Fair. I can't argue EU vs NA vehicle design and standards.
In terms of size, part of it could probably the 'goldfish effect'. Our commercial/emergency/etc. vehicles are larger simply because they can be. Fire vehicle, garbage trucks, etc. that have to be able to navigate narrow, windy streets in Europe have to be smaller of necessity. For that matter, that is likely one of the main criteria of European vehicles in general. There's no way the North American land yachts of the '60s and '70s could navigate much of any European city.
In terms of emergency services, smaller often means you need 'more of' for a given incident. Even in North America, I know NYFD has specific width standards that require things like recessed grab handles, narrow mirrors, etc., to allow them to get down inner-city streets. Many US jurisdictions use 'tiller' type ladder trucks simply to allow longer (therefore higher) vehicles to navigate narrow streets in older neighbourhoods.