A 34-year-old male volunteer fire fighter (the victim) died after the engine he was driving veered off the road and rolled two times before coming to rest. The incident occurred while the victim, a Lieutenant, and another fire fighter were responding in Engine 11 to a motor-vehicle incident involving injuries. While en route, the tires on the engine's right side dropped off the road surface. As the victim attempted to bring the engine back onto the roadway, he overcompensated, causing the engine to cross the oncoming lane of traffic. The engine crossed a small ditch rolled across another roadway, crossed another ditch, and rolled again before coming to rest in a resident's yard. The Lieutenant and fire fighter were thrown from the engine and the victim was killed instantly. The lieutenant and fire fighter were taken by ambulance to a local hospital where they were treated and released. The victim, who was entrapped in the vehicle, was removed 1 hour later. NIOSH investigators concluded that, to minimize the risk of similar occurrences, fire departments should: Establish, implement, and enforce standard operating procedures (SOPs) on the use of seatbelts in all emergency vehicles; ensure drivers of fire apparatus do not move vehicles until all occupants in vehicles are secured with seatbelts; ensure all drivers of fire department vehicles are responsible for the safe and prudent operation of the vehicle under all conditions; ensure all drivers of fire department vehicles receive driver training at least twice a year.