The incidence of profound hearing impairment by the age of 5, derived from a number of retrospective studies in the UK (population about 58 million; birth rate 141000), is estimated to be about 300 per annual birth cohort in the 1990s. This estimate includes 80 children who might be expected to acquire deafness in those first 5 years. Projected to Europe as a whole (population 511 million; birth rate 121000) this would mean a population who should be considered as potential cochlear implant patients of some 2268 children, given a variety of assumptions. At a take-up rate of 25% for both congenital and acquired cases of profound hearing impairment this would imply a European-wide expenditure of the order of @$17 m/p.a. on hardware and associated rehabilitation programmes. The need for such programmes is explored, in the context of strategies of early identification of hearing impairments.