Investigating the ultrastructural and viscoelastic characteristics of whole blood after exposure to the heavy metals cadmium, lead and chromium, alone and in combination

ABSTRACT In recent years, heavy metal exposure has become a serious health concern as more humans are being exposed to heavy metals on a daily basis. Most of the environmental contamination and human exposure result from anthropogenic activities such as mining and smelting. The industrial and agricultural sectors also play a big role. Cigarette smoke in particular contains trace amounts of heavy metals that put chronic smokers at serious risk. Previous studies have determined that there is a strong correlation between heavy metal exposure and adverse effects on the coagulation system. The aim of this study was to investigate the effect of cadmium, lead and chromium alone and in combination on erythrocytes and fibrin networks that form part of the coagulation system as well as the viscoelastic properties of thrombus formation by using thromboelastography®. The choice of metals for this study was based on a previous study that compared the levels of metals between smokers and nonsmokers and found significantly higher levels of cadmium, lead and chromium in the platelet-rich fibrin of smoking individuals. Scanning electron microscopy analysis revealed that the cadmium and chromium combination groups caused the highest degree of echinocyte formation and fibrin network alterations. These findings were supported by the thromboelastography® analysis that indicated a significant decrease in reaction-time and split point values for the chromium-containing group, suggesting a shorter initiation time for clot formation. The findings of this study support the hypothesis that the coagulation pathway is a potential target for heavy metal toxicity.