Abstract: Employee #1, age 17, and coworkers were suspended in bosun's chairs painting the inside of a water tank. This was a confined space subject to the accumulation of flammable vapors that could affect the central nervous system of exposed individuals. After painting for several hours, Employee #1 and a coworker, who were wearing air-line respirators, entered the tank through its top opening. Once down at the base of the tank, they began re-rigging their bosun's chairs as necessary. Employee #1 had trouble seeing through the paint-spattered lens of his respirator, so he removed it. He was told to put his respirator back on, but did not. A coworker who entered the tank to make Employee #1 put the respirator back on was also unsuccessful. The two coworkers then exited the tank while Employee #1 remained inside, unprotected against the paint vapors. He removed a grate covering the tank's 90 ft tall and 4 ft diameter standpipe and began descending a fixed ladder into it. While descending the ladder Employee #1 became overwhelmed by the vapors and lost consciousness, falling as much as 90 ft. Because of the standpipe's narrow diameter, Employee #1 landed feet first onto sand that had accumulated at the base during sandblasting operations. The owner extracted him through the opening at the base of the standpipe. Employee #1 sustained numerous injuries to his body systems in addition to a compound fracture to his right leg. He was transported to Dorchester General Hospital, where he was treated for his injuries.