Pulmonary Functions and Capacities and Their Associations with Sociodemographic, Physical and Behavioural Risk Factors in Firefighters

Abstract

Public health relevance—How does this work relate to a public health issue? This study addresses occupational respiratory health among firefighters, a critical public health issue given their routine exposure to smoke, particulate matter, and toxic chemicals that place them at elevated risk of acute and chronic pulmonary disease. By documenting the prevalence of respiratory symptoms and changes in pulmonary function in a South African firefighting cohort, this study contributes to understanding the health burden associated with emergency service occupations. Public health significance—Why is this work of significance to public health? Firefighters represent an essential workforce, and declines in pulmonary function linked to occupational exposure, smoking, physical inactivity, ageing, and adverse body composition have implications for workforce sustainability, healthcare utilisation, and long-term morbidity. The findings provide population-specific evidence from a low- and middle-income country context, addressing a notable gap in the global occupational health literature and informing locally relevant prevention strategies. Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health? For practitioners and policymakers, the results highlight the need for routine pulmonary function surveillance, smoking cessation support, targeted fitness programmes, and body composition management as part of comprehensive occupational health policies for firefighters. For researchers, this study highlights the importance of longitudinal investigations into cumulative occupational exposure, ageing, and modifiable lifestyle factors to inform evidence-based interventions that protect respiratory health in high-risk occupations. Introduction: Firefighters are exposed to toxic smoke and hazardous environmental conditions that place them at risk for pulmonary disorders. This study aimed to determine the prevalence of pulmonary symptoms and disorders among full-time firefighters in the City of Cape Town Fire and Rescue Service and to explore associations with sociodemographic, physical and behavioural risk factors. Methods: A cross-sectional, quantitative study was conducted among 278 full-time firefighters using convenience sampling. Data were collected using a researcher-generated questionnaire and spirometry measurements. Physical characteristics were assessed using bioelectrical impedance analysis. Descriptive and inferential statistics were applied (Kruskal–Wallis H, Chi-squared test, Pearson’s correlation), with p < 0.05 denoting statistical significance. Results: More than half (53.60%) of firefighters presented with at least one pulmonary symptom. Coughing (54.36%) and nasal congestion (40.94%) were the most common symptoms. Pulmonary symptoms were more frequent among firefighters aged 30–49 years. Significant differences were found in pulmonary function between age categories (p < 0.01) and obesity in firefighters (p < 0.01). Negative correlations were found between FVC and BMI (r =−0.35), BG% (r = −0.47) and years of experience (r =−0.21). Conclusions: Findings highlight the occupational burden of pulmonary health risks and the need for regular screening and preventive strategies within firefighting populations.