<p>The printing industry involves continuous exposure to volatile organic compounds (VOCs), potentially leading to pulmonary impairments. This study aimed to evaluate long-term pulmonary impairments among printing workers over a five-year period. A five-year retrospective cohort study (2020–2024) was conducted involving 87 operational printing workers (exposed group) and 86 administrative staff members (unexposed group). Occupational exposure to VOCs (benzene, toluene, ethylbenzene, xylene, isopropyl alcohol, ethyl acetate, ethanol) was assessed using NIOSH-based air sampling and GC–FID analysis. Pulmonary function was measured annually using standardized spirometry according to American Thoracic Society (ATS) guidelines. Respiratory symptoms were evaluated with the ATS questionnaire. Groups were comparable in demographics except working hours (<i>p</i> &lt; 0.05). A significant upward trend in VOCs concentrations—particularly toluene, xylene, and isopropanol—was observed throughout the follow-up period (<i>p</i> &lt; 0.05). Exposed workers showed declines in FEV₁, FVC, PEF, and FEF (<i>p</i> &lt; 0.001), with lower values than controls in 2024 (<i>p</i> &lt; 0.001, except FEV₁/FVC <i>p</i> = 0.059). Respiratory symptoms—including dyspnea, cough, wheezing, sputum production, and hoarseness—were reported significantly more frequently among exposed workers (<i>p</i> &lt; 0.05). Long-term occupational exposure to VOCs in the printing industry is associated with progressive decline of pulmonary function and an increased prevalence of respiratory symptoms, even at concentrations below established occupational exposure limits. These findings underscore the need for continuous monitoring of air pollutants, regular spirometry screening, improved ventilation, substitution of hazardous solvents, and stricter adherence to protective measures within the printing industry.</p>