RESUMO
BACKGROUND: United States solid waste workers suffer a high fatal injury rate due to their frequent exposures to refuse-vehicle-related hazards. The Occupational Safety and Health Administration (OSHA) allows workers to ride on the rear steps of a garbage truck (exterior riding) if employers abide by American National Standard Z245.1 (ANSI Z245.1). The State of California (CA) has banned exterior riding since 1984, and the City of New York (NYC) has implemented its own initiatives to prevent exterior riding deaths. METHODS: Fatal exterior riding incidents were identified from two online databases. Variables relating to deceased workers, employers, and injury circumstances were analyzed. RESULTS: The study identified 181 exterior riding deaths from 604 refuse-vehicle-related fatal incidents (deaths either directly caused by a refuse vehicle or one in which the victim was performing a refuse-vehicle-related task) in the United States (1984-2020). A total of 50 (27.6%) of the exterior riding deaths had no ANSI Z245.1 violations. Risk factors other than those addressed by ANSI Z245.1 contributed to these worker deaths. CONCLUSIONS: Exterior riding deaths identified by this study were all preventable. Temporary workers and workers in the public sector may be at higher risk for exterior riding deaths. Both CA and NYC had taken measures to prohibit the practice of exterior riding, and both had lower numbers of exterior riding deaths. ANSI Z245.1 and current OSHA enforcement policy do not address the inherent dangers of falling off a moving heavy vehicle while standing on a small and elevated platform, and are not effective in preventing fatal exterior riding incidents.