Relationships between body composition and firefighter occupational performance: A systematic review and meta-analysis

Background: Firefighters face substantial physical demands in their profession, executing a range of challenging tasks under variable and high-stress conditions. Understanding the relationship between body composition and occupational performance tests (OPTs) can help to prepare both current and aspiring firefighters for the physical demands of the job. Objective: To evaluate the relationship between body composition and the completion of firefighting OPTs. Methods: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies utilized career or firefighter recruits and examined the association of measures of body composition, body fat percentage (BF%), fat-free mass (FFM), fat mass (FM) and body mass index (BMI), with OPT outcomes. The meta-analysis synthesized correlation coefficients via a random-effects model. Results: The systematic review included 26 studies. Body composition was assessed through a mix of laboratory and field tests. Twenty studies featured an OPT circuit with simulated fire suppression and rescue tasks. Pooled correlations between time to complete an OPT with fat free mass, body fat%, and body mass index were r̅ = −0.61, r̅ = 0.46, and r̅ = 0.10, respectively. For individual firefighting tasks, pooled correlations were generally strongest for FFM, followed by BF%, with weakest correlations observed for BMI. Conclusions: The literature indicates that greater FFM and lower BF% are beneficial for the performance of firefighting OPTs, highlighting the importance of focusing on specific body composition measures for firefighter capabilities. The findings can be used to inform body composition screening and training programs designed to optimize firefighters’ ability to perform occupational duties.