If there is stuff in the ducts, the fact that it’s laying there and not being blown into the rooms is proof positive that it is hurting no-one. The 5-6 exceptions you cite in this article I’ll buy, but only with the caveat that at least some of those could have been avoided by proper protection (during remodeling for example) – and if asbestos/lead/whatever winds up in your ducts- the remodeling contractor should be the one paying to remove it.
Professional cleaning involves getting the dust and debris outside, so they use outdoor ventilation equipment. It is so important that homeowners make sure the professional contractor is using good equipment then, as they could otherwise spread the spores into the home and further agitate sensitive family members. In the case of mold, a cleaner will only be able to tell you it is there, followed by needing an additional mold professional to come out and test or remove the mold. Air duct cleaning industries do not require state licensing, so make sure to check for a company with references.

I can't believe the number of people saying a good properly installed central heating system never needs to be cleaned. Maybe they live in hermetically sealed cells? One look into a cold air return and you can see that it definitely needs periodic cleaning. The air in the house "always" has some dust in it and that's where it ends up. We just had ours cleaned and I saw what came out of it, disgusting. But always ask if they use the "air whip" to sweep/beat the inside of the metal duct. If not, don't bother. These folks used a little whip on the end of a pressure hose and swept the entire length of all the ducts. I have lighted bore scope that allowed me to see into the duct after he was done and it was spic and span. But do change your filters often, 2 or 3 times a year.
The most effective way to clean air ducts and ventilation systems is to employ Source Removal methods of cleaning. This requires a contractor to place the system under negative pressure, through the use of a specialized, powerful vacuum. While the vacuum draws air through the system, devices are inserted into the ducts to dislodge any debris that might be stuck to interior surfaces. The debris can then travel down the ducts to the vacuum, which removes it from the system and the home.
Pay particular attention to cooling coils, which are designed to remove water from the air and can be a major source of moisture contamination of the system that can lead to mold growth. Make sure the condensate pan drains properly. The presence of substantial standing water and/or debris indicates a problem requiring immediate attention. Check any insulation near cooling coils for wet spots.

My 48 yr old house (mine for the last 4 yrs) has considerable dust in the return plenum (fiber duct). I’m remodeling and recently re-sealed the return plenum AND the site-fabbed transition built when the new unit was installed, 2013. The return was leaky no doubt drawing musty, dusty air from the crawl space due to the Red-Neck fab & seal job! Pitiful craftsmanship! It took me 7 hours to fix the new transition piece. Anyway, the dust in the house is the same “color” as whats in the return duct and I’m getting way too much & too often in the house. I’ve also cleaned my coils, which were not that dirty.
All these pro duct cleaners answer with "it's common sense, everything operates better when cleaner" etc. But your explanation is correct. Especially so with flex tube ducting where dust gets "stuck" between the lowest valleys (between wire coil supports) where air flow is drastically reduced -- which is more than 50 pct of the entire interior surface area of the flex ducting. That sounds like a bad thing but also has a good effect of trapping dust from escaping.
Professional cleaning involves getting the dust and debris outside, so they use outdoor ventilation equipment. It is so important that homeowners make sure the professional contractor is using good equipment then, as they could otherwise spread the spores into the home and further agitate sensitive family members. In the case of mold, a cleaner will only be able to tell you it is there, followed by needing an additional mold professional to come out and test or remove the mold. Air duct cleaning industries do not require state licensing, so make sure to check for a company with references.
And if you have flex duct and/or fiberglass ductboard in your home- the last thing you want is a big brush or anything abrasive running through it. Even high-pressure air can erode ductboard so I wouldn’t clean it with anything. If it becomes contaminated, get rid of it and install real ductwork. If your ductwork is accessible in the basement – the best thing to do is take it down and manually clean it if it’s full of junk. It’s not going to cost a nickel more to do that than to pay $500-1000 for a ‘duct cleaning machine” AKA big blower and vacuum – to do the job.

If not properly installed, maintained and operated, these components may become contaminated with particles of dust, pollen or other debris. If moisture is present, the potential for microbiological growth (e.g., mold) is increased and spores from such growth may be released into the home's living space. Some of these contaminants may cause allergic reactions or other symptoms in people if they are exposed to them. If you decide to have your heating and cooling system cleaned, it is important to make sure the service provider agrees to clean all components of the system and is qualified to do so. Failure to clean a component of a contaminated system can result in re-contamination of the entire system, thus negating any potential benefits. Methods of duct cleaning vary, although standards have been established by industry associations concerned with air duct cleaning. Typically, a service provider will use specialized tools to dislodge dirt and other debris in ducts, then vacuum them out with a high-powered vacuum cleaner.
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