The bottom line is: no one knows. There are examples of ducts that have become badly contaminated with a variety of materials that may pose risks to your health. The duct system can serve as a means to distribute these contaminants throughout a home. In these cases, duct cleaning may make sense. However, a light amount of household dust in your air ducts is normal. Duct cleaning is not considered to be a necessary part of yearly maintenance of your heating and cooling system, which consists of regular cleaning of drain pans and heating and cooling coils, regular filter changes and yearly inspections of heating equipment. Research continues in an effort to evaluate the potential benefits of air duct cleaning.
I agree that good filtration and a sealed system will prevent the need for duct cleaning. However, when we do get called it is because the duct work has reached a noticeable state of restriction or dust or the homeowner is hyper-sensitive to these pollutants in their home. Most of the time we find that no filter or a cheap (99 cent) filter is being used or they have serious duct leaks in the system. If you are hiring a cleaner make sure they are using professional cleaning equipment which will consist of a rotating brush system and a vacuum source. Be highly skeptical of the contractor with no branded system or the guy who shows up with just chimney brushes and a shop vac. He will not be able to reach around all the corners or all the runs in your system and he will be taking your money for a superficial cleaning at best. Only trust a company that offers VIDEO inspection and more importantly.... a contractor who repairs, installs and seals ducts if a problem is discovered or heaven forbid, created. Good luck and get your ducts sealed if you do have a leak! It is one of the greatest energy losses to a home other than being poorly insulated.
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. This is because much of the dirt in 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 your health.