I replaced all the ducts but the trunks in my 1969 home when I replaced the horizontal furnace under the house with a gas pack. I got advice from a friend who was an HVAC contractor. I was surprised to find the trunks and other ducts very clean. I replaced the individual runs with flex primarily for the insulation. I wrapped the trunks with insulation also.

Pro HVAC company Southern Comfort Mechanical says on its blog, “If there’s mold growth inside the handler due to excess moisture, algae in the condenser drain line or a dirty evaporator coil, it can negatively impact your AC unit’s efficiency. The filters inside may also build up excess dirt and become clogged, which will also make your AC [or heat pump] waste energy trying to sustain the cool climate inside your home.” These issues are easy to solve. They don’t require replacing the air handler.
You may consider having your air ducts cleaned simply because it seems logical that air ducts will get dirty over time and should be occasionally cleaned. Provided that the cleaning is done properly, no evidence suggests that such cleaning would be detrimental. EPA does not recommend that the air ducts be cleaned routinely, but only as needed. EPA does, however, recommend that if you have a fuel burning furnace, stove or fireplace, they be inspected for proper functioning and serviced before each heating season to protect against carbon monoxide poisoning.

On the other hand, if family members are experiencing unusual or unexplained symptoms or illnesses that you think might be related to your home environment, you should discuss the situation with your doctor. EPA has published the following publications for guidance on identifying possible indoor air quality problems and ways to prevent or fix them.
Duct cleaning has never been shown to actually prevent health problems. Neither do studies conclusively demonstrate that particle (e.g., dust) levels in homes increase because of dirty air ducts or go down after cleaning. This is because much of the dirt that may accumulate inside air ducts adheres to duct surfaces and does not necessarily enter the living space. It is important to keep in mind that dirty air ducts are only one of many possible sources of particles that are present in homes. Pollutants that enter the home both from outdoors and indoor activities such as cooking, cleaning, smoking, or just moving around can cause greater exposure to contaminants than dirty air ducts. Moreover, there is no evidence that a light amount of household dust or other particulate matter in air ducts poses any risk to health.
So, the total price to a contractor for this project is $7,195.77 (Carrier is expensive), which we’ll use to calculate a fair HVAC installation cost. As I said, we typically use 40% in the industry to cover our own personal profit, as well as our insurance and other expenses. Let’s take a look at page three of a Final Report from our own online HVAC calculator, the HVAC Design & Consultation Program.
Some research suggests that cleaning heating and cooling system components (e.g., cooling coils, fans and heat exchangers) may improve the efficiency of your system, resulting in a longer operating life, as well as some energy and maintenance cost savings. However, little evidence exists that cleaning only the ducts will improve the efficiency of the system.
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