Background This paper describes deaths of American workers involving forklifts during the 15-year period from January 1, 1980 to December 31, 1994. Methods Death certi®cate data were obtained from the National Institute for Occupational Safety and Health's (NIOSH's) National Traumatic Occupational Fatality (NTOF) surveillance system. The narrative ®elds on the death certi®cate were searched for keywords indicating that a powered industrial vehicle (PIV) or forklift was involved in the death. This study examined the circumstances of the forklift-related deaths, the nature of the injury, and the decedent's age, gender, race, occupation, and industry. Average annual employment data from the Bureau of the Census were used to calculate civilian fatality rates by age, gender, industry, and occupation. Results A total of 1,021 deaths were identi®ed. The average age of the fatally injured worker was 38 years; the 1,021 forklift-related deaths resulted in a total of 27,505 years of productive life lost. The three most common circumstances of the fatalities were forklift overturns (22%), pedestrian struck by forklifts (20%), and worker crushed by forklift (16%). The greatest proportion of the fatalities (37%) occurred to workers in Manufacturing, followed by Transportation, Communication, and Public Utilities, (TCPU), (17%), Construction (16%), Wholesale Trade (8%), and Agriculture, Forestry, and Fishing (AFF) (7%). The highest forklift-related fatality rates per ten million workers occurred among transport operatives (34.0) and laborers (32.0). Conclusions Many of the fatalities resulting from forklift ``overturns'' might have been prevented if the operator had been restrained with a lap/shoulder belt. Careful consideration should be given to separating pedestrian and forklift traf®c, and restricting the use of forklifts near time clocks, exits, and other areas where large numbers of pedestrians pass through an area in a short time. Additionally, systematic traf®c control, including rules for pedestrian and forklift traf®c, will be necessary to reduce the enormous injury and death toll associated with forklifts.