On December 26, 2003, a 17-year-old warehouse worker (the victim) was fatally injured when the sit-down type forklift he was operating outside the warehouse tipped over and crushed him. The youth was employed by an agricultural cooperative through a work-based learning program in his high school. At approximately 2:00 p.m., the victim had apparently lost control of the forklift, which was not carrying a load, as he was making a right turn toward the ramp leading to the warehouse entrance. The forklift tipped over 90 degrees onto its left side. A customer heard a loud noise and saw the victim trapped under the forklift. He ran to get help. While the customer and the victim's coworker ran back to assist the victim, another coworker ran into the company's store to call 911. The customer and coworker were unable to lift the forklift manually. As coworkers lifted the forklift off the victim using a front-end loader, the customer pulled the victim clear. The victim was conscious but was having difficulty breathing. Police and fire department personnel responded at 2:00 p.m. and provided emergency assistance. The victim was transported by an emergency medical services (EMS) ambulance toward a meeting point with a medical helicopter, but en-route the victim's condition deteriorated. EMS personnel transported the victim to a local hospital where he was pronounced dead at 3:16 p.m. in the hospital's emergency room. NIOSH investigators concluded that, to help prevent similar occurrences, employers should: 1. ensure, through periodic inspections and reminders, that equipment operators use seat belts provided on equipment they are assigned to operate. Operators should also be reminded that they should never try to jump from an overturning sit-down type forklift; 2. ensure that travel routes used by forklift operators are free of obstacles and other unsafe conditions; 3. establish work policies that comply with child labor laws prohibiting youths less than 18 years of age from performing hazardous work, including operating power-driven hoisting equipment such as forklifts. Employers should communicate these work policies to all employees; 4. develop, implement, and enforce a comprehensive written safety program for all workers which includes training in hazard recognition and the avoidance of unsafe conditions. A written training plan should require training for all forklift operators that includes the equipment manufacturers' recommendations for safe equipment operation; and, 4. identify and label equipment that is not to be operated by young workers less than 18 years and provide keys to only trained and authorized machine users. Additionally: 1. equipment manufacturers should consider placing a warning decal on equipment indicating that the equipment is not to be operated by workers less than 18 years, and note this restriction in the operator's manual; and, 2. school officials and employers participating in work-based learning programs for youth should ensure that work assigned to youth is allowed by law, the work environment is safe and free of recognized hazards, and that youth receive appropriate safety and health training.