On July 24, 2007, a 38-year-old male volunteer fire fighter (victim) died after falling from the top of an engine. The victim had returned to the fire station after working a structure fire and was preparing the engine for future fire calls. Following the reloading of hose on the engine, the victim climbed on the driver's side of the engine to adjust and secure a vinyl hose bed cover. While attempting to adjust the cover, the victim slipped and fell onto the station's concrete apron. The victim landed on his head and lay supine on the ground. The victim was transported to an area hospital where he received medical care and was pronounced dead. Key contributing factors identified in this investigation include: the design of the engine which introduced numerous potential fall risks when loading the hose bed and securing the vinyl protective cover, fire department practices in loading the hose bed and securing the vinyl hose bed cover which were unwritten and inadequately addressed fall hazards, and damage to the mounting system of snaps which made securing the vinyl hose bed cover more cumbersome. NIOSH investigators concluded that, to minimize the risk of similar incidents, fire departments should: 1. develop and implement Standard Operating Procedures (SOPs) on the correct procedures/safe methods for reloading hose and securing hose bed covers; 2. consider requiring the use of a ladder when servicing items that are out of reach from ground level on the fire apparatus; 3. ensure that hose bed covers on fire apparatus are maintained in good physical condition or are replaced when needed; 4. consider when purchasing a new fire apparatus, that it be equipped with available safety features to assist with hose loading and covering the hose bed (e.g., a hose bed that hydraulically lowers, or hose bed covers that are hydraulic, roll-up, or hinged metal). Although it was difficult to substantiate the actual level of lighting when the incident occurred, NIOSH concludes that as a matter of prudent safe operations, fire departments should ensure adequate exterior lighting for activities outside the fire station.