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are exposed to a range of harmful substances during firefighting. Exposure to fire smoke has been associated with a decrease in their lung function. However, the cause\u2013effect relationship between those two factors is not yet demonstrated. This meta-analysis aimed to evaluate the potential associations between firefighters\u2019 occupational exposure and their lung function deterioration. Studies were identified from PubMed, Web of Science, Scopus and Science Direct databases (August 1990\u2013March 2021). The studies were included when reporting the lung function values of Forced Expiratory Volume in 1 s (FEV1) or Forced Vital Capacity (FVC). The meta-analyses were performed using the generic inverse variance in R software with a random-effects model. Subgroup analysis was used to determine if the lung function was influenced by a potential study effect or by the participants\u2019 characteristics. A total of 5562 participants from 24 studies were included. No significant difference was found between firefighters\u2019 predicted FEV1 from wildland, 97.64% (95% CI: 91.45\u2013103.82%; I2 = 99%), and urban fires, 99.71% (95% CI: 96.75\u2013102.67%; I2 = 98%). Similar results were found for the predicted FVC. Nevertheless, the mean values of firefighters\u2019 predicted lung function varied significantly among studies, suggesting many confounders, such as trials\u2019 design, statistical methods, methodologies applied, firefighters\u2019 daily exposure and career length, hindering an appropriate comparison between the studies.<\/jats:p>","DOI":"10.3390\/ijerph192416799","type":"journal-article","created":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T01:52:30Z","timestamp":1671069150000},"page":"16799","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["The Effect of Fire Smoke Exposure on Firefighters\u2019 Lung Function: A Meta-Analysis"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8018-0317","authenticated-orcid":false,"given":"Joana V.","family":"Barbosa","sequence":"first","affiliation":[{"name":"Laboratory for Process Engineering, Environment, Biotechnology and Energy (LEPABE), Faculdade de Engenharia, Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal"},{"name":"ALiCE\u2014Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal"}]},{"given":"Mariana","family":"Farraia","sequence":"additional","affiliation":[{"name":"Laboratory for Process Engineering, Environment, Biotechnology and Energy (LEPABE), Faculdade de Engenharia, Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4163-0936","authenticated-orcid":false,"given":"Pedro T. B. S.","family":"Branco","sequence":"additional","affiliation":[{"name":"Laboratory for Process Engineering, Environment, Biotechnology and Energy (LEPABE), Faculdade de Engenharia, Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal"},{"name":"ALiCE\u2014Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal"}]},{"given":"Maria Concei\u00e7\u00e3o M.","family":"Alvim-Ferraz","sequence":"additional","affiliation":[{"name":"Laboratory for Process Engineering, Environment, Biotechnology and Energy (LEPABE), Faculdade de Engenharia, Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal"},{"name":"ALiCE\u2014Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0960-4620","authenticated-orcid":false,"given":"Fernando G.","family":"Martins","sequence":"additional","affiliation":[{"name":"Laboratory for Process Engineering, Environment, Biotechnology and Energy (LEPABE), Faculdade de Engenharia, Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal"},{"name":"ALiCE\u2014Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6340-9300","authenticated-orcid":false,"given":"Isabella","family":"Annesi-Maesano","sequence":"additional","affiliation":[{"name":"Desbrest Institute of Epidemiology and Public Health (IDESP), Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM), Montpellier University, 34093 Montpellier, France"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4139-673X","authenticated-orcid":false,"given":"Sofia I. V.","family":"Sousa","sequence":"additional","affiliation":[{"name":"Laboratory for Process Engineering, Environment, Biotechnology and Energy (LEPABE), Faculdade de Engenharia, Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal"},{"name":"ALiCE\u2014Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"349","DOI":"10.5694\/mja2.50511","article-title":"Bushfire smoke: Urgent need for a national health protection strategy","volume":"212","author":"Vardoulakis","year":"2020","journal-title":"Med. J. 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