Yes - the aggregation is happening at the DSLAM in the Telephone Exchange. This Wikipedia Article explains it fairly well:
http://en.wikipedia.org/wiki/Digital_subscriber_line_access_multiplexer
A T1 line won't go through a DSLAM - as that is for DSL lines.
Upload / Download speed requirements can vary from compnay to company depending on their use.
If you have a company that sends more mail than it receives or sends out large graphics to people, then a faster outbound speed (upload) would be better than inbound (download) speed.
On the other hand, if a company spends it's day browsing the web and downloading items from it, then download speed would be more interesting speed.
I am on an up to 24mb download speed with an up-to 2.5mb upload speed. When I got connected, I was more interested in having the best upload speed possible as I host mail, so download speed was not as useful to me. I ended up with 1.9Mb upload and about 9Mb download. I am very happy!