The relationship between cardiorespiratory fitness and firefighter occupational performance: a systematic review and meta-analysis examining absolute versus relative VO_2max

Unequivocally greater cardiorespiratory fitness (CRF) is beneficial for performing firefighting occupational tasks (OTs); however, the contribution of absolute vs. relative VO_2max with OT performance warrants further study. This systematic review and meta-analysis compared the relationship between relative and absolute VO_2max with the performance of firefighting OTs. Studies included career, volunteer, and firefighter recruits and examined the association of CRF measures with OT performance. Thirty-two studies were identified with 19 studies incorporating an occupational circuit of simulated firefighting OTs such as stair climbing, carrying equipment, victim rescue, forcible entry, and search tasks. The relative and absolute VO_2max pooled correlations were r̅ =–0.64 (95%CI: [–0.69,–0.58]) and r̅ = −0.75 (95%CI: [−0.88, −0.62]), respectively. The findings support the importance of CRF, particularly absolute VO_2max, for effective performance of firefighting OTs. Absolute VO_2max likely has a stronger relationship with firefighters’ functional work rate during operations, reflecting the absolute demands of firefighting tasks. This systematic review and meta-analysis examined the relationship between absolute and relative VO_2max and firefighter task performance. Findings revealed that absolute VO_2max has a stronger correlation with occupational task efficiency, emphasising its relevance for firefighter readiness. The results provide insights for developing cardiorespiratory fitness standards and guidelines in the fire service.