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<h3>Introduction</h3> The Grenfell Tower fire in 2017 exposed firefighters to unusually high levels of toxic smoke. The long-term effects of smoke particulates have not been extensively studied. Although literature exists surrounding the 9/11 fire and large wildfires, findings of decline in respiratory health are not generalisable to the UK urban setting and require further research. The Grenfell Firefighter Study (GFS) was established to investigate the health risks of firefighting, and specifically the association between occupational fire smoke exposure at the Grenfell Tower fire and longitudinal lung function. <h3>Methods</h3> 685 firefighters from the London Fire Brigade (LFB) were recruited to the GFS. At a single study visit, spirometry was performed and a symptom questionnaire completed. Historical spirometry records from occupational health were obtained. Exposure was defined by attendance at the Grenfell Tower fire: fire phase (first 23h), recovery phase (day 2–13) or non-attendance. Historical routine spirometry records were obtained from LFB. Piecewise linear mixed models were used to analyse the slopes of absolute forced expiratory volume in one second (FEV<sub>1</sub>) before and after the Grenfell Tower fire using splines, adjusting for age and height. Other models also included exposure and the interaction of time and exposure. <h3>Results</h3> We had usable spirometry from their study visit for 621 male firefighters (mean age 44.8 years, 88% Caucasian, 33.2% ever smokers). Mean FEV<sub>1</sub> was 3.97L (SD 0.59), 4.01L (0.56) and 4.12L (0.62) for the fire phase, recovery, and non-attendees respectively. Respiratory symptoms were reported in a dose response manner.(table 1) Preliminary analyses showed annual declines in absolute FEV<sub>1</sub> before and after the Grenfell Fire of 20.9 ml (95% CI -24.8, -17.1) and 58.5 ml (95% CI -63.1, -53.8) respectively. Further models explore the role of exposure and a time-exposure interaction. <h3>Conclusion</h3> Differences in FEV1 at assessment between the groups were clinically small. Initial analyses show a steeper decline in absolute FEV1 after the fire, however further analyses exploring the role of exposure and time-exposure interaction will show if the differences before and after the fire are dependent on the role of the firefighter or reflective of ageing.