I think this is just a matter of best practices. There are probably a lot of people who use non-sterile saline to flush their nasal passages, and most of the time it is harmless. But very occasionally there can be a bad outcome. For example, there is a kind of amoeba that is very occasionally found in tap water (it probably enters the water supply from dirty pipes/storage tanks rather than coming from the treatment plant). When it gets into peoples sinuses, it can migrate to the brain and cause an untreatable, fatal infection. Obviously this is a very rare event, but is it worth taking the risk?