Existing building digital twins treat indoor environments as static geometric containers, ignoring the dynamic coupling between ventilation structure states and indoor environmental quality. Furthermore, managing indoor and outdoor spaces as separate data silos prevents the continuous assessment of occupant exposure across building boundaries. This paper proposes an environment-aware, indoor-outdoor integrated digital twin framework coupling geometric entity states with physical environmental fields for healthy mobility assessment. The framework utilizes a three-layer architecture. First, the Geometric-Semantic Layer provides a seamless LOD4 model with topologically stitched spaces, modeling ventilation facilities as first-class entities with mutable state attributes (Full Closed, Half Open, Full Open). Second, the Physical Field Layer maps mobile sensing data (PM2.5, CO2) onto semantic entities using a semantic-constrained method, treating walls and closed windows as aggregation barriers. Finally, the Behavioral Response Layer combines entity-level pollution values with pedestrian counts to compute a cumulative Crowd Exposure Index (CEI). Implemented on a Cesium platform, the framework was validated through a week-long university building experiment. Results show indoor PM2.5 in a fully enclosed study room averaged 61.2 μg/m³—1.6 times the outdoor level and 4.1 times the WHO guideline. This resulted in a CEI 12 times higher than in outdoor transit areas. Semantic correlation confirms the "Full Closed" window state primarily drives pollutant accumulation. This validates the framework's core geometry-physics coupling, demonstrating its potential to guide intelligent ventilation interventions and healthy building management.