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

This article systematically reviews and meta-analyzes the relationship between body composition and firefighters' performance on occupational performance tests (OPTs), which simulate firefighting tasks. The findings from 26 studies involving 2,224 firefighters indicate that greater fat-free mass (FFM)—primarily muscle—and lower body fat percentage (BF%) are associated with improved performance, reflected by faster completion times on OPTs. In contrast, body mass index (BMI) showed weak or no significant correlation with OPT performance, likely due to its inability to distinguish between muscle and fat mass. These results suggest that firefighter health and training programs should prioritize increasing FFM and managing BF% to enhance occupational capabilities and address obesity-related health risks within the fire service.