On April 7, 2005, a 48-year-old Hispanic laborer (the victim) died after he fell from the top of a pile of construction debris that had been loaded into the bed of a trash-style body truck (hereafter referred to as a trash truck), to a paved driveway approximately 8.5 feet below. Just moments before the incident, one of two brothers who owned the debris hauling company and also worked as the crew's foreman, loaded debris (drywall, scrap lumber, plywood, concrete block, etc.) into the bed of the trash truck with a skid steer loader. He exited the skid steer loader with its bucket in the raised position resting against the right rear side of the truck bed, and walked approximately 15 feet away to use a portable restroom. The victim was standing on debris inside the truck bed near the rear, and a coworker was standing on debris inside the truck bed near the cab and facing away from the victim, when the coworker heard a loud thumping sound. He turned and looked for the victim but he was no longer in the bed of the truck. He looked over the side of the trash truck bed and saw the victim lying on the paved driveway near the rear tires. He yelled to the foreman who rushed to the rear of the truck. The foreman observed that the victim was bleeding extensively from his mouth, nose, and ears and immediately called 911 using his cell phone. Sheriff's department and fire department personnel arrived on the scene within nine minutes of the 911 call but were unable to resuscitate the victim. EMS personnel dispatched from an area hospital examined the victim and found through examination and cardiac monitoring that he had died. After the sheriff's department completed their investigation, a second ambulance was called and transported the victim's body to an area hospital where the medical examiner pronounced the victim dead and determined the cause of death. NIOSH investigators concluded that, to help prevent similar occurrences, employers should: 1. establish work procedures that would eliminate the need for workers to enter the trash truck bed during and after loading operations where they are exposed to potential fall hazards; 2. contact equipment manufacturers before making any modifications or additions to purchased equipment, such as extending the side height of trash truck beds; 3. develop, implement and enforce a comprehensive safety program, and provide training in language(s) and literacy levels of workers, which includes training in hazard recognition and the avoidance of unsafe conditions. Additionally, general contractors should consider requiring in their bid specifications that all contract proposals include a written comprehensive safety program that addresses safe operating procedures, and documents worker training for all tasks to be performed under the contract.