When these aren't properly maintained and sanitized, they can build up dust, pollen, and even mold. This means when the air conditioner or heater turns on, the spores are released into the air for you to inhale. While some are less harmful, people who have allergies or sensitivity to certain spores will react negatively. Plus, mold is dangerous for anyone to ingest and should be avoided by regular maintenance.
Is duct cleaning worth it? There is not a yes or no answer that suits everyone. On an Air Force base, the system was not air tight and there was leakage around the filters. The system got dirty. A professional company was called out. The Duct was big enough that a technician could go inside the metal duct and clean it. There was a new Air Handler installed and things were sealed up better. in this case it was worth it.
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All of the products discussed above are registered solely for the purpose of sanitizing the smooth surfaces of unlined (bare) sheet metal ducts. No products are currently registered as biocides for use on fiber glass duct board or fiber glass lined ducts, so it is important to determine if sections of your system contain these materials before permitting the application of any biocide.
I always get a laugh at anyone claiming to be in the business for any length of time that doesnt understand the importance of cleaning out a ventilation system. Not only for better indoor air quality but for maintaining your heating equipment. I guess it makes more sense to some people that the furnace will just run better with a ton of dust and debris and maybe this wont be a big cause of sytem breakdown and malfunction. I mean really? Maybe this guy got a bad company and or cleaning and is a little jaded but to advise cleaning your grills , which does nothing, and replacing a filter....come on guy.
There are many interesting comments from several informed individuals. The question that has not been answered is how do duct systems get dusty and dirty? As a RESNET Home Energy Rater, I perform pressure tests on homes and duct systems, and the one common thread is . . . most air delivery sytems have large amounts of air leakage. The solution is to seal the duct system, and pay particular attention to the return duct system and ductwork near the air handler (the 'blower'). As others have said, a captive (sealed) duct system with proper filter maintenance should be more then adequate for most occupants. For those who have allergy, asthma, or other breathing problems, a filter with a higher MERV rating (number should be listed on the package) or a HEPA filter are good choices. These filters will capture smaller particulates and should improve the indoor air quality. Again, make certain that the entire duct system is sealed, preferably with mastic, second choice UL-181 foil tape - never use cloth duct (also known as duck) tape.
R-22 Freon is being phased out & isn't readily available. So the service company may only purchase as needed and the lack of availability would make their cost high. But, as long as they can get it, whatever the cost, unfortunately, is less expensive than replacing the A/C. Which will be the case eventually since it's no longer manufactured or sooner as in my case with a not so old a/c that sprang a leak, that would have been just a repair, but since it uses R-22 the whole unit has to be upgraded(replaced).  
When central air conditioning service fails during a heat spell, you may have to wait days for an HVAC repair technician or an ac contractor to show up, and you'll probably pay at least several hundred for the repair. But if you're comfortable working around electricity and are willing to spend about $50 on parts, you can probably repair your air conditioning service yourself in about two hours and save about $225 on parts markup and labor.
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