Objectives: Environmental intolerance (EI) can negatively impact well-being and daily life, and even lead to disability. Healthcare can detect EI early and conduct interventions. This study explored ways of identifying environmental exposure-related health worries and EI during occupational health (OH) check-ups, and their associations with unselected working-age employees’ perceived work ability, stress and overall health. Material and Methods: A crosssectional survey was conducted among 355 employees attending OH check-ups at an occupational health services (OHS) unit in Southern Ostrobothnia, Finland. Health worries about environmental exposures were measured using 2 single-item questions, one on exposures in general, the other on indoor air. Cutoffs were set for excessive worries. Environmental intolerance was defined using the Quick Environmental Exposure and Sensitivity Inventory (QEESI). Perceived stress, work ability and health were inquired. The analyses used descriptive statistics, Fisher’s exact test and linear regression. Results: Participants with EI (N = 25, 7%) reported significantly poorer work ability and health, and higher stress than those without EI. Environmental intolerance was also associated with comorbid diseases such as asthma, migraine, mental disorders and irritable bowel syndrome. Those with excessive health worries about environmental exposure (N = 73, 21%) and indoor air (N = 182, 51%) outnumbered and mostly included those with EI. All the participants’ (N = 355) increased health worry about environmental exposures was independently associated with poorer work ability and health, and higher perceived stress. The health worry questions for identifying EI were sensitively phrased, and the general question demonstrated good specificity. Conclusions: The findings show that environmental exposure-related health worries can be detected by and EI identified by single questions. Their interrelation and association with poorer work ability and health suggest they are part of the same continuum of increasing environmental worries and exposure- related reactions. Identifying health worries enables early detection and interventions such as psychoeducation, to prevent any related disability and adverse health outcomes. Int J Occup Med Environ Health. 2025;38(4)