southbound lane, fish tailing and then coming to a complete stop. They recalled seeing the driver of that truck getting out of his vehicle and walking around the truck as if he were inspecting his truck for any damages or malfunctioning parts. The driver then got back into his truck and drove away. Approximately 2 minutes later, another truck driver heading southbound stopped and informed the fire fighters that he had just passed a fire fighter who was lying on the ground in front of a fire truck. The fire fighters from both departments then drove up the road and found that the victim and R-205 had both been struck by a motor vehicle. The victim was treated at the scene and then transported by ambulance to the local hospital. Medical treatment was continued at the hospital where he was later pronounced dead. NIOSH investigators concluded that, to minimize the risk of similar incidents, fire departments should: establish, implement, and enforce standard operating procedures (SOPs) regarding emergency operations for highway incidents; ensure that fire fighters responding to a scene involving a highway incident or fire first control the oncoming vehicles before safely turning their attention to the emergency in the event police have not arrived; ensure that personnel park or stage unneeded vehicles off the street/highway whenever possible; ensure that personnel wear personal protective clothing that is suitable to that incident while operating at an emergency scene such as a highly visible reflectorized flagger vest (strong yellow green and orange); ensure that personnel conducting traffic control measures use a highly visible stop/slow paddle; establish pre-incident plans for areas that have a higher rate of automobile incidents.