Underground medical care is required in certain instances where patients sustain life or limb threatening injuries or illness while in the underground environment. This most often occurs during deep mining operations, both coal and non-coal, and during recreational caving activities. Additional situations such as industrial tunneling, underground repositories and storage areas and building collapses, such as might occur in a natural disaster or in terroristic activities might also occasion the need for such care. The U.S. mining industry suffered 102 fatal accidents with 250 total permanent disabilities during 1980. In 1983 there were 70 fatalities and in 1984, 124 miners died because of mining accidents. Analysis of accident reports indicate that 25–50% of these injuries may have been ameliorated by timely delivery of physician and paramedic based care in the underground environment. From 1967–1975, 187 recorded caving accidents resulted in 33 deaths among 311 victims. It is unclear how many of these fatalities or injuries could have been prevented or ameliorated by rapid delivery of physician and paramedic based underground medical care.