Fear of contracting or transmitting COVID-19 had a profound impact on workers’ mental health. Although workplaces implemented COVID-19 protective measures, their effectiveness has been underexplored, particularly regarding the involvement of worker representatives. This research examines whether the presence and active participation of worker representatives in negotiating and implementing COVID-19 protective measures relates to reduced concerns about contracting or transmitting the disease. A cross-sectional study using logistic regression models was conducted on microdata from a Spanish survey conducted in April–May 2021 (n = 19,452). Concerns about contracting or transmitting COVID-19 were studied as dependent variables, whereas the independent variables were integrated into an indicator of participatory implementation of thirteen COVID-19 protective measures. Results show that active involvement of worker representatives in negotiating protective measures is significantly associated with reduced concerns about COVID-19 infection and, to a lesser extent, transmission. Moreover, the presence of worker representatives in workplaces is linked to a greater use of protective measures. Even unnegotiated measures have a positive, albeit smaller, effect. Organisational measures, such as shortening working hours, proved more effective in alleviating infection concerns than personal hygiene measures. In conclusion, active worker participation may serve as a protective factor for workers’ mental health during pandemics.