The jury is out on whether or not cleaning your air ducts and vents has a significant enough impact to be necessary. A proven connection between immaculate duct systems and air quality in the home has not been made. However, if your vents display any of the signs listed above, cleaning would certainly be in your best interest. Allowing mold, debris and bacteria to fester could create bigger problems down the line. If having your system disinfected is within your budget, you may prefer to take care of these issues rather than ignore them.
I am very interested by your post. We recently had a lead inspection on our property and one thing the lead inspector suggested was to get the air ducts cleaned out. We had our ducts cleaned last year after we under went a large renovation project (since we have a toddler in the house). This year we decided to go for lead compliance and had all our lead removed (we moved out for the work). Recently, my son had a false positive lead test, which prompted us to get a lead dust inspection around the house (including having the vents dust-wiped on the inside). The levels inside the ducts weren't crazy high (but more than would be acceptable for a floor). As it turned out my son's lead levels are very low (but not zero). Is it possible however that lead dust from the inside of a vent can come out? Would this be a scenario where you think air duct cleaning would be beneficial?
Without proper ventilation, carbon monoxide can be lethal at concentrations of 1000 ppm (0.1%). However, at several hundred ppm, carbon monoxide exposure induces headaches, fatigue, nausea, and vomiting. Carbon monoxide binds with hemoglobin in the blood, forming carboxyhemoglobin, reducing the blood's ability to transport oxygen. The primary health concerns associated with carbon monoxide exposure are its cardiovascular and neurobehavioral effects. Carbon monoxide can cause atherosclerosis (the hardening of arteries) and can also trigger heart attacks. Neurologically, carbon monoxide exposure reduces hand to eye coordination, vigilance, and continuous performance. It can also affect time discrimination.
I agree, if you replace (or wash depending on type) your air filters regularly AND vaccum, then you probably don't need the ducts or air coils cleaned. However, if you purchase a pre-owned home, and the previous owners did not regularly change the air filter or vaccum the home, then duct cleaning is worth the expense especially if you are sensitive to allergens. Especially if the previous owners had pets.