At the request of local industry to prevent a serious air pollution hazard, the Forsyth County Office of Environmental Assistance and Protection (FCOEAP) was established in 1968 (before the Clean Air Act was enacted in 1970) as the Air Pollution Control Department ot dealt with such issues as air quality monitoring, open burning, and visible emissions. In 1974, the title of the Office was changed to Environmental Affairs to accurately portray its involvement in the protection of land and water in addition to air quality.

In 1976, the Environmental Affairs Board was established for the purpose of advising the Forsyth County Board of Commissioners and assisting the Environmental Affairs Department with topics related to environmental management. In 2011, the Environmental Affairs Department moved into its current location on the 5th floor of the Government Center on Chestnut Street in downtown Winston-Salem. Shortly afterwards, the title of the office changed to its current namesake, the Office of Environmental Assistance and Protection.

The air quality monitoring services provided by the Analysis & Monitoring (A&M) division of the FCOEAP are conducted to measure concentrations of criteria air pollutants (NO2, SO2, PM, and O3) and air toxics (or hazardous air pollutants) in accordance with the United States Environmental Protection Agency (USEPA) regulatory requirements. Air quality measurements taken by FCOEAP are used to assess compliance with National Ambient Air Quality Standards (NAAQS). The NAAQS define air pollutant concentration level thresholds through extensive scientific research and empirical evidence to protect the public health and welfare of the United States. A&M is also responsible for the county's pollen sampling and forecasting program (established in 1997) and radon information/awareness. In addition, A&M also provides air quality outreach and education through the Triad Air Awareness program.