BOSTON — Pilots should be required to wait at least 12 hours after taking a drink before they fly, and their blood alcohol levels should be almost zero, a report recommends.

The rules, proposed by two physicians, would sharply tighten regulations already imposed by the Federal Aviation Administration.

“The weight of the evidence suggests that even small amounts of alcohol can have a profoundly negative effect on flight safety,” the doctors wrote.

Under their proposed changes:

Pilots would not be allowed to fly if their blood alcohol levels were more than .01 percent. Current federal rules allow .04 percent.

They would need to wait at least 12 hours after drinking before flying. The current “bottle-to-throttle” rule is eight hours.

Flying would be prohibited within 24 hours of consuming five or more drinks or when hung over.

Pilots would be quizzed about their knowledge of alcohol’s effects when taking licensing exams.

The rules were proposed by Drs. Jack G. Modell and James M. Mountz of the University of Michigan in a report in Thursday’s New England Journal of Medicine.

They also recommended studying the possibility of equipping planes with locks that require pilots to pass coordination tests before they can start their planes.