COVID-19 and First Responders: Potential Impacts on Aerobic Fitness and Return-to-Work Practices

The COVID-19 pandemic had significant impacts on first responders (i.e., police, firefighters, emergency services), in part due to these personnel continuing to work to serve the public. First responders had increased COVID-19 exposure rates during the pandemic when responding to emergencies and public interactions, and are still at greater risk due to a high volume of continued population contacts. Contracting the virus could result in long-term negative health outcomes. Increased stress, lockdowns, and potential COVID-19 infection could have impacted the physical activity levels of first responders further compromising their health and occupational fitness. Given the myriad of health effects associated with COVID-19, information about long-term fitness impacts could be extrapolated from body composition and aerobic fitness measurements. PURPOSE: To extrapolate potential impacts of COVID-19 in a sample of first responders through analyzing differences in body composition and aerobic fitness across 5 years (2019-2023). METHODS: A retrospective cross-sectional analysis was conducted on data collected from 73 firefighters from 2019-2023 as part of a wellness program. Body mass index (BMI), body fat percentage (BF%), pulmonary function (forced expiratory volume and forced vital capacity ratio; FEV/FVC), and estimated maximal aerobic capacity (V̇O2max) were measured each year following the National Fire Protection Association guidelines. The pandemic changed how the data were measured (FEV/FVC was not recorded in 2020), in addition to how many firefighters were tested per year. Accordingly, this study analyzed the data as a group per year, rather than tracking individuals from year-to-year. A series of univariate ANOVAs, with birth year as a covariate, compared the years in BMI, BF%, FEV/FVC, and V̇O2max (p<0.05). Post hoc analyses were conducted with a Bonferroni adjustment for multiple comparisons. RESULTS: There were no significant differences in BMI across the 5 years (p=0.936). The 2022 group had a significantly lower BF% compared to the 2021 group (p=0.025). The 2019, 2022, and 2023 groups had a significantly (p≤0.002) lower FEV/FVC ratio compared to the 2021 group. Both the 2022 and 2023 groups had a significantly lower V̇O2max (p≤0.009) compared to the 2019-2021 groups. CONCLUSIONS: BMI was not significantly different across the 5 years and there were limited differences in BF%. As body composition can be influenced by physical activity, it is possible that the firefighters in this sample may have been able to maintain some form of exercise over the years. However, in this sample FEV/FVC peaked in 2021 before declining. Notably, the lowest V̇O2max recordings occurred in 2022-2023, where the aftereffects of COVID-19 may have influenced the aerobic fitness of firefighters in this sample. Overall, the groups were generally below the recommended V̇O2max standard of 45 ml/kg/min for firefighters. PRACTICAL APPLICATIONS: Although there are multiple factors that contribute to the body composition and fitness of first responders, this data does provide information regarding potential impacts of COVID-19. The lower V̇O2max recorded in 2022-2023 is concerning. First responder organizations should provide aerobic re/conditioning programs for personnel, especially for those returning from COVID-19 infection. Wellness programs could also be used to record baseline aerobic capacity data for use in return-to-work protocols for first responders.