General introduction 15 With hearing loss, the performance of job tasks can be more challenging. Individuals with hearing loss often attempt to optimize their perception of the sounds of interest by expanding cognitive resources, causing them to experience higher levels of concentration and listening effort (Beechey et al., 2020; McGarrigle et al., 2014). This increased listening effort is related to psychosocial distress and fatigue (Grimby & Ringdahl, 2000). Hearing loss is related to longer and more intense mental and physical fatigue after a day of work. In other words: adults with hearing loss generally experience higher Need For Recovery (NFR) after work compared to normallyhearing adults (Nachtegaal et al., 2009). It has been shown that the incidence of sick leave due to mental distress is higher in individuals with hearing loss compared to those with normal hearing (Kramer et al., 2006). Also, hearing loss can limit the type or amount of work that can be done, resulting in the feelingof beingunable toperformthe job sufficientlywell (Nachtegaal et al., 2012). Several studies have shown that it is more difficult for individuals with hearing loss to maintain employment (Danermark & Gellerstedt, 2004; Emmett & Francis, 2015; Granberg & Gustafsson, 2021). The level of unemployment is higher in populations with hearing loss and taking earlier retirement is more common in individuals with hearing loss. Hearing assessment Several tools and diagnostic instruments can be used to describe, qualify, or quantify the functioning of adults with hearing loss, together capturing all aspects of the ICF framework. Most tools and instruments serve to diagnose a specific aspect of functioning, as will be described below. Additionally, van Leeuwen (2019) developed an ICF-based e-intake tool that can be used in adults with hearing loss. The aimof this tool is to support the identification of problems, personal factors, and environmental factors relevant to the functioning of an individual with hearing loss. Assessment of anatomy and physiology The ear can be inspected for abnormalities using otoscopic inspection of the ear (Hogan & Tadi, 2020). A tuning fork can be used to indicate whether the hearing loss is conductive or sensorineural (Isaacson & Vora, 2003). This inspection is often performed by an otolaryngologist. The status of the tympanic membrane and
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