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.
I am NADCA Certified Air Systems Cleaning Specialist. Over the years I have learned on simple answer to this questions: there air duct cleaners and there are pretenders. There will be no benefit at all if you use on the very cheap pretender because they will not really clean anything. On the other hand if you call a qualified air duct cleaner with a NADCA Certification you will, like 99% of my customers, report improvement with your respiratory problems, you will see less dust and the job will pay for itself with energy savings and repair prevention.
Air duct cleaning service providers may tell you that they need to apply chemical biocide to the inside of your ducts as a means to kill bacteria (germs) and fungi (mold) and prevent future biological growth. They may also propose the application of a "sealant" to prevent dust and dirt particles from being released into the air or to seal air leaks. You should fully understand the pros and cons of permitting application of chemical biocides or sealants. While the targeted use of chemical biocides and sealants may be appropriate under specific circumstances, research has not demonstrated their effectiveness in duct cleaning or their potential adverse health effects. No chemical biocides are currently registered by EPA for use in internally-insulated air duct systems (see Should chemical biocides be applied to the inside of air ducts?).