Abstract:
Global and South African populations continue to increase exponentially, with large flows of persons into urban
centres. Urban air quality and bioaerosol are therefore becoming an increasingly important consideration in the face
of a growing burden of allergic respiratory diseases. More than 20% of South Africans have asthma, with morbidity
being disproportionately high compared to high-income countries (HICs). Air pollutants (particularly particulate matter
and ozone), pollen and fungal spores are known triggers and exacerbating factors in asthma and, alarmingly, the levels
of air pollutants remain high in hotspot areas despite robust air-quality legislation in South Africa. The concern is that
genetically and environmentally vulnerable children in low- and middle-income countries (LMICs) such as South Africa will
have asthma triggered and exacerbated disproportionately by poor air quality. Urban green areas are increasingly being
recognised by many stakeholders as important possible mitigation tools. However, multiple factors must be considered for
having an optimal green space design. In this review, we bring together experts across the fields of health, air quality and
aerobiology to outline the intersection between asthma and air quality and/or aerobiology in South Africa. We highlight the
importance of careful multidisciplinary green space design as a possible healing tonic. We conclude that detailed studies
combining air quality, pollen dispersal and health issues are needed to derive more precise exposure–response functions
of the green spaces in South Africa and other LMICs.
