<p>Rapid industrialization has intensified environmental pollution, with cement manufacturing becoming a major source of particulate emissions and associated health risks in emerging economies like India. To systematically investigate the temporal relationship between respiratory health, cement production, and environmental variables, this research formulates a time-series model for India between 1990 and 2023 in terms of an autoregressive distributed lag (ARDL) model. The methodology captures both short-run dynamics and long-run equilibrium to deal with the lagged effect and cumulative association between cement-induced pollution on health. Based on the empirical results, cement production and PM_2.5 are significantly associated with the respiratory disease burden in the long and short terms. In particular, a 1% growth in cement production is associated with a 0.08% rise in disability-adjusted life years (DALYs) and a 0.12% rise in chronic respiratory disease (CRD) mortality, in the long run, and PM_2.5 also shows a positive and significant impact. Health spending is associated with a reduction in disease burden, while the positive association between environmental policy stringency and respiratory health outcomes may reflect weak policy implementation and enforcement despite stricter environmental regulations in India. These findings highlight both the structural health externalities associated with cement-intensive industrialization and the imperative for stronger implementation of environmental regulation and health investment in reducing the respiratory health risks in India over the long run.</p>