Fatal incidents among tree care workers in the United States: A case series approach.

For over three decades, tree care workers in the United States have experienced disproportionately high rates of fatal injuries. While the types of fatalities have been well documented, few studies have used a qualitative approach to examine underlying circumstances and other contributing risk factors. In this study, a total of 69 investigative fatal injury reports spanning from 1987 to 2023 from the National Institute of Occupational Safety and Health (NIOSH) were reviewed and assessed. Overall, most fatal work incidents resulted from falls from trees, being struck by tree sections or branches, being caught, or dragged into equipment (e.g., woodchippers, stump grinders), and electrocutions. Over 23.0% of decedents had been on the job one year or less at the time of death. An estimated 58.0% of employers lacked a safety plan, and only 39.1% provided job training to employees. Recurring safety assessment recommendations stressed that employers and workers conduct thorough job hazard assessments, provide proper training, and develop and implement a work safety plan. These findings support current initiatives to implement public health policy action to protect tree care workers. Additional safety measures must be considered for new and vulnerable workers, before actively performing tree care work. The persistent occurrences of these fatal incidents demand a call to action, necessitating the adoption of a national policy that establishes uniform safety standards and mandates comprehensive training. Implementing these decisive measures will not only protect workers but also reduce costly accidents and insurance premiums, decrease lost productivity, and promote a culture of safety within the industry.