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New drugs called "vaptans" could help VWF sufferers
In the past, if your job involved the use of vibrating tools, machinery or, if you worked with materials being vibrated as part of a production process, then you may now suffer from Vibration White Finger (VWF). Chances are, when it gets cold your fingers, toes or any extremity turns waxy white, then maybe blue, then maybe red and then they hurt; with severe debilitating pain. Your doctor has probably told you that you have Raynaud's. Sometimes called a disease, sometimes called a phenomenon – and also primary or secondary Raynaud's - however it is diagnosed, if you suffer from it, you'll know how acutely it can affect your life.
A severe case, where the skin hardens, is known as Scleroderma. This can be emotionally very traumatic as well as being physically unbearable. The cause of these symptoms can be connected to hand arm vibration syndrome (HAVS) where tools and machinery cause damage to the small blood vessels in the extremities (usually fingers of HAVS sufferers).
A healthy response to cold would be for the body to try to maintain core temperature deep in the body. Blood vessels that control blood flow to the skin's surface move blood from arteries that are chilling to veins closer to the body's core. In Raynaud's sufferers, the body's response is intensified by sudden spasmodic contractions of the small blood vessels (arterioles) close to the surface. The arteries of fingers and toes may collapse and so, blood supply is cut off completely, thus causing the abnormal skin discolouration and pain.
It is the hormone vasopressin that controls this function of the arteries and blood vessels, and medical professionals, who are continuing to seek treatments for Raynaud's, have recently tested a new strain of drug known as "vaptans" that act as blockers to vasopressin and therefore inhibit the constriction of the blood flow to the fingers and toes. They are widely known as vasopressin-receptor-antagonists hence "vaptans".
Blood pressure and skin temperature were measured during the controlled testing of a group of sufferers. One half of the group were given a placebo and the other half were given the vasopressin antagonist SR 49059 (as it was known in the trial).
The conclusion of the trial surmised that the group taking the vaptan drug showed favourable effects when compared to the patients who took the placebo. Beneficial effects were noticed on the blood pressure and skin temperature recovery rates after exposure to cold, without creating changes to passive heart rate and blood pressure.
The treatment of Raynaud's disease and VWF depends greatly on its severity and the presence of any underlying disease. There are many medical views on treatments including topical suggestions of protection against the cold, hand warmers and gloves for example. Lifestyle modifications are a further recommended treatment, such as dietary changes and stopping smoking.
However, it is widely recognised that prevention is better than cure and proper working practice could well be used to prevent future cases of vibration white finger or Raynaud's disease. If you use power tools and/or vibrating machinery you should be aware of how your hands and fingers feel after five to ten minutes of work. If your hands are tingling or stinging, then this could be a sign of risk. Your employer may need to adjust the machinery, replace it, or find an alternative tool for the job.
You may require proper training in order to use the machinery correctly, or you may need to wear protective gloves to lessen the vibrations. It could be that adequate breaks are required whilst using the machinery. Whichever solution is applied, if your hands continue to tingle, or you experience pain, you could be running the risk of developing Raynaud's disease and this would not be a desirable outcome for your working life.
