Abstract: At 12:07 p.m. on July 9, 2011, an employee was assigned to work riding the back of a refuse collection truck. They began their route at approximately 7:45 am. Employee #1 was riding on the back of the truck at times, as well as in the cab during their route which involved travelling a variety of distances between customers as they picked up refuse contents from a variety of bins, dumpsters and other containers. They stopped at a convenience store at about 10:30 am for refreshments, when the Employee #1 began to exhibit signs of distress. He became unresponsive and an ambulance was summoned. He was transported to the local hospital where he was pronounced dead of a heart attack.