Book excerpt: During nine days in June 1983, 1984, and 1985, four major metropolitan areas of Virginia were surveyed to determine the extent to which safety restraints were being used by urban travelers. Observers stationed at selected signalized intersections displayed to stopped motorists a clipboard bearing the question, Are you wearing safety belts? The observers then approached the vehicles to visually verify any response given, and recorded whether safety belts or child safety seats were being used. They also recorded the license numbers of the vehicles and the sex and approximate age of each occupant. Results published in previous reports have shown that passage of the state's Child Safety Seat Law resulted in a significant positive change in the usage rates by passengers less than four years of age. The rates of usage for infants in 1983, 1984, and 1985 were nearly identical. Nearly three-fourths of the infants traveling as right front passengers (RFP's) and two-thirds of the infants classed as remaining passengers (RP's) were observed to be in safety restraints (Table 6). The 1985 data replicate earlier findings that when there was an infant in the car, and the infant was in a child safety seat, belt use by drivers and passengers was significantly higher than use rates by drivers and passengers when the infant was not in a child seat (Table 3). In 1984 and 1985, over 30% of the drivers, 40% of the RFP's, and 75% of the RP's used belt systems when a child was in a child seat, but fewer than 10% of these occupants were using safety restraints when the child was not in a child seat. The study also identified an association between the driver's use of safety belts and the use by other passengers. When drivers do not use belts, few passengers use belts. When drivers use lap belts, an increasing proportion of passengers use safety belts. Belt use rates by passengers are highest when drivers use the lap/shoulder belt combination (Table 2). This longitudinal study of observed belt use patterns shows an increase in the use of safety restraint systems by drivers and passengers. In June 1985, 28.4% of the drivers and 25.7% of all passengers were using belt systems (Table I). The rates in 1984 were 20.4% and 19.4% and those in 1983 were 16.4% and 19.0% An analysis of the data also produced additional findings that could relate to various educational or public information campaigns. These findings include the following: I. the percentage of belt use by female drivers and RFP's is higher than that for their male counterparts (Table 4); 2. belt use by drivers was highest in the afternoon, but use by passengers was highest in the morning (Table 5); 3. other than that for infants, belt use was highest for middle adult drivers and pre-adult passengers (Table 6); 4. belt use by drivers and passengers was greater in newer cars (Table 7); and 5. belt use was highest in the northern area and lowest in the western area of the state (Table 9). These findings lead to the conclusion that the Child Safety Seat Law has been responsible for a significant increase in restraint usage by infants. There also appears to have been a spillover effect that has increased safety restraint usage by other categories of vehicle occupants.