The use of safety belts and child safety seats is a proven means of reducing injuries to motor vehicle occupants involved in traffic crashes. There have been various methods used in efforts to increase safety belt and safety seat usage. Past efforts have included public information campaigns, local and statewide legislation, and enforcement of the legislation. Most recently, Kentucky changed the statewide legislation requiring the use of safety belts for all vehicle occupants from secondary to primary enforcement. A statewide law providing secondary enforcement was enacted in 1994, with the primary enforcement law passed in 2006. The first legislation in this area in Kentucky was a law enacted by the 1982 Kentucky General Assembly. This required the use of a “child restraint system” for children 40 inches or less in height. Prior to the statewide law, there were local safety belt usage laws in several jurisdictions in Kentucky. The first local law, which became effective in July 1990, was enacted by the Lexington-Fayette Urban County Government. The first statewide observational surveys were conducted in Kentucky in 1982 and have been conducted annually to document safety belt and safety seat usage. Following the enactment of the statewide secondary law, safety belt usage among drivers increased each survey year, from four percent in 1982 to 58 percent in 1994. The rate has steadily climbed since 1994. Examples of the increasing rates are 60 percent in 2000, 66 percent in 2004, 73 percent in 2008, and 86 percent in 2014. Statewide usage of child safety seats (CSS) or safety belts for children under four years of age increased from about 15 percent in 1982, before enactment of the mandatory child restraint law, to 30 percent for 1984 through 1986. After a financial penalty was added to the law, this percentage increased to almost 50 percent in 1988. There has been a continued increase in usage, with rates of reaching 98 percent in recent years. However, while usage rates are very high, studies have found problems with the proper use of child safety seats.