If the gutters become clogged they can no longer do what they were installed to do. Cleaning should be done on a regular basis, the frequency depending on your situation.
If you live in an area with many trees, fallen leaves can quickly become a deterent to proper drainage. In areas that do not have as much tree cover, cleaning frequently won't be as necessary.
Failure to clean your gutter system could result in structural damage to the roof. This would happen when the water has no where else to go.
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The American Lung Association -
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