BACKGROUND: The emergence of the coronavirus brought about significant respiratory challenges in various groups, including those groups with increased risk of respiratory damage such as firefighters. Given the prevalence of COVID-19 and the unknown long-term complications, it imperative to investigate the changes in respiratory function among firefighters. PURPOSE: The aim of this study was to assess respiratory function among firefighters over the course of the pandemic years (2019-2023). METHODS: 73 career firefighters participated in health and fitness assessments, following the guidelines set by the National Fire Protection Association (NFPA). The pandemic posed a challenge to the program's continuity and the measurement of specific physical health variables, particularly those related to lung function in the year 2020. To gauge annual changes in lung function variables while considering repeated measures and adjusting for baseline age, mixed models were employed. Additionally, correlational analyses were conducted utilizing plots to explore the interplay between changes in body composition and lung function. RESULTS: The average age of participants at baseline was 30.96 ± 10.7 years old in 2019 and all were male. Mixed models showed a pattern of improvement in lung function from 2019 to 2020, but deterioration in 2021, 2022, and 2023. As compared to 2019, VO2 max significantly increased in 2020 (p=0.047, Mean Difference [MD] 2.59 ± 1.28 ml/kg/min, Effect Size [ES]=2.02, Large ES), but significantly decreased in 2022 and 2023 (p<0.0001, MD -4.92 ± 1.03 ml/kg/min, ES=-4.78, Large ES, and p<0.0001, MD=-6.06 ± 1.11 ml/kg/min, ES=-5.45, respectively); 2021 did not show statistically significant change. FEV1/FVC ratio significantly increased in 2021 (p<0.0001, MD=8.36 ± 0.89%., ES=9.39); but for 2022 the change was not statistically significant. Improvement was not maintained in 2023 (p=0.001, MD=2.83 ± 0.81%, ES=3.49). CONCLUSIONS: The data suggest a decrease of lung function and VO2 max since 2020 while FEV1/FVC ratio significantly increased in 2021 but was not maintained. It is important to continue to monitor lung function not only due to the occupational hazard but other environmental factors that could exacerbate the complications in fire fighters.

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