I recommend this video to look more into OSR philosophy regarding the rules: https://www.youtube.com/live/bCxZ3TivVUM?si=aZ-y2U_AVjn9a6Ua
this post was submitted on 04 Sep 2023
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Because water is generally everywhere and you might go in it? Surviving poisonous gases? Strangulation? If you wanted to point at rarely used rules there's a plethora of better options to pick. This is more like asking why do you need rules for combat.
Except the rules are written in such way that they render holding breat irrelevant. You may as well write "unless in combat a character can hold their breath. When in combat, you must roll concentration at end of your turn or suffer level of exhaustion. DM may decide to treat particularly dangerous or prolonged situation as combat at their discression". And done, you didn't need to invent new rules just for it, you used an existing system. You could even simplyfy it further and just slap it under concentration rules.