Chapter 7 154 The focus of this thesis is on employees with hearing loss and the difficulties that they face during and after work performance. Therefore, hearing loss is not considered to be an isolated medical problem, but a social cultural phenomenon affecting the hearing function, functioning in everyday activities, and – in particular – work functioning as part of participation in life situations (Danermark et al., 2013; Granberg et al., 2014). Many job tasks need to be performed in complex working environments, such as workplaces with noise and/or reverberation (Soli, Giguère, et al., 2018). Especially in these workplaces, even employees with a mild degree of hearing loss may perceive problems, such as difficulties with communicating, productivity issues, or social withdrawal after work hours (Granberg & Gustafsson, 2021; Kramer et al., 2006). Although this broader perspective on hearing loss is increasingly acknowledged, it is only sparsely implemented in current research and audiological practices (Granberg & Gustafsson, 2021; Zuriekat et al., 2021). Recently, Zuriekat et al. (2021) conducted interviews with audiologists in the UK to explore their perspectives regarding hearing health care for employees with hearing loss. These audiologists described employees with hearing loss to be ‘challenging cases with specific needs’. However, they reported to miss specific information and training to support this group accordingly. The literature is scarce regarding the impact of hearing loss on work functioning, interventions that may be effective for employees with hearing loss, and diagnostic instruments that can be used to assess auditory fitness for job assessment (Granberg & Gustafsson, 2021; Tufts et al., 2009). In this thesis we have used existing clinical tests, more advanced clinical tests, and questionnaires: • To explore what hearing-related, personal, and environmental factors influence the difficulties of employees with hearing loss and how these factors interfere with each other; • To evaluate the effect of current rehabilitation practices measured with tools that are currently used in audiological practice; • To evaluate tests that can be used to assess the performance of hearingcritical job tasks and to describe the development of a new tool to evaluate the ability to detect auditory warning signals.
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