Last week, 43-year-old New York City sanitation worker Steven Frosch was killed when he was struck by a street sweeper at a Sanitation Department garage in Maspeth, Queens. He had been a sanitation worker for 15 years. Though it was the DSNY’s first line-of-duty fatality since 2011, it was nonetheless a tragic reminder that removing the city’s trash is among the most dangerous jobs around.

Frosch left the New York police department in 1999 after five years as a city policeman for what he thought would be a safer job. It’s a common misconception that sanitation work is less risky than being a cop or a fireman, according to NYU anthropologist Robin Nagle, who documented her experience toiling alongside New York’s Strongest in a 2013 book, Picking Up. “Sanitation work is not as dramatic as working for the police or fire departments,” she says. “But these guys are working all day around hulking pieces of heavy machinery. There’s not a lot of room for error.” In 2001, mayoral candidate Michael Bloomberg caught heat for saying something similar. “I bet you could find statistics that say being a sanitation worker in this day and age is more dangerous than being a policeman or a fireman,” Bloomberg told an audience at Tavern on the Green. “Every day these guys are hanging off the back of a truck. And they are dealing with medical waste. It’s a dangerous job.”

Though he was blasted by representatives of the Patrolmen’s Benevolent Association and the Uniformed Firefighters Association, Bloomberg was right. According to the Bureau of Labor Statistics, “refuse and recyclable material collectors” consistently have one of the highest rates of on-the-job fatalities. Only loggers, fishermen, aircraft pilots, roofers, and steel workers were at greater risk of dying on the job in 2012, the last year for which data are available.

“While the fatality rate for all occupations is 4.7 deaths per 100,000 workers, garbage collectors die at a rate of 46 per 100,000,” wrote journalist Elizabeth Royte in her 2005 book Garbage Land: On the Secret Trail of Trash. “In fact, they’re approximately three times more likely to be killed on the job than police officers or firefighters.” Before Frosch, who was the 17th sanitation worker to die in the line of duty since 2000, 16-year veteran Thomas Lermand, 48, was the last Gotham sanitation worker to die on the job. He collapsed behind the wheel of a DSNY truck while working his Brooklyn route in 2011. Excluding 9/11-related deaths, the 35,000-member NYPD had 21 line-of-duty deaths since 2000. The FDNY, with almost twice as many uniformed employees as the 7,300-person strong DSNY, had 25 non-9/11-related deaths in that same period.

Nagle says that the public doesn’t appreciate just how dangerous sanitation work is. “We don’t often hear gunshots in the street, but we see garbage every day,” she says. “People think, ‘How could something so mundane be the source of such hazard?’” But it is—and the fatalities are just one window on that danger. A study done in the 1980s by one-time New York City health commissioner Joseph Cimino found that sanitation workers had higher rates of chronic diseases than other male workers, including respiratory and heart disease, arthritis, and back problems. DSNY reported 1,457 work-related injuries to its uniformed workers and supervisors in 2013. Accidents went up 5 percent from 2012 to 2013.

Traffic is the biggest culprit. Sanitation workers move in and out of New York’s busy streets all day. “We have laws about going around a school bus, but people think nothing of trying to squeeze past a sanitation truck,” says Nagle, who has been the DSNY’s “anthropologist-in-residence” since 2006. Rookie sanitation worker Danny Interlandi almost lost his left leg last year when he was struck by a drowsy driver in a rented truck on a Brooklyn street. In 2011, 27-year-old sanitation worker Michael Russo spent three weeks in a coma after being hit by a driver trying to get around his truck in Whitestone, Queens. In 2010, 11-year DSNY veteran Frank Justich was struck and killed by a milk-delivery truck on Ditmars Boulevard in Astoria, Queens.

It’s not just the traffic, the heavy lifting—sanitation workers lift up to six tons a day—or the heavy machinery that makes the job so dangerous. It’s the trash itself, which can be a toxic brew of hazardous materials. The sanitation collection trucks’ massive compactor blades frequently cause bagged trash to burst, leaving workers vulnerable to flying metal objects and clouds of poisonous substances. In 1996, 22-year sanitation worker Michael Hanly died after inhaling hydrofluoric acid that exploded from a gallon-sized container being crushed in the hopper of his truck. His partner, Thomas Giammarino, came to his aid and was also severely injured.

Improved truck design could make sanitation work safer. So could a law against passing stopped collection trucks. Such a measure would likely be unpopular with city drivers, but Mayor de Blasio should consider it as part of his Vision Zero campaign to reduce traffic-related fatalities.

In 2004, 41-year old Eva Barrientos became the first female sanitation worker to die in the line of duty when she was crushed to death by a mechanical lever on her collection truck. At the time, she was one of just 153 women in the then-6,000 member department. Her Red Hook funeral was attended by more than 1,000 DSNY officials and workers. Steven Frosch, meanwhile, leaves behind a wife and four young children—and a sanitation department whose workers proudly call themselves the city’s strongest, but who may actually be its most vulnerable.