Objectives To examine the prevalence of hearing loss (HL) among employed persons, the association between HL and non-employment, assessing whether this has changed over the last two decades. To identify susceptible groups for HL-related work problems and examine the association between HL and co-worker relations. Design Cross-sectional analyses of working-age participants (20–66 years). HL was defined as the pure-tone average threshold of 0.5–4 kHz in the better hearing ear: 20–34 dB (mild) or ≥35 dB (disabling). Associations were assessed with logistic regression. Study sample Data from two waves of the Trøndelag Health Study (HUNT): HUNT2 1996–1998 (N = 38,603), HUNT4 2017–2019 (N = 19,614). Results The nationally weighted prevalence of HL among employees was 5.8%. HL was associated with non-employment, more strongly in HUNT2 (odds ratio (OR) 2.2, 95% confidence interval (CI) 2.0–2.4) than HUNT4 (OR 1.9, CI 1.7–2.1). HL was not associated with poorer co-worker relations. The association between HL and non-optimal work performance was stronger among white-collar workers than blue-collar workers. Conclusions Our study shows that HL is common in the employed population. It also indicates a weakened association between HL and non-employment in recent generations. White-collar workers appear to be more vulnerable to HL-related work problems than blue-collar workers.