Representative image of air pollution.
Credit: PTI Photo
Each winter, Delhi enters emergency mode as air quality crosses hazardous thresholds. The Graded Response Action Plan (GRAP) escalates through stages, culminating in Stage IV, when the strictest restrictions are imposed: older vehicles are banned, construction halts, offices are asked to adopt remote work, and residents are advised to stay indoors. What was once framed as extraordinary has now become a routine aspect of governance. Yet even at this level, the policy assumes an able body — one that can readily access masks, navigate indoor spaces, or avoid exposure. For persons with disabilities (PwDs), this assumption is flawed and exclusionary.
Air pollution is not neutral. Fine particulate matter (PM2.5 and PM10) penetrates deep into lungs and enters the bloodstream, causing inflammation, breathlessness, and cardiovascular stress. For people with respiratory disabilities, chronic obstructive pulmonary disease, or compromised immunity, exposure that may be a minor irritant for others can trigger medical emergencies.
The impact is broader than respiratory conditions. Persons with neurological, developmental, and cognitive disabilities are also affected. Research links air pollution to cognitive stress, worsened concentration, neurological inflammation, and anxiety. For children and adults with autism or intellectual disabilities, smog disrupts routines, intensifies sensory overload, and can trigger severe behavioural or emotional distress.
Government advisories often instruct citizens to stay indoors, wear masks, and use air purifiers. For many able-bodied individuals, these measures provide partial protection. For disabled people, they are frequently impractical or inaccessible. Air purifiers, while widely recommended, are rarely designed with accessibility in mind. Blind individuals, for example, cannot easily navigate filter maintenance or device settings without assistance. People with reduced mobility may struggle to transport or install these devices in their homes. Similarly, masks — while essential for filtering particulate matter — present their own challenges. For those with respiratory difficulties, prolonged mask usage can induce discomfort or even breathing distress. Individuals with sensory sensitivities, such as people on the autism spectrum, may find masks intolerable, leading to heightened stress and physical strain.
Daily life for many disabled people necessitates outdoor movement. Medical appointments, therapy sessions, and essential errands cannot be postponed, yet public transport — often the only viable option — exposes them to polluted streets and transit hubs. Wheelchair users and those with locomotor disabilities face uneven footpaths, crowded buses, and limited paratransit options, which prolongs exposure to toxic air. Inaccessible infrastructure compounds health risk: a journey that might take ten minutes for others can take an hour or more for disabled commuters, with every extra minute outdoors magnifying the danger posed by pollution.
Pollution interacts with disability in ways that are often invisible. Masks obscure facial expressions, a critical communication tool for people with hearing impairments who rely on lip-reading. Smog-induced eye irritation further disrupts visual cues, which are essential for the deaf and for individuals with low vision. For visually impaired people, poor air quality reduces visibility in streets and public spaces, increasing the risk of accidents. Those with cognitive or sensory processing disabilities experience heightened anxiety, disorientation, and disrupted routines in environments where air quality fluctuates unpredictably. In these ways, pollution magnifies daily barriers to independence, autonomy, and safety.
Hospital systems in Delhi already face surges in pollution-related admissions each winter. For disabled people, access to timely, disability-sensitive care is limited. Mobility challenges, long outpatient waits, and inadequate adaptive facilities delay or prevent treatment. Health insurance, intended as a safety net, is often inaccessible; pre-existing condition exclusions and prohibitive premiums leave many PwDs without coverage. The result is a triple burden: heightened exposure, greater susceptibility to illness, and fewer protective mechanisms. Pollution becomes not only a health hazard but also a marker of systemic inequality.
Policy blind spots and ableist assumptions
Despite the severity of Delhi’s air quality challenges, pollution policies remain largely able-bodied in their design. GRAP Stage IV curbs, while essential for emission control, fail to address the unique vulnerabilities of PwDs. Advisory messages and emergency protocols are framed for a generic citizen, ignoring how disability intersects with environmental risk. This ableist lens ensures that pollution, even when controlled in theory, continues to disproportionately harm those least able to protect themselves.
A truly equitable approach would explicitly recognise persons with disabilities as a high-risk group in pollution advisories, ensuring communication is accessible and understandable. Healthcare responses must include home-based interventions, telemedicine, and disability-sensitive monitoring during peak pollution periods. Public transport and urban infrastructure should minimise exposure for those with mobility challenges. Even simple devices, like air purifiers, must be redesigned or adapted to be fully accessible. Critically, disabled people must be included in the planning and execution of environmental and health policies so that solutions reflect lived realities, not abstract assumptions.
Air pollution in Delhi is a public health emergency, but it is not a neutral one. It affects bodies differently, with disabled individuals bearing disproportionate physical, psychological, and economic costs. Until policy explicitly accounts for disability, pollution interventions will continue to favour the able-bodied, leaving the most vulnerable exposed, under-protected, and ignored. True public health protection requires acknowledging that environmental hazards intersect with social inequities. Clean air cannot be a privilege for the able-bodied alone; it is a right for all.
(The writer is a research fellow – disability inclusion and access, at Vidhi Centre for Legal Policy)
Disclaimer: The views expressed above are the author's own. They do not necessarily reflect the views of DH.