3.5 Nasal hyperreactivity
Nasal hyperreactivity (NHR) which is a frequent hallmark of rhinitis, is characterized by the induction of nasal symptoms upon encounter of unspecific environmental stimuli and is believed to play an important role in athletes 45, 46. Exposure to cold temperatures is one of the most important triggers for NHR 43, 47and can be an issue for winter-sports athletes; This has been confirmed by Bonadonna who reported on a prevalence of almost 50 % of cold-induced rhinorrhea in over a hundred skiers, independent from their atopy state 48. But also, exposures to pollution and chlorination products in outdoor and aquatic athletes, might induce rhinitis symptoms in those with pre-existing rhinitis with NHR, even in the absence of a direct irritant effect.