5.1.1 Trigger avoidance
A very safe, cheap and adequate treatment option is the avoidance of
triggering agents 62. For AR patients, this means
allergen avoidance, but for all athletes suffering from NHR, exposure to
unspecific triggers such as airway irritants, pollution and cold
temperatures should be circumvented whenever possible. For some athletes
this may be hard to accomplish; winter sport athletes cannot avoid
exposure to cold temperatures and outdoor athletes will always be
exposed to pollens and/or pollution. Also, for swimmers, exposure to
chlorination products is basically unavoidable. In indoor pools,
trichloramine is the chlorination byproduct that is most closely related
with respiratory symptoms 63, 64 and the WHO
regulations demand a maximum level of 0.5 mg/m3trichloramine in the air of indoor swimming pools 65.
Yet, in most countries regular monitoring of swimming pool water and air
is rarely performed.