The Sanitation Department says the worker has been with the department for seven years.
He's under arrest and was being questioned by police at the 90th Precinct.
Witnesses say the arrest was surprising, and that the sound of the impact was startling.
"I heard a boom then I ran outside. I work right here and everybody was like oh my goodness," a witness said.
There was no question what the sound of shrieking brakes and crunched metal was - a head-on collision between the garbage truck and an outmatched Hyundai sedan.
"I saw the driver," witness Rachel Walker said. "He was pinned in the car, and the passenger was able to get out, but he was holding onto the car because he was in shock. And the police and the fire truck guys, one of the things, one of the clamps, to get him out, and he was like fainting a lot of the time because he was like passing out. He lost a lot of blood."
Walker ran out the laundry mat across the street where she works.
A crowd of people followed to see if the two men inside the car were okay.
The Sanitation Department worker was quickly questioned by police on Bushwick Avenue near Grand Street.
"They gave him a breathalyzer test," a witness said. "He failed. They put him in handcuffs and he said, 'Can I go home, can I go home? The guy's alive. I'm sorry. I'm sorry.' He was crying and everything. He was scared and panicking."
A Sanitation Department official vehicle sat in front of the hospital while police at the 90th Precinct continued their investigation.
"I hope the guy is okay, because that's a really big truck to hit a little car like that," Walker said.
Both men are in stable condition.
There's no word on the extent of their injuries.
The driver was stationed at the Brooklyn South District 11.
He was driving a loaded garbage truck to a transfer station to be unloaded when the accident happened.